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The epidemiology, healthcare and societal burden and costs of asthma in the UK and its member nations: analyses of standalone and linked national databases. BMC Med 2016; 14:113. [PMID: 27568881 PMCID: PMC5002970 DOI: 10.1186/s12916-016-0657-8] [Citation(s) in RCA: 170] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 07/15/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There are a lack of reliable data on the epidemiology and associated burden and costs of asthma. We sought to provide the first UK-wide estimates of the epidemiology, healthcare utilisation and costs of asthma. METHODS We obtained and analysed asthma-relevant data from 27 datasets: these comprised national health surveys for 2010-11, and routine administrative, health and social care datasets for 2011-12; 2011-12 costs were estimated in pounds sterling using economic modelling. RESULTS The prevalence of asthma depended on the definition and data source used. The UK lifetime prevalence of patient-reported symptoms suggestive of asthma was 29.5 % (95 % CI, 27.7-31.3; n = 18.5 million (m) people) and 15.6 % (14.3-16.9, n = 9.8 m) for patient-reported clinician-diagnosed asthma. The annual prevalence of patient-reported clinician-diagnosed-and-treated asthma was 9.6 % (8.9-10.3, n = 6.0 m) and of clinician-reported, diagnosed-and-treated asthma 5.7 % (5.7-5.7; n = 3.6 m). Asthma resulted in at least 6.3 m primary care consultations, 93,000 hospital in-patient episodes, 1800 intensive-care unit episodes and 36,800 disability living allowance claims. The costs of asthma were estimated at least £1.1 billion: 74 % of these costs were for provision of primary care services (60 % prescribing, 14 % consultations), 13 % for disability claims, and 12 % for hospital care. There were 1160 asthma deaths. CONCLUSIONS Asthma is very common and is responsible for considerable morbidity, healthcare utilisation and financial costs to the UK public sector. Greater policy focus on primary care provision is needed to reduce the risk of asthma exacerbations, hospitalisations and deaths, and reduce costs.
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152
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Yang HJ. Impact of perinatal environmental tobacco smoke on the development of childhood allergic diseases. KOREAN JOURNAL OF PEDIATRICS 2016; 59:319-27. [PMID: 27610180 PMCID: PMC5014911 DOI: 10.3345/kjp.2016.59.8.319] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/24/2015] [Accepted: 09/03/2015] [Indexed: 12/11/2022]
Abstract
Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and food allergy, are most common chronic, noncommunicable diseases in childhood. In the past few decades, the prevalence has increased abruptly worldwide. There are 2 possible explanations for the rising prevalence of allergic diseases worldwide, that an increased disease-awareness of physician, patient, or caregivers, and an abrupt exposure to unknown hazards. Unfortunately, the underlying mechanisms remain largely unknown. Despite the continuing efforts worldwide, the etiologies and rising prevalence remain unclear. Thus, it is important to identify and control risk factors in the susceptible individual for the best prevention and management. Genetic susceptibility or environments may be a potential background for the development of allergic disease, however they alone cannot explain the rising prevalence worldwide. There is growing evidence that epigenetic change depends on the gene, environment, and their interactions, may induce a long-lasting altered gene expression and the consequent development of allergic diseases. In epigenetic mechanisms, environmental tobacco smoke (ETS) exposure during critical period (i.e., during pregnancy and early life) are considered as a potential cause of the development of childhood allergic diseases. However, the causal relationship is still unclear. This review aimed to highlight the impact of ETS exposure during the perinatal period on the development of childhood allergic diseases and to propose a future research direction.
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Affiliation(s)
- Hyeon-Jong Yang
- Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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153
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Ozdogan S, Urganci N, Usta M, Uslu Kizilkan N. Prevalence of Asthma and Allergic Rhinitis in Children with Celiac Disease. IRANIAN JOURNAL OF PEDIATRICS 2016; In Press. [DOI: 10.5812/ijp.6358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
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154
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Webb EL, Nampijja M, Kaweesa J, Kizindo R, Namutebi M, Nakazibwe E, Oduru G, Kabubi P, Kabagenyi J, Nkurunungi G, Kizito D, Muhangi L, Akello M, Verweij JJ, Nerima B, Tukahebwa E, Elliott AM, Sanya R, Mirembe B, Okello J, Levin J, Zziwa C, Tumusiime J, Sewankambo M, Nsubuga D, Cose S, Wammes L, Niwagaba E, Kabami G, Abayo E, Muwonge F, Abiriga D, Nannozi V, Kaweesa J. Helminths are positively associated with atopy and wheeze in Ugandan fishing communities: results from a cross-sectional survey. Allergy 2016; 71:1156-69. [PMID: 26918891 PMCID: PMC4949563 DOI: 10.1111/all.12867] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2016] [Indexed: 01/15/2023]
Abstract
Background Parasitic helminths are potent immunomodulators and chronic infections may protect against allergy‐related disease and atopy. We conducted a cross‐sectional survey to test the hypothesis that in heavily helminth‐exposed fishing villages on Lake Victoria, Uganda, helminth infections would be inversely associated with allergy‐related conditions. Methods A household survey was conducted as baseline to an anthelminthic intervention trial. Outcomes were reported wheeze in last year, atopy assessed both by skin prick test (SPT) and by the measurement of allergen‐specific IgE to dust mites and cockroach in plasma. Helminth infections were ascertained by stool, urine and haemoparasitology. Associations were examined using multivariable regression. Results Two thousand three hundred and sixteen individuals were surveyed. Prevalence of reported wheeze was 2% in under‐fives and 5% in participants ≥5 years; 19% had a positive SPT; median Dermatophagoides‐specific IgE and cockroach‐specific IgE were 1440 and 220 ng/ml, respectively. S. mansoni, N. americanus, S. stercoralis, T. trichiura, M. perstans and A. lumbricoides prevalence was estimated as 51%, 22%, 12%, 10%, 2% and 1%, respectively. S. mansoni was positively associated with Dermatophagoides‐specific IgE [adjusted geometric mean ratio (aGMR) (95% confidence interval) 1.64 (1.23, 2.18)]; T. trichiura with SPT [adjusted odds ratio (aOR) 2.08 (1.38, 3.15)]; M. perstans with cockroach‐specific IgE [aGMR 2.37 (1.39, 4.06)], A. lumbricoides with wheeze in participants ≥5 years [aOR 6.36 (1.10, 36.63)] and with Dermatophagoides‐specific IgE [aGMR 2.34 (1.11, 4.95)]. No inverse associations were observed. Conclusions Contrary to our hypothesis, we found little evidence of an inverse relationship between helminths and allergy‐related outcomes, but strong evidence that individuals with certain helminths were more prone to atopy in this setting.
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Affiliation(s)
- E. L. Webb
- London School of Hygiene and Tropical Medicine London UK
| | - M. Nampijja
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - J. Kaweesa
- Vector Control Division Ministry of Health Kampala Uganda
| | - R. Kizindo
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - M. Namutebi
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | | | | | - P. Kabubi
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - J. Kabagenyi
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - G. Nkurunungi
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - D. Kizito
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - L. Muhangi
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - M. Akello
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - J. J. Verweij
- Laboratory for Medical Microbiology and Immunology St Elisabeth Hospital LC Tilburg the Netherlands
| | - B. Nerima
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
| | - E. Tukahebwa
- Vector Control Division Ministry of Health Kampala Uganda
| | - A. M. Elliott
- London School of Hygiene and Tropical Medicine London UK
- MRC/UVRI Uganda Research Unit on AIDS Entebbe Uganda
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155
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"Cumulative Stress": The Effects of Maternal and Neonatal Oxidative Stress and Oxidative Stress-Inducible Genes on Programming of Atopy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:8651820. [PMID: 27504149 PMCID: PMC4967692 DOI: 10.1155/2016/8651820] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/27/2016] [Accepted: 06/22/2016] [Indexed: 12/16/2022]
Abstract
Although extensive epidemiological and laboratory studies have been performed to identify the environmental and immunological causes of atopy, genetic predisposition seems to be the biggest risk factor for allergic diseases. The onset of atopic diseases may be the result of heritable changes of gene expression, without any alteration in DNA sequences occurring in response to early environmental stimuli. Findings suggest that the establishment of a peculiar epigenetic pattern may also be generated by oxidative stress (OS) and perpetuated by the activation of OS-related genes. Analyzing the role of maternal and neonatal oxidative stress and oxidative stress-inducible genes, the purpose of this review was to summarize what is known about the relationship between maternal and neonatal OS-related genes and the development of atopic diseases.
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156
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Bardal S, Smith A, Luo HA, Zhang T, Groeneweg G, Jimenez Mendez R, Goldman R, Carleton BC. Asthma in British Columbia: Are we finally breathing easier? A population-based study of the burden of disease over 14 years. J Asthma 2016; 54:308-317. [PMID: 27414432 DOI: 10.1080/02770903.2016.1208223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Asthma presents a significant global burden, but whether the incidence and prevalence of asthma is rising is still debated. The objective of this study was to determine the prevalence and incidence of asthma in British Columbia (BC), Canada, and characterize associated health services utilization. METHODS We extracted data from provincial administrative hospitalization, medical services, and prescription drug databases for patients aged 5 to 55 years, during 1996 to 2009 having ≥270 MSP registration days and meeting asthma definition of: ≥1 hospital admissions with asthma as the principal diagnosis, or ≥2 physician visits for asthma as the principal diagnosis, or ≥3 asthma drug dispensings. Regression models were used to test change in asthma incidence and prevalence, and use of various health care services, such as physician and emergency department (ED) visits, and hospitalizations. RESULTS 379,950 patients met the study criteria. The prevalence (2.6%) and incidence (0.7%) of asthma was relatively stable over the study period. There was a decline in proportion of patients visiting family practitioners (FP) (OR 0.92; 95% CI 0.90-0.94), specialists (OR 0.60; 95% CI 0.58-0.62), using ED services (OR 0.31; 95% CI 0.30-0.32) and hospitalizations (OR 0.34; 95% CI 0.31-0.37). Regional differences were noted, with lower rates of FP and specialist visits and higher rates of ED visits for asthma in rural versus urban areas. CONCLUSIONS In BC, the incidence and prevalence of asthma has remained stable over 14 years. Although health service utilization declined, there is variation between rural and urban regions.
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Affiliation(s)
- Stan Bardal
- a Island Medical Program, University of British Columbia , Vancouver , British Columbia , Canada
| | - Anne Smith
- b Pharmaceutical Outcomes Programme (POPi), Department of Pediatrics, University of British Columbia , Vancouver , British Columbia , Canada
| | - Hao Allan Luo
- c Department of Statistics , University of British Columbia , Vancouver , British Columbia , Canada
| | - Tingting Zhang
- d Department of Neurology , University of British Columbia , Vancouver , British Columbia , Canada
| | - Gabriella Groeneweg
- b Pharmaceutical Outcomes Programme (POPi), Department of Pediatrics, University of British Columbia , Vancouver , British Columbia , Canada
| | - Ricardo Jimenez Mendez
- b Pharmaceutical Outcomes Programme (POPi), Department of Pediatrics, University of British Columbia , Vancouver , British Columbia , Canada
| | - Ran Goldman
- e Division of Emergency Medicine, Department of Pediatrics, British Columbia Children's Hospital , Vancouver , British Columbia , Canada
| | - Bruce C Carleton
- f Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia , Vancouver , British Columbia , Canada
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157
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Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma. J Clin Psychol Med Settings 2016; 22:179-93. [PMID: 26054697 PMCID: PMC4575360 DOI: 10.1007/s10880-015-9423-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 ± 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups analyzed in previous research, scores on the Parenting Stress Index in mothers and fathers of the children with problematic severe asthma were low. Higher parenting stress was associated with higher levels of internalizing and externalizing behavioral problems in children (Child Behavior Checklist). Higher parenting stress in mothers was also associated with higher airway inflammation (FeNO). Thus, although parenting stress was suggested to be low in this group, higher parenting stress, especially in the mother, is associated with more airway inflammation and greater child behavioral problems. This indicates the importance of focusing care in this group on all possible sources of problems, i.e., disease exacerbations and behavioral problems in the child as well as parenting stress.
