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MAIEREAN A, CIUMARNEAN L, ALEXESCU TG, DOMOKOS B, RAJNOVEANU R, ARGHIR O, TODEA D, BUZOIANU AD, DOGARU G, BORDEA RI. Complementary therapeutic approaches in asthma. BALNEO RESEARCH JOURNAL 2019. [DOI: 10.12680/balneo.2019.258] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Asthma is defined by The Initiative for Asthma (GINA 2018) as a heterogeneous disease, which include chronic airway inflammation and a history of respiratory symptoms. In the last decades asthma had a rise in prevalence, becoming one of the most frequent diagnosed diseases in the world. The main goals of asthma management are to achieve good symptom control, minimize the risks of exacerbations, decrease rescue medication intake, improve the quality of life by decreasing respiratory system inflammation and ameliorating the patient’s lung function. Beside effective medications, asthma continues to impair quality of life for most patients. Due to the difficulty of controlling symptoms and exacerbations, the need of developing complementary options of treatment is increasing in order to achieve an optimum control and a lower risk of acute episodes or fatal events. Pulmonary rehabilitation is suggested for asthma patients when adequate medical therapy poorly control the symptoms and mental, physical or social consequences of illness persist during the daily life. The following non-drug therapy components are included in the rehabilitation program: physical training, comprehensive smoking cessation program, comprehensive patient education, respiratory physiotherapy, psychosocial support and comprehensive nutritional counseling. These complementary therapies have been proven to improve muscle strength, exercise capacity and symptomatology. Also, it has been associated to fewer exacerbations and a lower use of rescue medication, leading to a better quality of life. Key words: asthma, quality of life, symptomatology, rehabilitation, physiotherapy,
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Affiliation(s)
- Anca MAIEREAN
- 1. „Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Lorena CIUMARNEAN
- „Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Internal Medicine, Cluj Napoca, Romania
| | - Teodora Gabriela ALEXESCU
- „Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Internal Medicine, Cluj Napoca, Romania
| | - Bianca DOMOKOS
- ”Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Pneumology, Cluj Napoca, Romania
| | - Ruxandra RAJNOVEANU
- ”Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Pneumology, Cluj Napoca, Romania
| | - Oana ARGHIR
- “Ovidius” University from Constanta, Romania
| | - Doina TODEA
- ”Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Pneumology, Cluj Napoca, Romania
| | - Anca Dana BUZOIANU
- „Iuliu Hatieganu” University of Medicine and Pharmacy, Department of Pharmacology, Cluj Napoca, Romania
| | - Gabriela DOGARU
- „Iuliu Hatieganu” University of Medicine and Pharmacy, Medical Rehabilitation Department, Cluj Napoca, Romania
| | - Roxana Ioana BORDEA
- „Iuliu Hatieganu” University of Medicine and Pharmacy, Dentistry Faculty, Cluj Napoca, Romania
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Al Ghamdi BR, Koshak EA, Ageely HM, Omer FM, Awadalla NJ, Mahfouz AA. Prevalence and factors associated with adult bronchial asthma in Aseer region, Southwestern Saudi Arabia. Ann Thorac Med 2019; 14:278-284. [PMID: 31620212 PMCID: PMC6784440 DOI: 10.4103/atm.atm_67_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Bronchial asthma (BA) is one of the most common chronic respiratory diseases in Saudi Arabia (SA). Most of the studies investigating the prevalence of BA in SA have focused on children and its exact prevalence in adults is unknown. OBJECTIVES: The objective of this study is tto investigate the prevalence and factors associated with adult BA in Aseer region, southwestern SA. METHODS: A cross-sectional study was conducted on a representative sample of adults who attended primary health care centers. A validated Arabic version of the International Study of Asthma and Allergies in Childhood questionnaire was used. The presence of wheeze in the past 12 months was used as a proxy for BA. RESULTS: The study included 960 adults. The prevalence rate of BA was 19.2% (95% confidence interval [CI]: 16.72–21.80). In a multivariable analysis, the following factors were significantly associated with BA in adults; living in low-altitude areas (adjusted odds ratio [aOR] = 1.51, 95% CI: 1.04–2.21), being in rural areas (aOR = 1.58, 95% CI: 1.12–2.23), using analgesics (aOR = 1.52, 95% CI: 1.06–2.20), residing near heavy trucks traffics (aOR = 1.67, 95% CI: 1.13–2.46), having cats in the house (aOR = 2.27, 95% CI: 1.30–5.94), and being aged 55–64-year-old (aOR = 1.94, 95% CI: 1.02–3.69). CONCLUSION: The prevalence of BA was high, affecting one-fifth of adults in Aseer region. The study revealed some modifiable factors significantly associated with BA in adults. There is a need to improve asthma control programs at the primary health-care level, particularly at rural and at low-altitude areas, and more focus should address the elders. In addition, enhancing community-based health promotion programs tackling the identified modifiable factors of BA are required.
