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Kaulamo JT, Lätti AM, Koskela HO. Recurrent Cough in the Elderly: A Forgotten Entity. Lung 2023; 201:545-553. [PMID: 37964136 PMCID: PMC10673973 DOI: 10.1007/s00408-023-00654-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/28/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Recurrent cough is little researched in adults. We investigated the prevalence, risk factors, and consequences of recurrent cough, and compared the results to those of isolated chronic cough. METHODS Cross-sectional email survey in an elderly community-based population. Recurrent cough was defined as ≥ 3 cough episodes within one year (each lasting ≥ 1 week) and no current chronic cough. Isolated chronic cough was defined as current cough lasting ≥ 8 weeks and no recurrent cough. RESULTS The prevalence of recurrent cough was 3.8% among all respondents (n = 5983). Recurrent cough was associated with asthma (aOR 3.32 (95% CI 2.13-5.18)), chronic rhinosinusitis (2.91 (1.89-4.46)), family history of chronic cough (2.59 (1.88-3.56)), analgesic intolerance (2.13 (1.27-3.57)), male gender (1.92 (1.39-2.66)), gastro-esophageal reflux disease (1.73 (1.21-2.47)), obstructive sleep apnoea (1.69 (1.23-2.32)), symptom sum (1.12 per symptom (1.03-1.22)), and younger age (0.96 per year (0.93-1.00)). Isolated chronic cough was associated with chronic rhinosinusitis (3.45 (2.39-4.97)), asthma (2.17 (1.38-3.41), gastro-esophageal reflux disease (1.80 (1.32-2.47)), family history of chronic cough (1.80 (1.35-2.41)), obstructive sleep apnoea (1.49 (1.12-2.00)), symptom sum (1.18 per symptom (1.10-1.27)), and body mass index (0.96 per unit (0.93-1.00)). Among subjects with recurrent and isolated chronic cough, the prevalence of depressive symptoms were 7.7% and 4.2%, p = 0.11, the Leicester Cough Questionnaire total scores 15.2 (14.6-15.8) and 16.3 (16.0-16.6), P = 0.001, and the mean number of yearly cough-related doctor`s visits 0.58 (0.45-0.71) and 0.36 (0.19-0.53), P = 0.007, respectively. CONCLUSION The risk factors and consequences of recurrent and isolated chronic cough were comparable. Recurrent cough seems beneficial to address in cough evaluation.
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Affiliation(s)
- Johanna Tuulikki Kaulamo
- School of Medicine, Institute of Clinical Sciences, Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
- Mehiläinen Terveyspalvelut Oy, Healthcare Services for Prisoners, Kauppakatu 39A, 70100, Kuopio, Finland.
| | - Anne Marika Lätti
- School of Medicine, Institute of Clinical Sciences, Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland
- Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, PL 100, 70029, Kuopio, Finland
| | - Heikki Olavi Koskela
- School of Medicine, Institute of Clinical Sciences, Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland
- Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, PL 100, 70029, Kuopio, Finland
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Chang EH, Pouladi N, Guerra S, Jandova J, Kim A, Li H, Li J, Morgan W, Stern DA, Willis AL, Lussier YA, Martinez FD. Epithelial cell responses to rhinovirus identify an early-life-onset asthma phenotype in adults. J Allergy Clin Immunol 2022; 150:604-611. [PMID: 35367470 PMCID: PMC9463086 DOI: 10.1016/j.jaci.2022.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/15/2022] [Accepted: 03/24/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The study of pathogenic mechanisms in adult asthma is often marred by a lack of precise information about the natural history of the disease. Children who have persistent wheezing (PW) during the first 6 years of life and whose symptoms start before age 3 years (PW+) are much more likely to have wheezing illnesses due to rhinovirus (RV) in infancy and to have asthma into adult life than are those who do not have PW (PW-). OBJECTIVE Our aim was to determine whether nasal epithelial cells from PW+ asthmatic adults as compared with cells from PW- asthmatic adults show distinct biomechanistic processes activated by RV exposure. METHODS Air-liquid interface cultures derived from nasal epithelial cells of 36-year old participants with active asthma with and without a history of PW in childhood (10 PW+ participants and 20 PW- participants) from the Tucson Children's Respiratory Study were challenged with a human RV-A strain (RV-A16) or control, and their RNA was sequenced. RESULTS A total of 35 differentially expressed genes involved in extracellular remodeling and angiogenesis distinguished the PW+ group from the PW- group at baseline and after RV-A stimulation. Notably, 22 transcriptomic pathways showed PW-by-RV interactions; the pathways were invariably overactivated in PW+ patients, and were involved in Toll-like receptor- and cytokine-mediated responses, remodeling, and angiogenic processes. CONCLUSIONS Asthmatic adults with a history of persistent wheeze in the first 6 years of life have specific biomolecular alterations in response to RV-A that are not present in patients without such a history. Targeting these mechanisms may slow the progression of asthma in these patients.