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158
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Behr JG, Diaz R, Akpinar-Elci M. Health Service Utilization and Poor Health Reporting in Asthma Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E645. [PMID: 27376308 PMCID: PMC4962186 DOI: 10.3390/ijerph13070645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/16/2016] [Accepted: 06/20/2016] [Indexed: 01/03/2023]
Abstract
UNLABELLED The management and treatment of adult asthma has been associated with utilization of health services. OBJECTIVES First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. DATA SOURCE Data is derived from a random, stratified sampling of Hampton Roads adults, 18 years and older (n = 1678). STUDY DESIGN Study participants are interviewed to identify asthma diagnosis, access to primary care, frequency of emergency department utilization, hospital admissions, and days of poor physical health. Odds-ratios establish relationships with the covariates on the outcome variable. FINDINGS Those with asthma are found more likely (OR 1.50, 95% CI 1.05-2.15) to report poor physical health relative to non-asthma study participants. Further, asthma respondents are found more likely (OR 4.23, 95% CI 1.56-11.69) to frequently utilize primary care that may be associated with the management of the condition and are also more likely to utilize treatment services, such as the emergency department (OR 1.87, 95% CI 1.32-2.65) and hospitalization (OR 2.21, 95% CI 1.39-3.50), associated with acute and episodic care. Further, it is a novel finding that these likelihoods increase with frequency of utilization for emergency department visits and hospital stays. CONCLUSION Continuity in care and better management of the diseases may result in less demand for emergency department services and hospitalization. Health care systems need to recognize that asthma patients are increasingly more likely to be characterized as frequent utilizers of both primary and emergency department care as the threshold for what constitutes frequent utilization increases. Investments in prevention and better management of the chronic condition may result in less demand for acute care services, especially among high frequency utilizers.
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Affiliation(s)
- Joshua G Behr
- Virginia Modeling, Analysis and Simulation Center, Old Dominion University, Norfolk, VA 23529, USA.
| | - Rafael Diaz
- MIT-Zaragosa Logistics Center, Massachusetts Institute of Technology, Zaragoza 50197, España.
| | - Muge Akpinar-Elci
- Center for Global Health, Old Dominion University, Norfolk, VA 23529, USA.
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159
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Chen YT, Chien CY, Tai SY, Huang CM, Lee CTC. Asthma associated with chronic rhinosinusitis: a population-based study. Int Forum Allergy Rhinol 2016; 6:1284-1293. [PMID: 27353023 DOI: 10.1002/alr.21813] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/25/2016] [Accepted: 05/23/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Few studies have investigated the relationship between asthma and chronic rhinosinusitis (CRS). The present study investigated the association between asthma and the risk of CRS in a large national sample. METHODS Patients newly diagnosed with asthma (International Classification of Diseases, Ninth Revision [ICD-9], Clinical Modification code 493) between 2000 and 2008 were identified from the Taiwan National Health Insurance Research Database. The cases were compared with sex-, age-, residence-, and insurance premium-matched controls, and both groups were followed until the end of 2009 for incidences of CRS with or without nasal polyps (CRSwNP or CRSsNP, respectively). Competing risk-adjusted Cox regression analyses were performed after adjustment for sex, age, residence, insurance premium, steroid use, hyperlipidemia, diabetes, hypertension, coronary artery disease, Charlson comorbidity index score, and mortality. We also performed a case-control study to determine the association between asthma and CRS. RESULTS The cohort study analysis examined 81,462 patients with a mean ± standard deviation (SD) follow-up period of 5.8 ± 2.4 years. Asthma was an independent predictor of CRSsNP (hazard ratio = 2.58; 95% confidence interval [CI], 2.20 to 3.03; p < 0.001) in the fully adjusted models. In the case-control analysis, both CRSwNP and CRSsNP were associated with asthma in the fully adjusted models. CONCLUSION Asthma was associated with increased risks of CRSwNP and CRSsNP, independent of several potential confounding factors.
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Affiliation(s)
- Yu-Ting Chen
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Yu Chien
- Department of Otorhinolaryngology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Otorhinolaryngology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Shu-Yu Tai
- Department of Family Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Chiu-Mieh Huang
- School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Charles Tzu-Chi Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
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160
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Takeda K, Miyahara N, Matsubara S, Taube C, Kitamura K, Hirano A, Tanimoto M, Gelfand EW. Immunomodulatory Effects of Ambroxol on Airway Hyperresponsiveness and Inflammation. Immune Netw 2016; 16:165-75. [PMID: 27340385 PMCID: PMC4917400 DOI: 10.4110/in.2016.16.3.165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/20/2016] [Accepted: 05/27/2016] [Indexed: 02/07/2023] Open
Abstract
Ambroxol is used in COPD and asthma to increase mucociliary clearance and regulate surfactant levels, perhaps through anti-oxidant and anti-inflammatory activities. To determine the role and effect of ambroxol in an experimental model of asthma, BALB/c mice were sensitized to ovalbumin (OVA) followed by 3 days of challenge. Airway hyperresponsiveness (AHR), lung cell composition and histology, and cytokine and protein carbonyl levels in bronchoalveolar lavage (BAL) fluid were determined. Ambroxol was administered either before the first OVA challenge or was begun after the last allergen challenge. Cytokine production levels from lung mononuclear cells (Lung MNCs) or alveolar macrophages (AM) were also determined. Administration of ambroxol prior to challenge suppressed AHR, airway eosinophilia, goblet cell metaplasia, and reduced inflammation in subepithelial regions. When given after challenge, AHR was suppressed but without effects on eosinophil numbers. Levels of IL-5 and IL-13 in BAL fluid were decreased when the drug was given prior to challenge; when given after challenge, increased levels of IL-10 and IL-12 were detected. Decreased levels of protein carbonyls were detected in BAL fluid following ambroxol treatment after challenge. In vitro, ambroxol increased levels of IL-10, IFN-γ, and IL-12 from Lung MNCs and AM, whereas IL-4, IL-5, and IL-13 production was not altered. Taken together, ambroxol was effective in preventing AHR and airway inflammation through upregulation of Th1 cytokines and protection from oxidative stress in the airways.
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Affiliation(s)
- Katsuyuki Takeda
- Division of Cell Biology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, U.S.A
| | - Nobuaki Miyahara
- Division of Cell Biology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, U.S.A
| | - Shigeki Matsubara
- Division of Cell Biology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, U.S.A
| | - Christian Taube
- Division of Cell Biology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, U.S.A
| | - Kenichi Kitamura
- Department of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Astushi Hirano
- Department of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Mitsune Tanimoto
- Department of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Erwin W Gelfand
- Division of Cell Biology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, U.S.A
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161
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Wei HS, Hwa HL, Shen ACT, Feng JY, Hsieh YP, Huang SCY. Physical Conditions and Special Needs as Risk Factors of Peer Victimization Among School Children in Taiwan. J Sch Nurs 2016; 33:223-231. [PMID: 27216248 DOI: 10.1177/1059840516649237] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Students with physical symptoms and diseases may be at an increased risk of peer victimization. This study examined the associations of several medical conditions (obesity, asthma, allergy, epilepsy, and diabetes) with experience of physical, verbal, and relational victimization among children. A sample of 6,233 fourth-grade students from 314 elementary schools in Taiwan was recruited for the analysis. The mean age of the sample was 10.5, with an even distribution of gender (50.3% male and 49.7% female). Children with asthma, allergy, and epilepsy reported higher frequencies of peer victimization. Those who took daily medications or received treatment were also at a higher risk of being victimized. Diabetes and obesity were not found to be associated with peer victimization. The findings highlighted that children with physical conditions suffer maltreatment from peers. Sensitivity training should be provided to school health professionals, so they can evaluate the risk of victimization among students with special needs during assessment.
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Affiliation(s)
- Hsi-Sheng Wei
- 1 Department of Social Work, College of Social Sciences, National Taipei University, New Taipei City, Taiwan
| | - Hsiao-Lin Hwa
- 2 Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,3 National Taiwan University Children and Family Research Center, National Taiwan University, Taipei, Taiwan
| | | | - Jui-Ying Feng
- 5 Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ping Hsieh
- 6 Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
| | - Soar Ching-Yu Huang
- 7 California School of Professional Psychology, Alliant International University, San Diego, CA, USA
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162
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Controlled diesel exhaust and allergen coexposure modulates microRNA and gene expression in humans: Effects on inflammatory lung markers. J Allergy Clin Immunol 2016; 138:1690-1700. [PMID: 27283384 DOI: 10.1016/j.jaci.2016.02.038] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/31/2016] [Accepted: 02/17/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Air pollution's association with asthma may be due to its augmentation of allergenic effects, but the role of microRNA (miRNA) and gene expression in this synergy is unknown. OBJECTIVE We sought to determine whether exposure to allergen, exposure to diesel exhaust (DE), or coexposures modulate miRNA, gene expression, or inflammatory pathways and whether these measurements are correlated. METHODS Fifteen participants with atopy completed this controlled study of 2 hours of filtered air or DE (300 μg PM2.5/m3) exposure, followed by saline-controlled segmental bronchial allergen challenge. Gene and miRNA expression in bronchial brushings and lung inflammatory markers were measured 48 hours later, in study arms separated by approximately 4 weeks. Expression of miRNAs, messenger RNAs, and inflammatory markers and their interrelationships were determined using regression. RESULTS Robust linear models indicated that DE plus saline and DE plus allergen significantly modulated the highest number of miRNAs and messenger RNAs, respectively, relative to control (filtered air plus saline). In mixed models, allergen exposure modulated (q ≤ 0.2) miRNAs including miR-183-5p, miR-324-5p, and miR-132-3p and genes including NFKBIZ and CDKN1A, but DE did not significantly modify this allergenic effect. Repression of CDKN1A by allergen-induced miR-132-3p may contribute to shedding of bronchial epithelial cells. CONCLUSIONS Expression of specific miRNAs and genes associated with bronchial immune responses were significantly modulated by DE or allergen. However, DE did not augment the effect of allergen at 48 hours, suggesting that adjuvancy may be transient or require higher or prolonged exposure. In silico analysis suggested a possible mechanism contributing to epithelial wall damage following allergen exposure.