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Affiliation(s)
- Badr Rashed Al Ghamdi
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Emad Abdulkadir Koshak
- Department of Internal Medicine, College of Medicine, King Abdul Aziz University, Jeddah, Saudi Arabia
| | | | - Fakhreldin Mohamed Omer
- Department of Clinical Microbiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Nabil Joseph Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.,Department of Community Medicine, College of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.,Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Duenas-Meza E, Torres-Duque CA, Correa-Vera E, Suárez M, Vásquez C, Jurado J, Del Socorro Medina M, Barón O, Pareja-Zabala MJ, Giraldo-Cadavid LF. High prevalence of house dust mite sensitization in children with severe asthma living at high altitude in a tropical country. Pediatr Pulmonol 2018; 53:1356-1361. [PMID: 29938928 DOI: 10.1002/ppul.24079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/06/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Some studies, mainly in Europe, have shown a low level of sensitization to house dust mite (HDM) allergens at high altitude (HA). Differently, some others in tropical countries have shown a higher level. The aim of this study was to evaluate allergens sensitization, including HDM, in children with severe asthma (SA), residents at HA in a tropical middle-income developing country. METHODS Observational, analytical, cross-sectional study in children aged 6-15 years old with SA at HA (2640 m). Skin prick tests (SPT), serum IgE, exhaled fraction of nitric oxide (FENO ), spirometry, and asthma questionnaire (ACT) were performed. Associations were explored by Pearson or Spearman coefficients. RESULTS We included 61 children. Most patients were male (61.3%), median age: 10 years (Interquartile range [IQR]: 8-12), median BMI: 17 kg/m2 (IQR: 16-20); Median of positive SPT: 2 (IQR: 2-3). At least one SPT was positive in 88.7% of patients and 87.9% were positive for at least one HDM. Serum IgE: 348 UI/mL (IQR: 154-760) and FENO : 22 ppb (IQR: 9-41). Prebronchodilator values were (% predicted): FVC: 109.7% (±15.5%), FEV1 : 98.4% (±16.3); FEV1 /FVC: 82% (±8%). SPT were inversely correlated with the FEV1 /FVC (Rho: -0.34; 95% CI: -0.55 a -0.09; P = 0.008). CONCLUSIONS These children with SA living at HA in a tropical middle-income developing country have a high prevalence of HDM sensitization. One explanation for this might be that tropical conditions, such as temperature and humidity, could modify the effect of the altitude on asthma.
