Childhood asthma and chronic obstructive pulmonary disease: outcomes until the age of 50

Association between Asthma and Oral Health Symptoms in Adolescents

Oral health is an indicator of patients' overall quality of life. Poor oral health among adolescents with asthma can affect their health in adulthood. This study researched the association between asthma and oral health symptoms in South Korean adolescents. Data from the 2020 Korea Youth Risk Behavior Web-based Survey were used. A total of 44,940 students participated in this study. The dependent variables were self-reported oral health symptoms. Asthma was the primary independent variable based on diagnosis in the past 12 months. The chi-squared test and multivariable logistic regression analysis were used. Students with asthma were associated with oral health symptoms, compared with those without asthma (boys, odds ratio (OR): 1.29, 95% confidence interval (CI) = 1.01-1.66; girls, OR: 1.94, 95% CI = 1.40-2.69). Poor health habits, such as low physical activity, higher sweetened beverage consumption, and fewer sleeping hours, were associated with oral health symptoms. Students who did not receive asthma treatment also had higher oral health symptoms (boys, OR: 1.29, 95% CI = 1.13-1.48, girls, OR: 1.34, 95% CI = 1.15-1.57). Students with absence due to asthma had a higher risk of oral health than those without asthma (boys, OR: 1.31, 95% CI = 1.17-1.46, girls OR: 1.28, 95% CI = 1.12-1.46). Students with asthma had a high risk of poor oral health among South Korean adolescents, suggesting more attention be given to regular dental check-ups and maintaining oral hygiene.

A Suggested Approach for Management of Pediatric Asthma During the COVID-19 Pandemic

Asthma is a prevalent pediatric disease causing important health, economic, and emotional burdens around the world. Asthma attacks can be controlled with standardized management, but no cure exists for the disease. Many attacks are triggered by respiratory tract infections and children with basic airway diseases are at high risk for developing severe or critical illnesses. The new COVID-19 pandemic threatens to disrupt children's asthma control management and we have set out to summarize the main factors that need to be considered by pediatricians treating children with asthma at times like these. We discuss the intrinsic nature of asthma and its treatment, and the effects of irregular treatment giving recommendations such as the use of the WeChat platform and WeChat Official Accounts for follow-ups to improve children's asthma compliance during the pandemic. We also cover the COVID-19 protection strategies, and the importance of stress reduction, a balanced diet, exercise, and the avoidance of known attack triggers for maintaining good control of asthma during the pandemic.

Association between early history of asthma and COPD diagnosis in later life: a systematic review and meta-analysis

Background

Whereas most studies have reported prior history/diagnosis of asthma as an independent risk factor for chronic obstructive pulmonary disease (COPD) development in later life, no systematic review and meta-analysis has been conducted to synthesize these observational studies. The aim of this review is to investigate associations between prior history of asthma and later development of COPD.

Methods

We conducted a comprehensive search in PubMed, CINAHL and EMBASE for studies related to prior history of asthma and COPD diagnosis. Articles were screened for relevance by two independent reviewers. Methodological quality was independently assessed and data extracted for qualitative and quantitative review. We explored heterogeneity and performed a publication bias check.

Results

From the 1260 articles retrieved, 9 were included in the qualitative review and 7 in the meta-analysis. History of asthma was associated with developing COPD in later life (Inverse Variance Random-effects model, odds ratio: 7.87, 95% confidence interval: 5.40-11.45, p < 0.00001).

Conclusions

Studies with high methodological quality provided sufficient evidence to suggest that individuals with previous history of asthma have an increasing likelihood of developing COPD in later life.

Childhood Lung Function Predicts Adult Chronic Obstructive Pulmonary Disease and Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome

RATIONALE

The burden of chronic obstructive pulmonary disease (COPD) is increasing, yet there are limited data on early life risk factors.

OBJECTIVES

To investigate the role of childhood lung function in adult COPD phenotypes.

METHODS

Prebronchodilator spirometry was performed for a cohort of 7-year-old Tasmanian children (n = 8,583) in 1968 who were resurveyed at 45 years, and a selected subsample (n = 1,389) underwent prebronchodilator and post-bronchodilator spirometry. For this analysis, COPD was spirometrically defined as a post-bronchodilator FEV₁/FVC less than the lower limit of normal. Asthma-COPD overlap syndrome (ACOS) was defined as the coexistence of both COPD and current asthma. Associations between childhood lung function and asthma/COPD/ACOS were examined using multinomial regression.