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163
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Viral causes of acute respiratory infection among Egyptian children hospitalized with severe acute asthma exacerbation. J Egypt Public Health Assoc 2016; 88:52-6. [PMID: 23528533 DOI: 10.1097/01.epx.0000427636.90615.ad] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Viral respiratory infections are associated with nearly 80% of asthma exacerbation episodes. These can have severe adverse outcomes in patients with established asthma. AIM The aim of the study was to identify the viral causes of acute respiratory infection that precipitate acute asthma exacerbation in Egyptian asthmatic children. PATIENTS AND METHODS The current prospective study was conducted in Cairo University Children's Hospitals from December 2010 to December 2011. All asthmatic children (n=130) aged 2-12 years admitted with asthma exacerbation due to severe lower respiratory tract infection were included. All cases were subjected to nasopharyngeal or throat swabs that were analyzed for common respiratory viruses, including respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza B (Flu B), human parainfluenza virus (hPIV), influenza A (H1N1), and adenovirus (ADV) using the real-time PCR technique. All patients were followed up to record the outcome. RESULTS PCR analysis was positive for one respiratory virus in 54 asthmatic patients (41.5%) and was negative in 76 patients (58.5%), with a high predominance of RSV (51.9%) and hMPV (25.9%) especially in winter and early spring months. Hypoxia was detected in all patients with RSV infection; of these patients, 21.4% were admitted to the ICU, 14.3% required mechanical ventilation, and 14.3% died. In contrast, among those with hMPV infection, hypoxia was detected in 71.4%; none required ICU admission or mechanical ventilation. CONCLUSION AND RECOMMENDATIONS Viral etiology of lower respiratory tract infections constitutes an important cause of acute asthma exacerbation in asthmatic children admitted to children's hospitals in Cairo, supporting the need for large-scale multicentric studies on asthmatic patients over multiple years using a wider-panel PCR for detection of respiratory viruses.
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Rossi E, Picchi M, Bartoli P, Panozzo M, Cervino C, Nurra L. Homeopathic therapy in pediatric atopic diseases: short- and long-term results. HOMEOPATHY 2016; 105:217-224. [PMID: 27473542 DOI: 10.1016/j.homp.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 03/04/2016] [Accepted: 03/09/2016] [Indexed: 10/22/2022]
Abstract
AIM To study the outcomes of atopic diseases in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy) and related long-term results after approximately an 8-year period. MATERIALS AND METHODS Our data derive from an observational longitudinal study carried out on 857 pediatric patients who consecutive visited from 1998 to 2014. Children with atopic diseases were 325 (37.9%), 126 (39%) suffered from atopic dermatitis, 72 (22%) from allergic rhinitis, and 127 (39%) from asthma. Moreover, a long-term study was conducted on a subset of 107/165 patients, consecutively visited from 1998 to 2006, and with ≥5 years follow-up. The study also investigated the evolution of overall symptoms in those patients with a complex atopic symptomatology. RESULTS 75.8% of atopic children had moderate or major improvement (67.1% with asthma as the primary disease; 84.2% rhinitis; 84.2% dermatitis). At re-evaluation after 5-10 years, complete remission of atopic symptoms was obtained in 70.1% of the children: 84.2% in dermatitis; 48.1% in allergic rhinitis; 71.4% in asthma. Children with two or three atopic diseases at the first visit were completely cured in 40% of cases. CONCLUSION The results seem to confirm that homeopathic medicine produces positive therapeutic response in atopic children.
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Affiliation(s)
- Elio Rossi
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy.
| | - Marco Picchi
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy
| | - Paola Bartoli
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy
| | | | - Chiara Cervino
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy
| | - Linda Nurra
- Homeopathic Clinic, Campo di Marte Hospital, Local Health Unit No. 2, Lucca, Italy
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165
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Do DC, Zhao Y, Gao P. Cockroach allergen exposure and risk of asthma. Allergy 2016; 71:463-74. [PMID: 26706467 DOI: 10.1111/all.12827] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2015] [Indexed: 12/15/2022]
Abstract
Cockroach sensitization is an important risk factor for the development of asthma. However, its underlying immune mechanisms and the genetic etiology for differences in allergic responses remain unclear. Cockroach allergens identification and their expression as biologically active recombinant proteins have provided a basis for studying the mechanisms regarding cockroach allergen-induced allergic sensitization and asthma. Glycans in allergens may play a crucial role in the immunogenicity of allergic diseases. Protease-activated receptor (PAR)-2, Toll-like receptor (TLR), and C-type lectin receptors have been suggested to be important for the penetration of cockroach allergens through epithelial cells to mediate allergen uptake, dendritic cell maturation, antigen-presenting cell (APC) function in T-cell polarization, and cytokine production. Environmental pollutants, which often coexist with the allergen, could synergistically elicit allergic inflammation, and aryl hydrocarbon receptor (AhR) activation and signaling may serve as a link between these two elements. Genetic factors may also play an important role in conferring the susceptibility to cockroach sensitization. Several genes have been associated with cockroach sensitization and asthma-related phenotypes. In this review, we will discuss the epidemiological evidence for cockroach allergen-induced asthma, cockroach allergens, the mechanisms regarding cockroach allergen-induced innate immune responses, and the genetic basis for cockroach sensitization.
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Affiliation(s)
- D. C. Do
- Division Allergy and Clinical Immunology; Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Y. Zhao
- Division Allergy and Clinical Immunology; Johns Hopkins University School of Medicine; Baltimore MD USA
| | - P. Gao
- Division Allergy and Clinical Immunology; Johns Hopkins University School of Medicine; Baltimore MD USA
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Abstract
PURPOSE OF REVIEW There is considerable evidence that implicates eosinophils as important effector cells in the inflammation characteristic of eosinophilic asthma. IL-5 is central to eosinophil maturation and release from the bone marrow, their subsequent accumulation, activation and persistence in the tissues. IL-5 therefore represents an attractive target to prevent or blunt eosinophil-mediated inflammation resulting in the development of humanized anti-IL-5 monoclonal antibody such as mepolizumab. This review is an update of the evidence demonstrating the effectiveness of mepolizumab treatment of patients with asthma. RECENT FINDINGS Although early clinical trials with mepolizumab in patients with asthma gave disappointing clinical outcomes, it is becoming apparent that significant clinical effects with this biologic are more likely in carefully selected patient populations that take the eosinophilic asthma phenotype into account. A number of recent studies have reported significant effects by mepolizumab on reductions in exacerbations together with a significant glucocorticoid-sparing effect. SUMMARY Mepolizumab is a potentially important and well tolerated therapy in carefully selected populations of patients with asthma.
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167
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Leung JYY, Lam HS, Leung GM, Schooling CM. Gestational Age, Birthweight for Gestational Age, and Childhood Hospitalisations for Asthma and Other Wheezing Disorders. Paediatr Perinat Epidemiol 2016; 30:149-59. [PMID: 26739588 DOI: 10.1111/ppe.12273] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Preterm birth, early term birth, and low birthweight are associated with childhood wheezing disorders in developed Western settings, but observed associations could be confounded by socio-economic position. This study aims to clarify such associations in a developed non-Western setting with a different confounding structure. METHODS Using Cox regression, we examined the adjusted associations of gestational age and birthweight for gestational age with time to first public hospital admission for asthma, bronchitis, and bronchiolitis (International Classification of Diseases, Ninth Version Clinical Modification 466, 490, and 493) from 9 days to 12 years in a population-representative birth cohort of 8327 Chinese children in Hong Kong, a developed setting with less clear social patterning of prematurity or birthweight. Analyses were adjusted for infant and parental characteristics and socio-economic position. RESULTS Children born late preterm (34 to <37 weeks) had higher risk of hospitalisation for asthma and other wheezing disorders [hazard ratio (HR) 1.99, 95% confidence interval (CI) 1.48, 2.67] than children born full term (39 to <41 weeks). Early term births (37 to <39 weeks) had HR 1.01 (95% CI 0.84, 1.22), late term births (41 to <42 weeks) had HR 0.77 (95% 0.59, 1.01), and post-term births (≥42 weeks) had HR 0.56 (95% CI 0.32, 0.98). Large for gestational age was associated with lower risk of hospitalisation (HR 0.76, 95% CI 0.57, 0.99). CONCLUSION The association of preterm birth with childhood wheezing could be biologically mediated. We cannot rule out an association for early term births.
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Affiliation(s)
- June Y Y Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Hugh S Lam
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,School of Public Health and Hunter College, City University of New York, New York
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168
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Associations of Early Life Exposures and Environmental Factors With Asthma Among Children in Rural and Urban Areas of Guangdong, China. Chest 2016; 149:1030-41. [PMID: 26836923 DOI: 10.1016/j.chest.2015.12.028] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 12/13/2015] [Accepted: 12/21/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Environmental factors may play important roles in asthma, but findings have been inconsistent. OBJECTIVE The goal of this study was to determine the associations between early life exposures, environmental factors, and asthma in urban and rural children in southeast China. METHODS A screening questionnaire survey was conducted in 7,164 children from urban Guangzhou and 6,087 from rural Conghua. In the second stage, subsamples of 854 children (419 from Guangzhou, 435 from Conghua) were recruited for a case-control study that included a detailed questionnaire enquiring on family history, early life environmental exposures, dietary habits, and laboratory tests (including histamine airway provocation testing, skin prick tests, and serum antibody analyses). House dust samples from 76 Guangzhou families and 80 Conghua families were obtained to analyze levels of endotoxins, house dust mites, and cockroach allergens. RESULTS According to the screening survey, the prevalence of physician-diagnosed asthma was lower in children from Conghua (3.4%) than in those from Guangzhou (6.9%) (P < .001). A lower percentage of asthma was reported in rural subjects compared with urban subjects (2.8% vs. 29.4%; P < .001) in the case-control study. Atopy (OR, 1.91 [95% CI, 1.58-2.29]), parental atopy (OR, 2.49 [95% CI, 1.55-4.01]), hospitalization before 3 years of age (OR, 2.54 [95% CI, 1.37-4.70]), high consumption of milk products (OR, 1.68 [95% CI, 1.03-2.73]), and dust Dermatophagoides farinae group 1 allergen (OR, 1.71 [95% CI, 1.34-2.19]) were positively associated with asthma. Living in a crop-farming family at < 1 year of age (OR, 0.15 [95% CI, 0.08-0.32]) and dust endotoxin levels (OR, 0.69 [95% CI, 0.50-0.95]) were negatively associated with asthma. CONCLUSIONS Rural children from an agricultural background exhibited a reduced risk of asthma. Early life exposure to crop farming and high environmental endotoxin levels might protect the children from asthma in southern China.
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169
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Sim DW, Lee JH. Biomarkers of adult asthma and personalized medicine. ALLERGY ASTHMA & RESPIRATORY DISEASE 2016. [DOI: 10.4168/aard.2016.4.1.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Da Woon Sim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Hyun Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Al-Eyadhy AA, Temsah MH, Alhaboob AAN, Aldubayan AK, Almousa NA, Alsharidah AM, Alangari MI, Alshaya AM. Asthma changes at a pediatric intensive care unit after 10 years: Observational study. Ann Thorac Med 2015; 10:243-8. [PMID: 26664561 PMCID: PMC4652289 DOI: 10.4103/1817-1737.165302] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES: To describe the change in the management, and outcome of children with acute severe asthma (ASA) admitted to Pediatric Intensive Care Unit (PICU) at tertiary institute, as compared to previously published report in 2003. METHODS: This is a retrospective observational study. All consecutive pediatric ASA patients who were admitted to PICU during the study period were included. The data were extracted from PICU database and medical records. The Cohort in this study (2013 Cohort) was compared with the Cohort of ASA, which was published in 2003 from the same institution (2003 Cohort). RESULTS: In comparison to previous 2003 Cohort, current Cohort (2013) revealed higher mean age (5.5 vs. 3.6 years; P ≤ 0.001), higher rate of PICU admission (20.3% vs. 3.6%; P ≤ 0.007), less patients who received maintenance inhaled steroids (43.3% vs. 62.4%; P ≤ 0.03), less patients with pH <7.3 (17.9% vs. 42.9%; P ≤ 0.001). There were more patients in 2013 Cohort who received: Inhaled Ipratropium bromide (97% vs. 68%; P ≤ 0.001), intravenous magnesium sulfate (68.2% vs. none), intravenous salbutamol (13.6% vs. 3.6%; P ≤ 0.015), and noninvasive ventilation (NIV) (35.8% vs. none) while no patients were treated with theophylline (none vs. 62.5%). The median length of stay (LOS) was 2 days while mean LOS was half a day longer in the 2013 Cohort. None of our patients required intubation, and there was no mortality. CONCLUSION: We observed slight shift toward older age, considerably increased the rate of PICU admission, increased utilization of Ipratropium bromide, magnesium sulfate, and NIV as important modalities of treatment.