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Affiliation(s)
- Elida Duenas-Meza
- Pediatric Pulmonology Section, Fundación Neumológica Colombiana, Bogotá, Colombia.,Research Department, Fundación Neumológica Colombiana, Bogotá, Colombia.,Universidad de La Sabana, Bogotá, Colombia
| | - Carlos A Torres-Duque
- Research Department, Fundación Neumológica Colombiana, Bogotá, Colombia.,Universidad de La Sabana, Bogotá, Colombia
| | | | - Miguel Suárez
- Pediatric Pulmonology Section, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Catalina Vásquez
- Pediatric Pulmonology Section, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Jenny Jurado
- Pediatric Pulmonology Section, Fundación Neumológica Colombiana, Bogotá, Colombia
| | | | - Oscar Barón
- Pediatric Pulmonology Section, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - María J Pareja-Zabala
- Research Department, Fundación Neumológica Colombiana, Bogotá, Colombia.,Universidad de La Sabana, Bogotá, Colombia
| | - Luis F Giraldo-Cadavid
- Research Department, Fundación Neumológica Colombiana, Bogotá, Colombia.,Universidad de La Sabana, Bogotá, Colombia
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Grafetstätter C, Prossegger J, Braunschmid H, Sanovic R, Hahne P, Pichler C, Thalhamer J, Hartl A. No Concentration Decrease of House Dust Mite Allergens With Rising Altitude in Alpine Regions. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2016; 8:312-8. [PMID: 27126724 PMCID: PMC4853508 DOI: 10.4168/aair.2016.8.4.312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 10/09/2015] [Accepted: 11/06/2015] [Indexed: 11/20/2022]
Abstract
Purpose Several studies over the past 4 decades have indicated a significant reduction in house dust mite (HDM) and HDM allergen concentration in areas higher than 1,500 m above sea level. These have served as basis of allergen avoidance therapies for HDM allergy and asthma. However, modern construction techniques used in the insulation, heating, and glazing of buildings as well as global warming have changed the environmental parameters for HDM living conditions. The present study revisits the paradigm of decreasing HDM allergen concentrations with increasing altitude in the alpine region of Germany and Austria. Methods A total of 122 dust samples from different abodes (hotels, privates and mountain huts) at different altitudes (400-2,600 m) were taken, and concentrations of HDM allergens were analyzed. Humidity and temperature conditions, and numerous indoor environmental parameters such as fine dust, type of flooring, age of building, and frequency of cleaning were determined. Results HDM allergen concentrations did not significantly change with increasing altitude or relative humidity. At the level of indoor parameters, correlations could be found for different flooring types and the concentration of HDM allergens. Conclusions In contrast to the widespread view of the relationship between altitude and HDM allergen concentrations, clinically relevant concentrations of HDM allergens could be detected in high-lying alpine regions in Austria and Germany. These results indicate that improvement in conditions of asthmatic patients sensitized against HDMs during a stay at high altitude can no longer be ascribed to decreased levels of HDM allergens, instead, other mechanisms may trigger the beneficial effect.
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Affiliation(s)
| | - Johanna Prossegger
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Renata Sanovic
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
| | - Penelope Hahne
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | - Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | - Josef Thalhamer
- Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria.
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Gaisberger M, Šanović R, Dobias H, Kolarž P, Moder A, Thalhamer J, Selimović A, Huttegger I, Ritter M, Hartl A. Effects of ionized waterfall aerosol on pediatric allergic asthma. J Asthma 2012; 49:830-8. [PMID: 22861198 DOI: 10.3109/02770903.2012.705408] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Ionized water aerosols have been suggested to exert beneficial health effects on pediatric allergic asthma. Their effect was evaluated in a randomized controlled clinical trial as part of a summer asthma camp. METHODS Asthmatic allergic children (n = 54) spent 3 weeks in an alpine asthma camp; half of the group was exposed to water aerosol of an alpine waterfall for 1 hour per day, whereas the other half spent the same time at a "control site". Immunological analysis, lung function testing, and fractional exhaled nitric oxide (FeNO) testing were performed during the stay, and sustaining effects were evaluated 2 months later. Symptom score testing was done over a period of 140 days. RESULTS The water aerosol group showed a significant improvement in all lung function parameters, whereas only the peak expiratory flow improved in the control group. All patients showed a significant improvement in symptom score and a significant decrease in FeNO after the camp. Only the water aerosol group exhibited a long-lasting effect on asthma symptoms, lung function, and inflammation in the follow-up examination. Induction of interleukin (IL)-10 and regulatory T (Treg) cells was measured in both groups, with a pronounced increase in the water aerosol group. IL-13 was significantly decreased in both groups, whereas IL-5 and eosinophil cationic protein were decreased only in the water aerosol group. CONCLUSIONS Our findings confirm the induction of Treg cells and reduction in inflammation by climate therapy. They indicate a synergistic effect of water aerosols resulting in a long-lasting beneficial effect on asthma symptoms, lung function, and airway inflammation.
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Affiliation(s)
- Martin Gaisberger
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
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