MEASUREMENTS AND MAIN RESULTS

At 45 years, 959 participants had neither current asthma nor COPD (unaffected), 269 had current asthma alone, 59 had COPD alone, and 68 had ACOS. The reweighted prevalence of asthma alone was 13.5%, COPD alone 4.1%, and ACOS 2.9%. The lowest quartile of FEV₁ at 7 years was associated with ACOS (odds ratio, 2.93; 95% confidence interval, 1.32-6.52), but not COPD or asthma alone. The lowest quartile of FEV₁/FVC ratio at 7 years was associated with ACOS (odds ratio, 16.3; 95% confidence interval, 4.7-55.9) and COPD (odds ratio, 5.76; 95% confidence interval, 1.9-17.4), but not asthma alone.

CONCLUSIONS

Being in the lowest quartile for lung function at age 7 may have long-term consequences for the development of COPD and ACOS by middle age. Screening of lung function in school age children may identify a high-risk group that could be targeted for intervention. Further research is needed to understand possible modifiers of these associations and develop interventions for children with impaired lung function.

Childhood asthma is a risk factor for the development of chronic obstructive pulmonary disease

PURPOSE OF REVIEW

This review will catalog the many recent longitudinal studies that have investigated the relationship between asthma and lung function, or the persistence and trajectories of lung function deficits.

RECENT FINDINGS

Recent work has reported on 50-year follow-ups of some prominent population cohorts. A history of asthma confers a 10-30-fold risk of chronic obstructive pulmonary disease. Individuals reaching a reduced maximum growth of forced expiratory volume in 1 s in early adulthood are at risk for early or more severe chronic obstructive pulmonary disease (COPD).

SUMMARY

Taken together, there is a wealth of overlapping cohort studies of lung function, asthma and COPD. These show that asthma is associated with reduced lung function, which may start in infancy or prenatally, persists through childhood and adulthood and predisposes for early or more severe COPD.

Baby Boomers and Birth Certificates: Early-Life Socioeconomic Status and Cancer Risk in Adulthood

BACKGROUND

Early-life socioeconomic status (SES) may play a role in cancer risk in adulthood. However, measuring SES retrospectively presents challenges. Parental occupation on the birth certificate is a novel method of ascertaining early-life SES that has not been applied in cancer epidemiology.

METHODS

For a Baby-Boom cohort born from 1945-1959 in two Utah counties, individual-level Nam-Powers SES (Np-SES) was derived from parental industry/occupation reported on birth certificates. Neighborhood SES was estimated from average household income of census tract at birth. Cancer incidence was determined by linkage to Utah Cancer Registry records through the Utah Population Database. Hazard ratios (HR) for cancer risk by SES quartile were estimated using Cox proportional hazards regression.

RESULTS

Females with low Np-SES at birth had lower risk of breast cancer compared with those in the highest Np-SES group [HR_Q1/Q4 = 0.83; 95% confidence interval (CI), 0.72-0.97; HR_Q2/Q4 = 0.81; 95% CI, 0.69-0.96]. Np-SES was inversely associated with melanoma (HR_Q1/Q4 = 0.81; 95% CI, 0.67-0.98) and prostate cancer (HR_Q1/Q4 = 0.70; 95% CI, 0.56-0.88). Women born into lower SES neighborhoods had significantly increased risk for invasive cervical cancer (HR_Q1/Q4 = 1.44; 95% CI, 1.12-1.85; HR_Q2/Q4 = 1.33; 95% CI, 1.04-1.72). Neighborhood SES had similar effects for melanoma and prostate cancers, but was not associated with female breast cancer. We found no association with SES for pancreas, lung, and colon and rectal cancers.

CONCLUSIONS

Individual SES derived from parental occupation at birth was associated with altered risk for several cancer sites.

IMPACT

This novel methodology can contribute to improved understanding of the role of early-life SES on cancer risk. Cancer Epidemiol Biomarkers Prev; 26(1); 75-84. ©2016 AACR.

Diagnosis and investigation in the severe asthma clinic

Severe asthma is recognised as an important and emerging area of unmet need in asthma. The assessment of severe asthma should include three steps; (1) determining the diagnosis of asthma, including verification that the disease is severe asthma, (2) assessing comorbidities and contributing factors that will impact on clinical severity, as well as (3) assessing asthma phenotypes. These steps recognize the importance of heterogeneity in asthma as a key factor that determines the disease course and increasingly the choice of successful therapy. This assessment should be undertaken systematically and is best done by an expert multidisciplinary team. Here, we will outline the important aspects that should be included in the clinical assessment of the patient in the severe asthma clinic, including diagnosis, clinical history, the assessment of important comorbidities and the key investigations needed to support them.