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Affiliation(s)
- Ayman A Al-Eyadhy
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Ali A N Alhaboob
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Abdulmalik K Aldubayan
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Nasser A Almousa
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman M Alsharidah
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed I Alangari
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman M Alshaya
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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171
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Morin Attenuates Ovalbumin-Induced Airway Inflammation by Modulating Oxidative Stress-Responsive MAPK Signaling. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2016:5843672. [PMID: 26783416 PMCID: PMC4691473 DOI: 10.1155/2016/5843672] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/12/2015] [Accepted: 09/13/2015] [Indexed: 02/07/2023]
Abstract
Asthma is one of the most common inflammatory diseases characterized by airway hyperresponsiveness, inflammation, and remodeling. Morin, an active ingredient obtained from Moraceae plants, has been demonstrated to have promising anti-inflammatory activities in a range of disorders. However, its impacts on pulmonary diseases, particularly on asthma, have not been clarified. This study was designed to investigate whether morin alleviates airway inflammation in chronic asthma with an emphasis on oxidative stress modulation. In vivo, ovalbumin- (OVA-) sensitized mice were administered with morin or dexamethasone before challenge. Bronchoalveolar lavage fluid (BALF) and lung tissues were obtained to perform cell counts, histological analysis, and enzyme-linked immunosorbent assay. In vitro, human bronchial epithelial cells (BECs) were challenged by tumor necrosis factor alpha (TNF-α). The supernatant was collected for the detection of the proinflammatory proteins, and the cells were collected for reactive oxygen species (ROS)/mitogen-activated protein kinase (MAPK) evaluations. Severe inflammatory responses and remodeling were observed in the airways of the OVA-sensitized mice. Treatment with morin dramatically attenuated the extensive trafficking of inflammatory cells into the BALF and inhibited their infiltration around the respiratory tracts and vessels. Morin administration also significantly suppressed goblet cell hyperplasia and collagen deposition/fibrosis and dose-dependently inhibited the OVA-induced increases in IgE, TNF-α, interleukin- (IL-) 4, IL-13, matrix metalloproteinase-9, and malondialdehyde. In human BECs challenged by TNF-α, the levels of proteins such as eotaxin-1, monocyte chemoattractant protein-1, IL-8 and intercellular adhesion molecule-1, were consistently significantly decreased by morin. Western blotting and the 2',7'-dichlorofluorescein assay revealed that the increases in intracellular ROS and MAPK phosphorylation were abolished by morin, implying that ROS/MAPK signaling contributes to the relief of airway inflammation. Our findings indicate for the first time that morin alleviates airway inflammation in chronic asthma, which probably occurs via the oxidative stress-responsive MAPK pathway, highlighting a novel profile of morin as a potent agent for asthma management.
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172
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de Korte-de Boer D, Mommers M, Gielkens-Sijstermans CML, Creemers HMH, Mujakovic S, Feron FJM, van Schayck OCP. Stabilizing prevalence trends of eczema, asthma and rhinoconjunctivitis in Dutch schoolchildren (2001-2010). Allergy 2015; 70:1669-73. [PMID: 26289999 DOI: 10.1111/all.12728] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 11/30/2022]
Abstract
In contrast to many countries, a decrease in childhood wheeze prevalence was previously reported for the Netherlands. In repeated cross-sectional surveys in 2001, 2005 and 2010, we investigated whether this trend continued, and additionally examined prevalence trends of eczema, asthma and rhinoconjunctivitis among 8- to 11-year-old schoolchildren eligible for a routine physical examination. Overall, ~90% participated (mean age: 8.8 years in 2001 and 10.5 years in 2005 and 2010). Eczema, wheeze and asthma prevalence did not change significantly between 2001 and 2010, but rhinoconjunctivitis prevalence increased from 8.4% in 2001 to 12.3% in both 2005 and 2010 (Ptrend < 0.01). In conclusion, after a decrease in wheeze prevalence among Dutch schoolchildren between 1989 and 2001, no further decrease was observed until 2010. Similarly, the prevalence of eczema and asthma remained stable, but rhinoconjunctivitis prevalence increased between 2001 and 2010. The latter may be an effect of older age and not a true increase over time.
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Affiliation(s)
- D. de Korte-de Boer
- Department of Epidemiology; CAPHRI School for Public Health and Primary Care; Maastricht University; Maastricht The Netherlands
| | - M. Mommers
- Department of Epidemiology; CAPHRI School for Public Health and Primary Care; Maastricht University; Maastricht The Netherlands
| | | | - H. M. H. Creemers
- Department of Youth Health Care; Public Health Service South Limburg; Geleen The Netherlands
| | - S. Mujakovic
- Department of Research and Development; Public Health Service South Limburg; Geleen The Netherlands
| | - F. J. M. Feron
- Department of Social Medicine; CAPHRI School for Public Health and Primary Care; Maastricht University; Maastricht The Netherlands
| | - O. C. P. van Schayck
- Department of General Practice; CAPHRI School for Public Health and Primary Care; Maastricht University; Maastricht The Netherlands
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173
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Bonfim CB, dos Santos DN, Barreto ML. The association of intrafamilial violence against children with symptoms of atopic and non-atopic asthma: A cross-sectional study in Salvador, Brazil. CHILD ABUSE & NEGLECT 2015; 50:244-253. [PMID: 26149733 PMCID: PMC4685965 DOI: 10.1016/j.chiabu.2015.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 05/17/2015] [Accepted: 05/27/2015] [Indexed: 06/04/2023]
Abstract
This study aims to describe the types of intrafamilial violence perpetrated against children according to living conditions, family factors, and child characteristics, and to identify the association between types of intrafamilial violence and asthma symptoms in atopic and non-atopic children. A cross-sectional study was carried out with 1,370 caregivers as part of the Social Changes, Asthma and Allergy in Latin America (SCAALA) study, conducted in 2006 in Brazil. The study population was selected by random sampling. The main outcome measures were atopic and non-atopic asthma. We investigate the association between intrafamilial violence and asthma symptoms in atopic and non-atopic children. A backward multivariate logistic polytomous regression was performed to verify the main association. Nonviolent discipline (NVD) and maltreatment nonviolent discipline (MNVD) were positively associated with non-atopic asthma symptoms (NVD: odds ratio (OR)=1.95/95% confidence interval (CI)=1.17-3.25; MNVD: OR=1.95/95% CI=1.19-3.20). However, for the most severe intrafamilial violence, this association was not found after control of potential confounders. This study demonstrates the effect of types of intrafamilial violence on non-atopic asthma. Intrafamilial violence against children represents one more component in the determination of non-atopic asthma in Latin America.
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174
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Lundbäck B, Backman H, Lötvall J, Rönmark E. Is asthma prevalence still increasing? Expert Rev Respir Med 2015; 10:39-51. [DOI: 10.1586/17476348.2016.1114417] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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175
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176
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Ni ZH, Tang JH, Chen G, Lai YM, Chen QG, Li Z, Yang W, Luo XM, Wang XB. Resveratrol inhibits mucus overproduction and MUC5AC expression in a murine model of asthma. Mol Med Rep 2015; 13:287-94. [PMID: 26549244 DOI: 10.3892/mmr.2015.4520] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 09/16/2015] [Indexed: 11/06/2022] Open
Abstract
Previous in vitro studies have demonstrated that resveratrol is able to significantly inhibit the upregulation of mucin 5AC (MUC5AC), a major component of mucus; thus indicating that resveratrol may have potential in regulating mucus overproduction. However, there have been few studies regarding the resveratrol‑mediated prevention of MUC5AC overproduction in vivo, and the mechanisms by which resveratrol regulates MUC5AC expression have yet to be elucidated. In the present study, an ovalbumin (OVA)‑challenged murine model of asthma was used to assess the effects of resveratrol treatment on mucus production in vivo. The results demonstrated that resveratrol significantly inhibited OVA‑induced airway inflammation and mucus production. In addition, the mRNA and protein expression levels of MUC5AC were increased in the OVA‑challenged mice, whereas treatment with resveratrol significantly inhibited this effect. The expression levels of murine calcium‑activated chloride channel (mCLCA)3, an important key mediator of MUC5AC production, were also reduced following resveratrol treatment. Furthermore, in vitro studies demonstrated that resveratrol significantly inhibited human (h)CLCA1 and MUC5AC expression in a dose‑dependent manner. These results indicated that resveratrol was effective in preventing mucus overproduction and MUC5AC expression in vivo, and its underlying mechanism may be associated with regulation of the mCLCA3/hCLCA1 signaling pathway.
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Affiliation(s)
- Zhen-Hua Ni
- Central Laboratory, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Ji-Hong Tang
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Guo Chen
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Yi-Min Lai
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Qing-Ge Chen
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Zao Li
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Wei Yang
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Xu-Min Luo
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
| | - Xiong-Biao Wang
- Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, P.R. China
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Singh S, Sharma BB, Sharma SK, Sabir M, Singh V. Prevalence and severity of asthma among Indian school children aged between 6 and 14 years: associations with parental smoking and traffic pollution. J Asthma 2015; 53:238-44. [PMID: 26365004 DOI: 10.3109/02770903.2015.1087558] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Phase three of the International Study of Asthma and Allergy in Children (ISAAC) was carried out at various sites in India. The prevalence of asthma symptoms in school children and the effect of environmental tobacco smoke and traffic pollution on the occurrence of asthma were analysed. METHODS Two groups of school children, aged 6-7 yr and 13-14 yr, participated according to the ISAAC protocol. Schools were randomly selected and responses to the ISAAC questionnaire were recorded. RESULTS The prevalence of asthma was 5.35% in the 6-7 yr age group and 6.05% in the 13-14 yr age group. The odds ratios (ORs) for the risk of asthma in children with exposure to mild, moderate and heavy traffic pollution compared with minimal traffic pollution were 1.63 (95% CI: 1.43, 1.85), 1.71 (95% CI: 1.49, 1.96) and 1.53 (95% CI: 1.31, 1.78), respectively, in the younger group. Similarly, in the older group, they were 1.19 (95% CI: 1.04, 1.36), 1.51 (95% CI: 1.31, 1.75) and 1.51 (95% CI: 1.29, 1.76). Asthma was associated with maternal smoking [6-7 yr group: OR = 2.72 (2.05, 3.6); 13-14 yr group: OR = 2.14 (1.72, 2.66)] and paternal smoking [6-7 yr group: OR = 1.9 (1.70, 2.11); 13-14 yr group: OR = 1.21 (1.09, 1.34)]. CONCLUSIONS The prevalence of asthma was lower in the 6-7 than the 13-14 yr age group. Environmental tobacco smoke and traffic pollution were the factors most strongly associated with asthma in Indian children.