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Affiliation(s)
- Eugene H Chang
- Department of Otolaryngology, University of Arizona, Tucson, Arizona
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Nima Pouladi
- Department of Biomedical Informatics, The University of Utah School of Medicine, Salt Lake City, UT
| | - Stefano Guerra
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Jana Jandova
- Department of Otolaryngology, University of Arizona, Tucson, Arizona
| | - Alexander Kim
- Department of Otolaryngology, University of Arizona, Tucson, Arizona
| | - Haiquan Li
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Jianrong Li
- Department of Biomedical Informatics, The University of Utah School of Medicine, Salt Lake City, UT
| | - Wayne Morgan
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Debra A Stern
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
| | - Amanda L Willis
- Department of Otolaryngology, University of Arizona, Tucson, Arizona
| | - Yves A. Lussier
- Department of Biomedical Informatics, The University of Utah School of Medicine, Salt Lake City, UT
| | - Fernando D Martinez
- College of Medicine, University of Arizona, Tucson, Arizona
- Asthma / Airway Disease Research Center, University of Arizona, Tucson, Arizona
- The University of Arizona BIO5 Institute, University of Arizona, Tucson, Arizona
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Mulatu T, Yimer NB, Alemnew B, Linger M, Liben ML. Exclusive breastfeeding lowers the odds of childhood diarrhea and other medical conditions: evidence from the 2016 Ethiopian demographic and health survey. Ital J Pediatr 2021; 47:166. [PMID: 34344434 PMCID: PMC8335997 DOI: 10.1186/s13052-021-01115-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/14/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Lack of exclusive breastfeeding during the first 6 months of infant life contributes to childhood morbidity and mortality. This study aimed to investigate the association of exclusive breastfeeding and childhood illnesses in Ethiopia. METHODS A secondary data analysis was conducted using data from the 2016 Ethiopian Demographic and Health Survey (EDHS). Descriptive and multivariable logistic regression analyses were carried out. RESULTS A total of 1034 mother-infant pairs were included in the analysis. The overall magnitude of exclusive breastfeeding among infants aged under 6 months was 87.6% (95% CI: 84.3-90.3%). Compared to infants who were non-exclusively breastfed, the odds of having an illness with fever in the last 2 weeks among infants who were exclusively breastfed decreased by 66% (AOR: 0.34; 95% CI: 0.16, 0.75). Similarly, exclusively breastfed infants had lower odds of having an illness with a cough (AOR: 0.38; CI: 0.20, 0.72) and having diarrhea (AOR: 0.33; CI: 0.13, 0.83) compared to non-exclusively breastfed infants. CONCLUSION Exclusive breastfeeding lowers the odds of an illness with fever, illness with cough and diarrhea. The findings of this study implicate the need for promotion of exclusive breastfeeding in the country.
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Affiliation(s)
- Tesfahun Mulatu
- School of Public Health, College of Health Science, Woldia University, P.o.box: 400, Woldia University, Weldiya, Amhara, Ethiopia
| | - Nigus Bililign Yimer
- School of Midwifery, College of Health Science, Woldia University, Weldiya, Amhara, Ethiopia
| | - Birhan Alemnew
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Weldiya, Amhara, Ethiopia
| | - Melese Linger
- School of Public Health, College of Health Science, Woldia University, P.o.box: 400, Woldia University, Weldiya, Amhara, Ethiopia
| | - Misgan Legesse Liben
- School of Public Health, College of Health Science, Woldia University, P.o.box: 400, Woldia University, Weldiya, Amhara, Ethiopia.