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Affiliation(s)
- Sheetu Singh
- a Department of Pulmonary Medicine , Institute of Respiratory Diseases , Jaipur , India
| | | | - S K Sharma
- c Department of Internal Medicine , All India Institute of Medical Sciences , New Delhi , India
| | - Mohammed Sabir
- d Department of Medicine , Respiratory Division, S.P. Medical College , Bikaner , India , and
| | - Virendra Singh
- e Department of Pulmonary Medicine , Asthma Bhawan , Jaipur , India
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Ma YC, Lin CC, Yang SY, Chen HJ, Li TC, Lin JG. Time Trend Analysis of the Prevalence and Incidence of Diagnosed Asthma and Traditional Chinese Medicine Use among Adults in Taiwan from 2000 to 2011: A Population-Based Study. PLoS One 2015; 10:e0140318. [PMID: 26484761 PMCID: PMC4618865 DOI: 10.1371/journal.pone.0140318] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/24/2015] [Indexed: 11/18/2022] Open
Abstract
Background The aim of this study was to determine the annual trends of traditional Chinese medicine (TCM) use for prevalent and incident asthmatic adults in Taiwan from 2000 to 2011. The annual prevalence and incidence of asthma in adults among subgroups of sociodemographic factors were also investigated. Methods A population-based study was conducted using a random sample with one million beneficiaries of all residents aged ≥18 years enrolled in the National Health Insurance program. Adults diagnosed with asthma were identified from the National Health Insurance Research Database. The annual prevalence and incidence of asthma in the adult population were estimated by using International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes to identify relevant cases from 2000 to 2011. Results The number of annual prevalent cases of diagnosed asthma increased from 56,885 in 2000 to 101,535 in 2011. The prevalence increased significantly on annual basis, whereas the incidence rate fluctuated over time. The prevalence of TCM use by adults with asthma decreased significantly (p<0.05), from 38.58% in 2000 to 29.26% in 2011. The number of annual incident cases of diagnosed asthma decreased from 3,896 in 2000 to 2,684 in 2011. TCM use rates in asthma incident adults decreased significantly (p<0.05), from 54.24% in 2000 to 38.19% in 2011. Conclusion The prevalence of TCM utilization is high among adults with asthma in Taiwan. However, our study demonstrated a substantial decrease in the annual prevalence of TCM use by prevalent and incident asthmatic adults in Taiwan from 2000 to 2011. In addition, the prevalence of TCM use was higher among incident cases, compared with those with prevalent cases.
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Affiliation(s)
- Yi-Chun Ma
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Tai-An Hospital, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Sing-Yu Yang
- Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
- * E-mail: (TCL); (JGL)
| | - Jaung-Geng Lin
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- * E-mail: (TCL); (JGL)
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179
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Thongkham D, Tran J, Clunes MT, Brahim F. Prevalence and severity of asthmatic symptoms in Grenadian school children: the Grenada National Asthma Survey. BMJ Open 2015; 5:e008557. [PMID: 26482772 PMCID: PMC4611493 DOI: 10.1136/bmjopen-2015-008557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The goal of this study was to determine the prevalence of asthma in school children in the tri-island Caribbean nation of Grenada. SETTING, PARTICIPANTS AND OUTCOMES This was a self-report study provided to the guardians of all primary school children between ages 6 and 7 throughout Grenada, Carriacou and Petite Martinique in 2013. Of the 2362 surveys provided, 1374 were returned, resulting in a response rate of 58.2%. Only responders listing birthdays between 1 January 2006 and 31 December 2007 were included in the analysis, resulting in 1165 qualifying responders. Asthma diagnosis was based on previous physician diagnosed asthma and/or self-reported presence of wheeze in the past 12 months (current wheeze). Severity of asthma, medication usage, environmental exposures, physician and emergency department visits were compared among respondents. RESULTS The prevalence of wheezing in the past year was 30.5±1.8%, and of these 68.4% were previously diagnosed with asthma. Of the current wheeze participants, 39.9±9.2% reported moderate to severe asthma symptoms and increased exposure to cigarette smoke, excessive dust, burning brush and landfills. Carriacou and Petite Martinique, the two smaller islands, had a lower incidence of current wheeze (14.1±7.7%) and exposure rates to cigarette smoke and burning brush as compared to the larger, denser island of Grenada. Although 65.7% of respondents diagnosed with asthma reported taking medication, the number of annual doctor and emergency department visits were high (2.82 and 0.86, respectively). Respondents with the most severe asthma symptoms reported the most emergency department visits with an average of 1.05 visits annually, whereas respondents with moderate asthma symptoms had the most doctor visits with an average of 3.33 visits annually. CONCLUSIONS This study indicates that the prevalence of childhood asthma in Grenada is very high and warrants policy consideration in public health and education to decrease its morbidity.
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Affiliation(s)
- D Thongkham
- Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies
| | - J Tran
- Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies
| | - M T Clunes
- Department of Physiology and Neuroscience, School of Medicine, St. George's University, Grenada, West Indies
| | - F Brahim
- Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies
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180
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Truhlář A, Deakin CD, Soar J, Khalifa GEA, Alfonzo A, Bierens JJLM, Brattebø G, Brugger H, Dunning J, Hunyadi-Antičević S, Koster RW, Lockey DJ, Lott C, Paal P, Perkins GD, Sandroni C, Thies KC, Zideman DA, Nolan JP, Böttiger BW, Georgiou M, Handley AJ, Lindner T, Midwinter MJ, Monsieurs KG, Wetsch WA. European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances. Resuscitation 2015; 95:148-201. [PMID: 26477412 DOI: 10.1016/j.resuscitation.2015.07.017] [Citation(s) in RCA: 532] [Impact Index Per Article: 59.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Anatolij Truhlář
- Emergency Medical Services of the Hradec Králové Region, Hradec Králové, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic.
| | - Charles D Deakin
- Cardiac Anaesthesia and Cardiac Intensive Care, NIHR Southampton Respiratory Biomedical Research Unit, Southampton University Hospital NHS Trust, Southampton, UK
| | - Jasmeet Soar
- Anaesthesia and Intensive Care Medicine, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | | | - Annette Alfonzo
- Departments of Renal and Internal Medicine, Victoria Hospital, Kirkcaldy, Fife, UK
| | | | - Guttorm Brattebø
- Bergen Emergency Medical Services, Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - Hermann Brugger
- EURAC Institute of Mountain Emergency Medicine, Bozen, Italy
| | - Joel Dunning
- Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
| | | | - Rudolph W Koster
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - David J Lockey
- Intensive Care Medicine and Anaesthesia, Southmead Hospital, North Bristol NHS Trust, Bristol, UK; School of Clinical Sciences, University of Bristol, UK
| | - Carsten Lott
- Department of Anesthesiology, University Medical Center, Johannes Gutenberg-Universitaet, Mainz, Germany
| | - Peter Paal
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, Queen Mary University of London, London, UK; Department of Anaesthesiology and Critical Care Medicine, University Hospital Innsbruck, Austria
| | - Gavin D Perkins
- Warwick Medical School, University of Warwick, Coventry, UK; Critical Care Unit, Heart of England NHS Foundation Trust, Birmingham, UK
| | - Claudio Sandroni
- Department of Anaesthesiology and Intensive Care, Catholic University School of Medicine, Rome, Italy
| | | | - David A Zideman
- Department of Anaesthetics, Imperial College Healthcare NHS Trust, London, UK
| | - Jerry P Nolan
- Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK; School of Clinical Sciences, University of Bristol, UK
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181
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Pesce G, Locatelli F, Cerveri I, Bugiani M, Pirina P, Johannessen A, Accordini S, Zanolin ME, Verlato G, de Marco R. Seventy Years of Asthma in Italy: Age, Period and Cohort Effects on Incidence and Remission of Self-Reported Asthma from 1940 to 2010. PLoS One 2015; 10:e0138570. [PMID: 26439263 PMCID: PMC4595078 DOI: 10.1371/journal.pone.0138570] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 09/01/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma. OBJECTIVE To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010. METHODS The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever) was collected on 35,495 subjects aged 20-84 and born between 1925-1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC) were modelled using Poisson regression and APC models. RESULTS The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years). The incidence rates have been linearly increasing, with a percentage increase of +3.9% (95%CI: 3.1-4.5), from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease. CONCLUSIONS After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on self-reported events that could be affected by the recall bias.
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Affiliation(s)
- Giancarlo Pesce
- Unit of Epidemiology & Medical Statistics, Dept. of Public Health & Community Medicine, University of Verona, Verona, Italy
| | - Francesca Locatelli
- Unit of Epidemiology & Medical Statistics, Dept. of Public Health & Community Medicine, University of Verona, Verona, Italy
| | - Isa Cerveri
- Unit of Respiratory Diseases, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | | | - Pietro Pirina
- Institute for Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Ane Johannessen
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Simone Accordini
- Unit of Epidemiology & Medical Statistics, Dept. of Public Health & Community Medicine, University of Verona, Verona, Italy
| | - Maria Elisabetta Zanolin
- Unit of Epidemiology & Medical Statistics, Dept. of Public Health & Community Medicine, University of Verona, Verona, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology & Medical Statistics, Dept. of Public Health & Community Medicine, University of Verona, Verona, Italy
| | - Roberto de Marco
- Unit of Epidemiology & Medical Statistics, Dept. of Public Health & Community Medicine, University of Verona, Verona, Italy
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182
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de Korte-de Boer D, Mommers M, Creemers HMH, Dompeling E, Feron FJM, Gielkens-Sijstermans CML, Jaminon M, Mujakovic S, van Schayck OCP, Thijs C, Jansen M. LucKi Birth Cohort Study: rationale and design. BMC Public Health 2015; 15:934. [PMID: 26391882 PMCID: PMC4578419 DOI: 10.1186/s12889-015-2255-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/11/2015] [Indexed: 11/10/2022] Open
Abstract
Background Infancy and childhood are characterized by rapid growth and development, which largely determine health status and well-being across the lifespan. Identification of modifiable risk factors and prognostic factors in critical periods of life will contribute to the development of effective prevention and intervention strategies. The LucKi Birth Cohort Study was designed and started in 2006 to follow children from birth into adulthood on a wide range of determinants, disorders, and diseases. During preschool and school years, the primary focus is on the etiology and prognosis of atopic diseases (eczema, asthma, and hay fever) and overweight/obesity. Methods/Design LucKi is an ongoing, dynamic, prospective birth cohort study, embedded in the Child and Youth Health Care (CYHC) practice of the ‘Westelijke Mijnstreek’ (a region in the southeast of the Netherlands). Recruitment (1–2 weeks after birth) and follow-up (until 19 years) coincide with routine CYHC contact moments, during which the child’s physical and psychosocial development is closely monitored, and anthropometrics are measured repeatedly in a standardised way. Information gathered through CYHC is complemented with repeated parental questionnaires, and information from existing registries of pharmacy, hospital and/or general practice. Since the start already more than 5,000 children were included in LucKi shortly after birth, reaching an average participation rate of ~65 %. Discussion The LucKi Birth Cohort Study provides a framework in which children are followed from birth into adulthood. Embedding LucKi in CYHC simplifies implementation, leads to low maintenance costs and high participation rates, and facilitates direct implementation of study results into CYHC practice. Furthermore, LucKi provides opportunities to initiate new (experimental) studies and/or to establish biobanking in (part of) the cohort, and contributes relevant information on determinants and health outcomes to policy and decision makers. Cohort details can be found on www.birthcohorts.net.
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Affiliation(s)
- Dianne de Korte-de Boer
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands.
| | - Monique Mommers
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands.
| | - Huub M H Creemers
- Department of Youth Health Care, South Limburg Public Health Service, Geleen, The Netherlands.
| | - Edward Dompeling
- Department of Paediatric Respiratory Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Frans J M Feron
- Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | | | - Mariëlle Jaminon
- Orbis Child and Youth Health Care, Orbis Medical Concern, Sittard, The Netherlands.
| | - Suhreta Mujakovic
- Department of Research and Development, South Limburg Public Health Service, Geleen, The Netherlands.
| | - Onno C P van Schayck
- Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - Carel Thijs
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands.
| | - Maria Jansen
- Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
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183
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Riha RL. Diagnostic approaches to respiratory sleep disorders. J Thorac Dis 2015; 7:1373-84. [PMID: 26380763 DOI: 10.3978/j.issn.2072-1439.2015.08.28] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 08/13/2015] [Indexed: 12/18/2022]
Abstract
Sleep disordered breathing (SDB) comprises a number of breathing disturbances occurring during sleep including snoring, the obstructive sleep apnoea/hypopnea syndrome (OSAHS), central sleep apnoea (CSA) and hypoventilation syndromes. This review focuses on sleep disordered breathing and diagnostic approaches in adults, in particular clinical assessment and overnight assessment during sleep. Although diagnostic approaches to respiratory sleep disorders are reasonably straightforward, they do require a degree of clinical acumen when it comes to assessing severity and management options. Diagnosing respiratory sleep disorders on clinical features alone has limitations. Monitoring and measuring respiration during sleep has undergone many advances in the last 40 years in respect of quality and validity, largely regarding OSAHS. Despite the improvement in our diagnostic standards and recognition of sleep disordered breathing, many limitations still need to be overcome. Apart from assessing the individual patient, population screening for sleep disorders continues to preoccupy health professionals and policy makers in many countries. Research in the field is pushing current boundaries in terms of simplifying diagnosis and enhancing screening for sleep disordered breathing in large populations. At present, a number of these newer approaches require further validation.
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Affiliation(s)
- Renata L Riha
- Department of Sleep Medicine, Royal Infirmary Edinburgh, Scotland, UK
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184
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Tan DJ, Walters EH, Perret JL, Lodge CJ, Lowe AJ, Matheson MC, Dharmage SC. Age-of-asthma onset as a determinant of different asthma phenotypes in adults: a systematic review and meta-analysis of the literature. Expert Rev Respir Med 2015; 9:109-23. [PMID: 25584929 DOI: 10.1586/17476348.2015.1000311] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Age-of-asthma onset is often used to distinguish different adult asthma phenotypes; however, similarities and differences between early- and late-onset adult asthma have not been summarized to date. Of the 2921 records found, we identified 12 studies comparing early- and late-onset current asthma in adults. Age 12 was most commonly used to delineate the two age-of-onset phenotypes. Adults with early-onset current asthma were more likely to be atopic and had a higher frequency of asthma attacks, whereas adults with late-onset disease were more likely to be female, smokers and had greater levels of spirometrically defined fixed airflow obstruction. The prevalence of severe asthma was similar in both groups, and, in general, there were few phenotypic differences between severe asthmatics regardless of age of onset. Findings for several key characteristics, including lung function, were inconsistent between studies. Overall, there appears to be distinctive phenotypic differences with age of asthma onset. Although early-onset adult asthma is likely more attributable to atopy and potentially genetic factors, late-onset adult asthma appears to be more related to environmental risk factors, and so may be better targeted by preventive strategies. More detailed research is required to better characterize these phenotypes and to clarify potential clinical implications.
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Affiliation(s)
- Daniel J Tan
- Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic 3052, Australia
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185
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Thomsen SF. The contribution of twin studies to the understanding of the aetiology of asthma and atopic diseases. Eur Clin Respir J 2015; 2:27803. [PMID: 26672957 PMCID: PMC4653279 DOI: 10.3402/ecrj.v2.27803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 08/11/2015] [Indexed: 01/17/2023] Open
Abstract
The prevalence of asthma and other atopic diseases has increased markedly during the past decades and the reasons for this are not fully understood. Asthma is still increasing in many parts of the world, notably in developing countries, and this emphasizes the importance of continuing research aimed at studying the aetiological factors of the disease and the causes of its increase in prevalence. Twin studies enable investigations into the genetic and environmental causes of individual variation in multifactorial diseases such as asthma. Thorough insight into these causes is important as this will ultimately guide the development of preventive strategies and targeted therapies. This review explores the contribution of twin studies to the understanding of the aetiology of asthma and atopic diseases.
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Affiliation(s)
- Simon F Thomsen
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark;
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186
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Roncada C, Dias CP, Goecks S, Cidade SEF, Pitrez PMC. Usefulness of the WHOQOL-BREF questionnaire in assessing the quality of life of parents of children with asthma. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rppede.2015.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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187
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Brunst KJ, Baccarelli AA, Wright RJ. Integrating mitochondriomics in children's environmental health. J Appl Toxicol 2015; 35:976-91. [PMID: 26046650 PMCID: PMC4714560 DOI: 10.1002/jat.3182] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/23/2015] [Indexed: 12/18/2022]
Abstract
The amount of scientific research linking environmental exposures and childhood health outcomes continues to grow; yet few studies have teased out the mechanisms involved in environmentally-induced diseases. Cells can respond to environmental stressors in many ways: inducing oxidative stress/inflammation, changes in energy production and epigenetic alterations. Mitochondria, tiny organelles that each retains their own DNA, are exquisitely sensitive to environmental insults and are thought to be central players in these pathways. While it is intuitive that mitochondria play an important role in disease processes, given that every cell of our body is dependent on energy metabolism, it is less clear how environmental exposures impact mitochondrial mechanisms that may lead to enhanced risk of disease. Many of the effects of the environment are initiated in utero and integrating mitochondriomics into children's environmental health studies is a critical priority. This review will highlight (i) the importance of exploring environmental mitochondriomics in children's environmental health, (ii) why environmental mitochondriomics is well suited to biomarker development in this context, and (iii) how molecular and epigenetic changes in mitochondria and mitochondrial DNA (mtDNA) may reflect exposures linked to childhood health outcomes.
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Affiliation(s)
- Kelly J. Brunst
- Kravis Children’s Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Andrea A. Baccarelli
- Department of Environmental Health, Laboratory of Environmental Epigenetics, Exposure Epidemiology and Risk Program, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Rosalind J. Wright
- Kravis Children’s Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY 10029, USA
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188
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Yang HJ. Safety of influenza vaccination in children with allergic diseases. Clin Exp Vaccine Res 2015; 4:137-44. [PMID: 26273572 PMCID: PMC4524898 DOI: 10.7774/cevr.2015.4.2.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 05/20/2015] [Accepted: 05/30/2015] [Indexed: 11/15/2022] Open
Abstract
Global guidelines strongly recommend annual influenza vaccination in people age 6 months and older, particularly in asthmatic children. There is no doubt about the benefit of influenza vaccination in asthmatic children. However, some of the vaccine's components may elicit an IgE mediated hypersensitivity or disease exacerbation, including life-threatening events, in children with allergic diseases. As a result, concerns regarding the safety of the vaccine still continue today. The influenza vaccine is grown on hens' eggs and contains a trace of egg protein. Consequently, it can provoke an allergic reaction or anaphylaxis in children with an egg allergy or exacerbation in those with asthma. Therefore, we need to know the risks and benefits of the influenza vaccine and the best strategy for safe vaccination. Although most guidelines have consistently reported the safety of influenza vaccination in children with allergic disease, and have recommended annual administration, safety concerns impede guideline-based performance in practice. The safety and efficacy of influenza vaccination for allergic children are summarized in the present review.
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Affiliation(s)
- Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
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189
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Stiemsma LT, Reynolds LA, Turvey SE, Finlay BB. The hygiene hypothesis: current perspectives and future therapies. Immunotargets Ther 2015; 4:143-57. [PMID: 27471720 PMCID: PMC4918254 DOI: 10.2147/itt.s61528] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Developed countries have experienced a steady increase in atopic disease and disorders of immune dysregulation since the 1980s. This increase parallels a decrease in infectious diseases within the same time period, while developing countries seem to exhibit the opposite effect, with less immune dysregulation and a higher prevalence of infectious disease. The “hygiene hypothesis”, proposed by Strachan in 1989, aimed to explain this peculiar generational rise in immune dysregulation. However, research over the past 10 years provides evidence connecting the commensal and symbiotic microbes (intestinal microbiota) and parasitic helminths with immune development, expanding the hygiene hypothesis into the “microflora” and “old friends” hypotheses, respectively. There is evidence that parasitic helminths and commensal microbial organisms co-evolved with the human immune system and that these organisms are vital in promoting normal immune development. Current research supports the potential for manipulation of the bacterial intestinal microbiota to treat and even prevent immune dysregulation in the form of atopic disease and other immune-mediated disorders (namely inflammatory bowel disease and type 1 diabetes). Both human and animal model research are crucial in understanding the mechanistic links between these intestinal microbes and helminth parasites, and the human immune system. Pro-, pre-, and synbiotic, as well as treatment with live helminth and excretory/secretory helminth product therapies, are all potential therapeutic options for the treatment and prevention of these diseases. In the future, therapeutics aimed at decreasing the prevalence of inflammatory bowel disease, type 1 diabetes, and atopic disorders will likely involve personalized microbiota and/or helminth treatments used early in life.
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Affiliation(s)
- Leah T Stiemsma
- Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC, Canada; The Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Lisa A Reynolds
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Stuart E Turvey
- Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC, Canada; The Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - B Brett Finlay
- Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC, Canada; Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada; Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
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190
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Domínguez-Ortega J, Phillips-Anglés E, Barranco P, Quirce S. Cost-effectiveness of asthma therapy: a comprehensive review. J Asthma 2015; 52:529-37. [PMID: 25539023 DOI: 10.3109/02770903.2014.999283] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Asthma has an important impact in terms of both direct and indirect costs. In Europe, the disease costs € 19 000 million a year. Moreover, the cost is greater among patients with severe uncontrolled asthma and is even higher when the work productivity is also taken into account. Improved control of the disease results in cost savings. In this context, cost-effectiveness and cost-utility studies offer important information for clinicians in deciding the best treatment options for asthmatic patients and contribute to ensure an efficient use of the available healthcare resources. METHODS An English and Spanish literature search using electronic search engines (PubMed and EMBASE) was conducted in peer-review journals, from 2009 to June 2014. In order to perform the search for the most suitable and representative articles, key words were selected ("asthma", "cost-effectiveness", "cost-utility", "QALY", "cost-benefit", "economic impact of asthma" "healthcare cost", "asthma treatment" and "work productivity with asthma"). RESULTS Two-hundred forty-three titles and abstracts were identified by the primary literature search. The full text of the potentially 76 eligible papers was reviewed, and 22 articles were qualified to be finally included. CONCLUSIONS This article provides a comprehensive review on the evidence of cost-effectiveness of asthma treatments derived from the published literature and offers an overall summary of the socioeconomic burden of asthma and its relationship with the degree of disease control. Management alternatives, such as the use of combination therapy with ICS/LABA or omalizumab, when administered according to their current therapeutic indications, have been shown to be cost-effective.