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Johnston EJ, Campbell K, Coleman T, Lewis S, Orton S, Cooper S. Safety of Electronic Cigarette Use During Breastfeeding: Qualitative Study Using Online Forum Discussions. J Med Internet Res 2019; 21:e11506. [PMID: 31407672 PMCID: PMC6709563 DOI: 10.2196/11506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/15/2019] [Accepted: 03/05/2019] [Indexed: 01/19/2023] Open
Abstract
Background Electronic cigarettes (e-cigs) are an increasingly popular alternative to smoking, helping to prevent relapse in those trying to quit and with the potential to reduce harm as they are likely to be safer than standard cigarettes. Many women return to smoking in the postpartum period having stopped during pregnancy, and while this can affect their decisions about breastfeeding, little is known about women’s opinions on using e-cigs during this period. Objective The aim of this study is to explore online forum users’ current attitudes, motivations, and barriers to postpartum e-cig use, particularly as a breastfeeding mother. Methods Data were collected via publicly accessible (identified by Google search) online forum discussions, and a priori codes identified. All transcripts were entered into NVivo for analysis, with a template approach to thematic analysis being used to code all transcripts from which themes were derived. Results Four themes were identified: use, perceived risk, social support and evidence, with a number of subthemes identified within these. Women were using e-cigs to prevent postpartum return to smoking, but opinions on their safety were conflicting. They were concerned about possible transfer of harmful products from e-cigs via breastmilk and secondhand exposure, so they were actively seeking and sharing information on e-cigs from a variety of sources. Although some women were supportive of e-cig use, others provided harsh judgement for mothers who used them. Conclusions E-cigs have the potential to reduce the number of women who return to smoking in the postpartum period and potentially improve breastfeeding rates, if breastfeeding mothers have access to relevant and reliable information. Health care providers should consider discussing e-cigs with mothers at risk of returning to smoking in the postpartum period.
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Affiliation(s)
- Emily Jade Johnston
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Katarzyna Campbell
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Tim Coleman
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Sarah Lewis
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Sophie Orton
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Sue Cooper
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Abstract
PURPOSE OF REVIEW Microbiota consist of symbiotic microscopic neighbors that interact on and within our bodies in diverse and incompletely understood ways throughout our lifetime. Though various associations with allergic disease have been described, clear effective therapeutic interventions to prevent allergy have been elusive. RECENT FINDINGS The human microbiome is influenced by multiple factors, including: mode of infant delivery (vaginal vs. cesarean section), breastfeeding, diet, presence of siblings and pets, exposure to antibiotics and other medications (particularly antacids), lifestyle, and developmental context. Microbial species promoting atopic responses and tolerance have been described. Specific microbiota likely act through distinct metabolic pathways to promote the health of their human hosts, optimally directing the developing immune system away from pro-allergic, Th2-dominated responses to more T-regulatory-influenced behaviors. SUMMARY Evidence suggests that specific healthy infant microbiome signatures may influence development of some components of the allergic march of childhood by decreasing atopic dermatitis, asthma, and food allergy. Further understanding of factors that influence healthy microbiota may lead to specific strategies tailored for early intervention and disease prevention.
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Carr TF, Stern DA, Halonen M, Wright AL, Martinez FD. Non-atopic rhinitis at age 6 is associated with subsequent development of asthma. Clin Exp Allergy 2018; 49:35-43. [PMID: 30220097 DOI: 10.1111/cea.13276] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/24/2018] [Accepted: 09/01/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND It has been postulated that the association between allergic rhinitis and asthma is attributable to the progressive clinical expression of respiratory inflammation during childhood. The role of non-allergic rhinitis in early life in relation to subsequent asthma has not been extensively explored. OBJECTIVE We sought to determine whether rhinitis in early life was associated with risk of asthma development into adulthood, and whether this relationship is independent of allergic sensitization. METHODS Participants were identified from the Tucson Children's Respiratory Study, a non-selected birth cohort. Allergy skin prick testing was performed at age 6 years using house dust mix, Bermuda, mesquite, olive, mulberry, careless weed, and Alternaria aeroallergens. Atopy was defined as ≥1 positive tests. Physician-diagnosed active asthma from age 6 to 32 and physician-diagnosed rhinitis at age 6 were determined by questionnaire. Participants with asthma or active wheezing at age 6 were excluded from analyses. Risk estimates were obtained with Cox regression. RESULTS There were 521 participants who met inclusion criteria. The hazard ratio for subsequently acquiring a diagnosis of asthma between the ages of 8 and 32 for those with non-atopic rhinitis was 2.1 (95% CI: 1.2, 3.4, P = 0.005), compared with the non-atopic no rhinitis group, after adjusting for sex, ethnicity, maternal asthma, maternal education and smoking, and history of 4+ colds per year at age 6. Among the atopic participants, both the active and no rhinitis groups were more likely to develop and have asthma through age 32. The relation between non-atopic rhinitis and asthma was independent of total serum IgE levels at age 6. CONCLUSION AND CLINICAL RELEVANCE Childhood rhinitis, even in the absence of atopy, confers significant risk for asthma development through adulthood. These findings underscore the importance of non-allergic mechanisms in the development of asthma.
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Affiliation(s)
- Tara F Carr
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Debra A Stern
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Marilyn Halonen
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Anne L Wright
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona
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Forno E. Breast feeding in infancy and recurrent cough in adulthood: the longer the better? Thorax 2018; 73:801-802. [PMID: 29804091 DOI: 10.1136/thoraxjnl-2018-211871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 11/04/2022]
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