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Affiliation(s)
- Javier Domínguez-Ortega
- a Department of Allergy , Hospital La Paz Institute for Health Research (IdiPAZ) , Madrid , Spain
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191
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Erskine SE, Notley C, Wilson AM, Philpott CM. Managing chronic rhinosinusitis and respiratory disease: a qualitative study of triggers and interactions. J Asthma 2015; 52:600-5. [PMID: 25539398 DOI: 10.3109/02770903.2014.995308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this analysis is to explore views of patients with chronic rhinosinusitis (CRS) about of the aetiology of their respiratory symptoms and the relationship between upper and lower respiratory symptoms. METHODS This study is part of a larger mixed methods study investigating the epidemiology of CRS, which comprises a questionnaire study of patients with CRS and controls and a qualitative study of 21 patients with CRS. Semi structured qualitative interviews were undertaken with these patients; 11 males and 10 females. Twelve patients had asthma. Patients were recruited with a tertiary outpatient rhinology clinic. Interviews were transcribed verbatim and analysed using thematic analysis, using Nvivo software (QSR International, Melbourne, Australia). Several important and recurring themes were highlighted. RESULTS Patients described many perceived triggering factors and an interaction between upper and lower respiratory tract symptoms. They felt that their symptoms could be managed more holistically. CONCLUSIONS Concerns about triggers of respiratory symptoms and interactions between upper and lower respiratory symptoms are of significant concern to patients. These should be appropriately managed and acknowledged in formal treatment pathways, for example, through the use of combined ENT/respiratory clinics.
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Affiliation(s)
- Sally E Erskine
- a Norwich Medical School, Norwich Research Park, University of East Anglia , Norwich , UK
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192
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de Korte-de Boer D, Mommers M, Gielkens-Sijstermans CML, Creemers HMH, Feron FJM, van Schayck OCP. Trends in wheeze in Dutch school children and the role of medication use. Pediatr Pulmonol 2015; 50:665-71. [PMID: 24995931 DOI: 10.1002/ppul.23077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 05/09/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND While the prevalence of childhood wheeze continues to increase in many countries, decreasing trends have also been reported. This may be explained by increased use of asthma medication, which effectively suppresses wheeze symptoms. In this study we investigated trends in wheeze in Dutch school children between 1989 and 2005, and their association with medication use. METHODS In five repeated cross-sectional surveys between 1989 and 2005, parents of all 5- to 6-year-old and 8- to 11-year-old children eligible for a routine physical examination were asked to complete a questionnaire on their child's respiratory health. We identified all children for whom a questionnaire was completed in two successive surveys. Children were grouped according to birth year and classified into one out of four wheeze categories: "no wheeze," "discontinued wheeze," "continued wheeze," or "new-onset wheeze." RESULTS In total, 3,339 children, born in 1983 (N = 670), 1988 (N = 607), 1992 (N = 980), and 1995 (N = 1,082), participated twice. Over the study period, the proportion of children with "no wheeze" increased from 73.8% to 86.1% (Ptrend < 0.001), while the proportion of children with "discontinued" and "continued" wheeze decreased from 13.2% to 6.3% (Ptrend < 0.001) and from 8.8% to 3.1% (Ptrend < 0.001), respectively. Medication use was consistently associated only with the presence of wheeze symptoms and this association did not change over time (Pbirth year × medication use > 0.05 for all wheeze categories). CONCLUSION An increasing trend of Dutch school children with "no wheeze," and decreasing trends of children with "discontinued" and "continued" wheeze between 1989 and 2005 could not be explained by (increased) medication use. This suggests that wheeze prevalence is not masked by medication use, but is truly declining.
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Affiliation(s)
- Dianne de Korte-de Boer
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, the Netherlands
| | - Monique Mommers
- Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, the Netherlands
| | | | | | - Frans J M Feron
- Department of Social Medicine, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, the Netherlands
| | - Onno C P van Schayck
- Department of General Practice, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, the Netherlands
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193
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Danansuriya MN, Rajapaksa LC, Weerasinghe A. Genetic, familial and environmental correlates of asthma among early adolescents in Sri Lanka: a case control study. World Allergy Organ J 2015; 8:19. [PMID: 26140077 PMCID: PMC4469255 DOI: 10.1186/s40413-015-0068-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 03/30/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite advances in management, the mortality and morbidity due to asthma are increasing globally. Identification of specific correlates in the local context is useful in disease management. The objective of this study was to estimate the prevalence and to describe selected correlates of asthma among12-14 year old school children in a district in Sri Lanka. METHOD A school based cross-sectional study was conducted using a self administered questionnaire. Multi-staged stratified cluster sampling was used to select 42 classes in grades 7, 8 and 9. "Current asthma" (CA)(case) was defined as 'having Physician Diagnosed Asthma (PDA) and having had wheezing during the previous 12 months'. For each case, two healthy controls were selected from the same class to assess correlates. Information on correlates was collected by trained field midwives during home visits. Backward stepwise logistic regression model was used for analysis of correlates. Skin Prick Testing was carried out among asthmatics together with their healthy siblings using standard extracts of House Dust Mite (HDM), cockroach and Blomia. Ethical clearance was obtained from Ethical Review Committee, Faculty of Medicine, Colombo. RESULTS Out of 1483 subjects participated, 753 were females (50.8%). The prevalence rates for current wheezing (CW), ever wheezing (EW), current asthma (CA), and physician diagnosed asthma (PDA) were 16.7%, 19.4%, 10.7% and 14.5% respectively. A total of 158 CA cases were identified. Information on correlates of asthma was collected for 145 CA cases (97.9%) and for 285 controls (96.6%). The unconfounded predictors of having CA among adolescents in the present sample were; only child in the family (OR = 4.2, 95% CI: 1.7-9.9); first born of the family (OR = 2.6 95% CI: 1.3-5.2); presence of allergic rhinitis (OR = 2.7, 95% CI: 1.6-4.6); family history of asthma (OR = 1.8, 95% CI: 1.1-3.2); family history of allergic rhinitis (OR = 1.9, 95% CI: 1.1-3.2); family history of eczema (OR = 1.8, 95% CI: 1.0-3.2). Higher risk of sensitization to cockroach, HDM and Blomia was seen among asthmatics compared to healthy siblings. CONCLUSION A significant proportion of students reported to have asthma. Atopy and other genetic and environmental correlates should be considered as important correlates in asthma management among early adolescents in Sri Lanka.
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Affiliation(s)
| | - Lalini C Rajapaksa
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anura Weerasinghe
- Medicine and Immunology Dr Neville Fernando Teaching Hospital, South Asian Institute of Medicine and Technology, Malabe, Sri Lanka
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194
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Roncada C, Dias CP, Goecks S, Cidade SEF, Pitrez PMC. [Usefulness of the WHOQOL-BREF questionnaire in assessing the quality of life of parents of children with asthma]. REVISTA PAULISTA DE PEDIATRIA 2015; 33:268-74. [PMID: 26137868 PMCID: PMC4620952 DOI: 10.1016/j.rpped.2015.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/22/2015] [Accepted: 01/23/2015] [Indexed: 11/25/2022]
Abstract
Objective:: To evaluate the quality of life (QOL) of parents of children with asthma and to
analyze the internal consistency of the generic QOL tool World Health Organization
Quality of Life, abbreviated version (WHOQOL-BREF). Methods:: We evaluated the QOL of parents of asthmatic and healthy children aged between 8
and 16, using the generic WHOQOL-BREF questionnaire. We also evaluated the
internal consistency using Cronbach's alpha (αC), in order to
determine whether the tool had good validity for the target audience. Results:: The study included 162 individuals with a mean age of 43.8±13.6 years, of which
104 were female (64.2%) and 128 were married (79.0%). When assessing the QOL, the
group of parents of healthy children had higher scores than the group of parents
of asthmatic children in the four areas evaluated by the questionnaire (Physical,
Psychological Health, Social Relationships and Environment), indicating a better
quality of life. Regarding the internal consistency of the WHOQOL-BREF, values of
˛C were 0.86 points for the group of parents of asthmatic children, and 0.88 for
the group of parents of healthy children. Conclusions:: Parents of children with asthma have impaired quality of life due to their
children's disease. Furthermore, the WHOQOL-BREF, even as a generic tool, showed
to be practical and efficient to evaluate the quality of life of parents of
asthmatic children. © 2015 Sociedade de Pediatria de São Paulo. Published by
Elsevier Editora Ltda. All rights reserved.
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Affiliation(s)
- Cristian Roncada
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.
| | | | - Suelen Goecks
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil
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195
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Barnish MS, Tagiyeva N, Devereux G, Aucott L, Turner S. Diverging prevalences and different risk factors for childhood asthma and eczema: a cross-sectional study. BMJ Open 2015; 5:e008446. [PMID: 26059525 PMCID: PMC4466692 DOI: 10.1136/bmjopen-2015-008446] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To compare the prevalences of and risk factors for asthma, wheeze, hay fever and eczema in primary schoolchildren in Aberdeen in 2014. DESIGN Cross-sectional survey. SETTING Primary schools in Aberdeen, North-East Scotland. PARTICIPANTS Children in Scottish school years primary 1-7 were handed a questionnaire by their class teacher to be completed by their parents and returned to the researchers by post or online. MAIN OUTCOME MEASURES Lifetime history of asthma, eczema and hay fever, and recent history of wheeze. RESULTS 41 schools agreed to participate (87%). 11,249 questionnaires were distributed and 3935 returned (35%). A parent-reported lifetime history of asthma, eczema and hay fever was present in 14%, 30% and 24% of children, respectively. The odds of lifetime asthma increased with age (OR 1.1 per year, 95% CI 1.1 to 1.2), male sex (OR 1.89, 95% CI 1.4 to 2.3), parental smoking (OR 1.7, 95% CI 1.2 to 2.3) and eczema (OR 6.6, 95% CI 5.2 to 8.4). Prevalence of recent wheeze was also reported to be 14% and was positively associated with male sex, parental smoking and eczema. In contrast, parental eczema was the only identified predictor of childhood eczema risk. CONCLUSIONS The lifetime prevalence of asthma in primary schoolchildren was 14% in this survey, approximately half the prevalence of eczema. We report diverging prevalences in relation to previous studies in our locality, and different risk factors for asthma and eczema. These findings suggest that asthma and eczema are unlikely to have a common origin.
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Affiliation(s)
- Maxwell S Barnish
- Epidemiology Group, University of Aberdeen, Aberdeen, UK
- Child Health, University of Aberdeen, Aberdeen, UK
| | | | | | - Lorna Aucott
- Medical Statistics Team, University of Aberdeen, Aberdeen, UK
| | - Steve Turner
- Child Health, University of Aberdeen, Aberdeen, UK
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Engelkes M, Janssens HM, de Ridder MAJ, de Jongste JC, Sturkenboom MCJM, Verhamme KMC. Time trends in the incidence, prevalence and age at diagnosis of asthma in children. Pediatr Allergy Immunol 2015; 26:367-74. [PMID: 25827225 DOI: 10.1111/pai.12376] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Current knowledge on the prevalence of asthma is mainly based on cross-sectional questionnaire data. Current population-based data on the incidence of asthma in children are scarce. OBJECTIVE To study the incidence, prevalence, and age at diagnosis of asthma in children in the Netherlands over the study period 2000-2012. METHODS A population-based cohort study was conducted in the Integrated Primary Care Information database. The cohort consisted of 176,516 children (379,536 personyears (PY) of follow-up), aged 5-18 years between 2000 and 2012. All medical records of children with physician diagnosed asthma were validated. Incidence rates, annual percent change (APC), and prevalence for asthma were calculated. Influence of age and gender on incidence rates and change in age at diagnosis were studied. RESULTS We identified an asthma cohort of 14,303 children with 35,118 PY. The overall incidence rate was 6.7/1000 PY (95% CI, 6.45-6.97). Until 2008, the incidence rate was significantly increasing (APC 5.79 (95% CI 1.43-10.34); from 2008 onwards, a non-significant decrease was observed (APC -12.16 (95% CI -23.07 to 0.28). Incidence for girls was lower than for boys, this difference decreased with increasing age. (p < 0.001) Overall, the age at diagnosis increased over calendar time and was lower for boys. (linear trend p < 0.001). CONCLUSION Our population-based cohort study observed an incidence rate of 6.7 per 1000 PY of physician-diagnosed asthma in children in the Netherlands over 2000-2012. The asthma incidence rate was increasing until 2008. Further studies are needed to confirm the decrease in asthma incidence rate from 2008 onwards.
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Affiliation(s)
- Marjolein Engelkes
- Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands
| | - Hettie M Janssens
- Department of Pediatrics, Division Respiratory Medicine and Allergology, Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands
| | | | - Johan C de Jongste
- Department of Pediatrics, Division Respiratory Medicine and Allergology, Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands
| | | | - Katia M C Verhamme
- Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands
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197
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Brozek G, Lawson J, Szumilas D, Zejda J. Increasing prevalence of asthma, respiratory symptoms, and allergic diseases: Four repeated surveys from 1993-2014. Respir Med 2015; 109:982-90. [PMID: 26153339 DOI: 10.1016/j.rmed.2015.05.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/04/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Published data shows different prevalence trends depending on the region of Europe. AIM The aim of the study was to analyze time trends of the frequency of the respiratory symptoms and allergic diseases in school children (Silesia, Poland) over the last 21 years. METHODS We compared the results of four population-based surveys performed in a town of Chorzow in 1993, 2002, 2007 and 2014 in children aged 7-10 years. All four studies had the same study protocol, recruitment (cluster, school-based sampling), questionnaire (WHO respiratory health questionnaire) and the same principal investigator The surveys included 1130 children in 1993, 1421 children in 2002, 1661 children in 2007 and 1698 in 2014. RESULTS The results covered a 21 year span and showed a statistically significant (p < 0.05) increase in the prevalence of the following physician-diagnosed disorders (1993-2002-2007-2014): asthma (3.4%-4.8%-8.6%-12,6%); allergic rhinitis (4.3%-11.9%-15.9%-13.9%); atopic dermatitis (3.6%-7.9%-12.0%-13.9%); allergic conjunctivitis (4.3%-7.9%-8.3%-7.9%); A simultaneous increasing trend (p < 0.05) in the attacks of dyspnea (3.9%-5.9%-7.0%-7.3%) and symptoms (wheeze, dyspnea, cough) induced by exercise (7.5%-10.6%-22.0%-22.4%) and - at the same time - decrease (p < 0.05) in the prevalence of cough (31.6%-19.6%15.4%-14.4%). Among children with diagnosed asthma during the 21 year span there was significantly (p < 0.05) increased proportion of treated children (51.3%-51.3%-69.5%-60.7%) and a lower frequency of presenting current symptoms. CONCLUSIONS Our findings are in line with the concept of a real increase in the occurrence of asthma and allergic disease in children. The pattern involves not only physician-diagnosed allergic diseases but also occurrence of symptoms related to respiratory disorders. Diagnosed asthma is better treated and better controlled.
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Affiliation(s)
- Grzegorz Brozek
- Department of Epidemiology, School of Medicine, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland.
| | - Joshua Lawson
- Department of Medicine and Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 2Z4, Canada.
| | - Dawid Szumilas
- Department of Epidemiology, School of Medicine, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland.
| | - Jan Zejda
- Department of Epidemiology, School of Medicine, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland.
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198
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Burns J, Mason C, Mueller N, Ohlander J, Zock JP, Drobnic F, Wolfarth B, Heinrich J, Omenaas E, Stensrud T, Nowak D, Radon K. Asthma prevalence in Olympic summer athletes and the general population: An analysis of three European countries. Respir Med 2015; 109:813-20. [PMID: 26013359 DOI: 10.1016/j.rmed.2015.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/30/2015] [Accepted: 05/03/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Some studies have shown a higher prevalence of asthma in elite athletes as compared to the general population. It is inconclusive to what extent certain sport categories are especially affected. The present study offered a unique opportunity to assess these differences in asthma prevalence in the general population and elite summer athletes from a wide range of sport disciplines across various geographical areas. METHODS Cross-sectional data for 1568 general population participants from the European Community Respiratory Health Survey II and 546 elite athletes from the Global Allergy and Asthma European Network Olympic study from three European countries were analyzed. Using logistic regression, the asthma risks associated with athlete sport practice, endurance level and aquatic sport practice, respectively, were investigated. RESULTS Athletes in the highest endurance category had increased risk of doctor-diagnosed asthma (OR 3.5; 95% CI 1.7-7.5), asthma symptoms (OR 3.0; CI 1.5-6.0) and asthma symptoms or medication use (OR 3.5; CI 1.8-6.7) compared to the general population. Aquatic athletes were at increased risk of doctor-diagnosed asthma (OR 2.0; CI 1.1-3.9), asthma symptoms (OR 2.6; CI 1.3-5.0) and asthma symptoms or medication use (OR 2.3; CI 1.2-4.4) when compared to individuals not involved in aquatic sports. Regarding the entire athlete population, no increase in asthma was found when compared to the general population. CONCLUSIONS Practice of very high endurance and aquatic sports may be associated with increased asthma risks. Athlete participation as such showed no association with asthma risk.
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Affiliation(s)
- Jacob Burns
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Ziemssenstrasse 1, Munich, Germany
| | - Catherine Mason
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Ziemssenstrasse 1, Munich, Germany
| | - Natalie Mueller
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Ziemssenstrasse 1, Munich, Germany; Centre for Research in Environmental Epidemiology (CREAL), C/ Doctor Aiguader 88, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè 10-12, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid, Spain.
| | - Johan Ohlander
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Ziemssenstrasse 1, Munich, Germany
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology (CREAL), C/ Doctor Aiguader 88, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè 10-12, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid, Spain; Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, Utrecht, The Netherlands
| | - Franchek Drobnic
- Medical Services FC Barcelona and Sport Physiology, GIRSANE CAR, Av. Alcalde Barnils 3-5, Sant Cugat del Vallès, Spain
| | - Bernd Wolfarth
- Preventive and Rehabilitative Sports Medicine, Technical University Munich (TUM), Georg-Brauchle-Ring 56-58, Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München, Ingolstädter Landstr. 1, Neuherberg, Germany
| | - Ernst Omenaas
- Centre for Clinical Research, Haukeland University Hospital, Jonas Liesvei 65, Bergen, Norway
| | - Trine Stensrud
- Norwegian School of Sport Sciences (NIH), Mailbox 4014, Ulleval Stadion, Oslo, Norway
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Ziemssenstrasse 1, Munich, Germany
| | - Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Ziemssenstrasse 1, Munich, Germany
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Lee E, Seo JB, Lee HJ, Chae EJ, Lee SM, Oh SY, Kim N. Quantitative Assessment of Global and Regional Air Trappings Using Non-Rigid Registration and Regional Specific Volume Change of Inspiratory/Expiratory CT Scans: Studies on Healthy Volunteers and Asthmatics. Korean J Radiol 2015; 16:632-40. [PMID: 25995694 PMCID: PMC4435244 DOI: 10.3348/kjr.2015.16.3.632] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 02/12/2015] [Indexed: 01/15/2023] Open
Abstract
Objective The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT. Materials and Methods Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. ΔSV, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, ΔSV0.4 and ΔSV0.5, were defined as volume fraction of lung below 0.4 and 0.5 ΔSV, respectively. To assess the gravity effect of air-trapping, ΔSV values of anterior and posterior lung at three different levels were measured and ΔSV ratio of anterior lung to posterior lung was calculated. Color-coded ΔSV map of the whole lung was generated and visually assessed. Mean ΔSV, ΔSV0.4, and ΔSV0.5 were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed. Results Mean ΔSV, ΔSV0.4, and ΔSV0.5 in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). ΔSV values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as ΔSV0.5 and ΔSV0.4, showed negative strong correlation with FEF25-75, FEV1, and FEV1/FVC. ΔSV map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%). Conclusion Quantitative assessment of ΔSV (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.
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Affiliation(s)
- Eunsol Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Joon Beom Seo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Hyun Joo Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Eun Jin Chae
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Sang Min Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Sang Young Oh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Namkug Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
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Pitter G, Ludvigsson JF, Romor P, Zanier L, Zanotti R, Simonato L, Canova C. Antibiotic exposure in the first year of life and later treated asthma, a population based birth cohort study of 143,000 children. Eur J Epidemiol 2015; 31:85-94. [PMID: 25957084 DOI: 10.1007/s10654-015-0038-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 04/25/2015] [Indexed: 12/16/2022]
Abstract
Several epidemiological studies reported an association between antibiotic consumption in the first year of life and later asthma, but results are conflicting and affected by potential biases. We examined this controversial issue in a population-based birth cohort. Using administrative data, we identified 143,163 children born in 1995-2011 in Friuli-Venezia Giulia (Italy) (median follow-up 5.25 years, 927,350 person-years). Antibiotic prescriptions in the first year of life and subsequent treated asthma (defined as ≥2 anti-asthmatic drug prescriptions within a 12-month period) were retrieved from drug prescription records. We estimated incidence rate ratios (IRR) using Poisson regression models, adjusted for perinatal variables and for hospitalizations for infections in the first year of life. We identified 34,957 new-onset asthma cases. Antibiotic consumption in the first year of life increased the risk of new-onset asthma [IRR 1.51, 95% confidence interval (CI) 1.48-1.54] with a dose-response relationship (p-trend <0.001). The risk was highest for asthma identified at 13-35 months of life (IRR 2.07, 95% CI 2.00-2.14), but remained statistically significant for asthma identified at 36-71 months (IRR 1.17, 95% CI 1.14-1.21) and at ≥72 months (IRR 1.15, 95% CI 1.08-1.22). Antibiotics increased the risk of current asthma at ≥6 years (IRR 1.35, 95% CI 1.30-1.41) and at ≥13 years of age (IRR 1.19, 95% CI 1.08-1.33). Antibiotic exposure in infancy is associated with an increased risk of asthma up to adolescence. The association detected at older ages is not explained by reverse causation; however, confounding by respiratory infections not leading to hospital admission cannot be excluded.
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Affiliation(s)
- Gisella Pitter
- Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Via Loredan, 18, 35131, Padua, Italy
| | - Jonas Filip Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177, Stockholm, Sweden.,Department of Pediatrics, Örebro University Hospital, 70185, Örebro, Örebro, Sweden
| | - Pierantonio Romor
- Friuli-Venezia Giulia Regional Health Information System, Informatica per il Sistema degli Enti Locali (INSIEL) S.p.A., Udine, Italy
| | - Loris Zanier
- Epidemiological Service, Health Directorate, Friuli Venezia-Giulia Region, Udine, Italy
| | - Renzo Zanotti
- Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Via Loredan, 18, 35131, Padua, Italy
| | - Lorenzo Simonato
- Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Via Loredan, 18, 35131, Padua, Italy
| | - Cristina Canova
- Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Via Loredan, 18, 35131, Padua, Italy.
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