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Asthma, spirometry in children

Christian Bime, Joe K Gerald, Christine Y Wei, Janet T Holbrook, William G Teague, Robert A Wise, Lynn B Gerald
The childhood Asthma-Control Test (C-ACT) is validated for assessing asthma control in paediatric asthma. Among children aged 4-11 years, the C-ACT requires the simultaneous presence of both parent and child. There is an unmet need for a tool that can be used to assess asthma control in children when parents or caregivers are not present such as in the school setting. We assessed the psychometric properties and estimated the minimally important difference (MID) of the C-ACT and a modified version, comprising only the child responses (C-ACTc)...
October 20, 2016: NPJ Primary Care Respiratory Medicine
C Gonçalves, G Wandalsen, F Lanza, A L Goulart, D Solé, A Dos Santos
BACKGROUND: Prevalence of allergic diseases and impaired pulmonary function may be high in children born prematurely. This study aimed to assess pulmonary function and prevalence of asthma, atopic diseases and allergic sensitisation in these patients. METHODS: A cross-sectional study was conducted with children aged 6-14 years who were born prematurely with birth weight <2000g from January 2008 to May 2011. Exclusion criteria were: major malformations, or acute respiratory disorders...
October 15, 2016: Allergologia et Immunopathologia
Engi F Attia, Robert F Miller, Rashida A Ferrand
PURPOSE OF REVIEW: The incidence of pulmonary infections has declined dramatically with improved access to antiretroviral therapy (ART) and cotrimoxazole prophylaxis, but chronic lung disease (CLD) is an increasingly recognized but poorly understood complication in adolescents with perinatally acquired HIV. RECENT FINDINGS: There is a high prevalence of chronic respiratory symptoms, abnormal spirometry and chest radiographic abnormalities among HIV-infected adolescents in sub-Saharan Africa, wherein 90% of the world's HIV-infected children live...
October 7, 2016: Current Opinion in Infectious Diseases
Edith Chen, Madeleine U Shalowitz, Rachel E Story, Katherine B Ehrlich, Cynthia S Levine, Robin Hayen, Adam K K Leigh, Gregory E Miller
OBJECTIVES: The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES)-prestige and resources-and their associations with immune, behavioral, and clinical outcomes in childhood asthma. METHODS: Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures...
September 30, 2016: Psychosomatic Medicine
Luciano E Busi, Sebastián Restuccia, Ricardo Tourres, Peter D Sly
BACKGROUND: Measuring lung function, including bronchodilator response (BDR), is an integral part of asthma management in older children. While spirometry is possible in preschool-aged children, the question remains whether measuring BDR aids in asthma diagnosis in this age group. METHODS: 431 healthy children and 289 children with asthma, aged 3-5 years, were recruited from kindergartens and the pulmonology clinic in Trelew, Argentina. Spirometry was performed at visit 1 and repeated after 15 min, with children randomised to placebo or salbutamol (400 µg)...
October 14, 2016: Thorax
Ronen Bar-Yoseph, Nir Kugelman, Galit Livnat, Michal Gur, Fahed Hakim, Vered Nir, Lea Bentur
BACKGROUND AND OBJECTIVES: Asthma is a chronic inflammatory disorder requiring intermittent or continuous anti-inflammatory therapy. Patients often turn to alternative treatments as complements or replacements to conventional treatments. We aimed to evaluate the effect of salt room chambers (halotherapy) on bronchial hyper-responsiveness (BHR), fractional exhaled nitric oxide (FeNO), and quality of life in children with asthma. PATIENTS AND METHODS: Children aged 5-13 years with a clinical diagnosis of mild asthma not receiving anti-inflammatory therapy...
October 10, 2016: Pediatric Pulmonology
Ola A Dabbous, Mona M Soliman, Nagwa H Mohamed, Magda Y Elseify, Mai S Elsheikh, Asmaa A A Alsharkawy, Manal M Abd Al Aziz
Variable therapy of asthma is not sufficient yet to achieve good asthma control. Therapy decision requires serial investigations. Low-level laser acupuncture is a suitable non-invasive modality of complementary medicine. The exhaled breath condensate (EBC) is easy and useful to evaluate the efficacy of drugs or novel therapy. This study aimed to evaluate the effectiveness of low-level laser biostimulation of acupuncture points on asthma improvement in children. Forty-eight asthmatic children were subdivided into case (laser) group, which received 12 direct contact low-power laser acupuncture sessions (three sessions/week) on specific traditional Chinese acupuncture points for bronchial asthma, and control asthmatic group, which received sham laser acupuncture on the same acupoints and number of sessions of the case (laser) group...
October 5, 2016: Lasers in Medical Science
Iny Jhun, Jonathan M Gaffin, Brent A Coull, Michelle F Huffaker, Carter R Petty, William J Sheehan, Sachin N Baxi, Peggy S Lai, Choong-Min Kang, Jack M Wolfson, Diane R Gold, Petros Koutrakis, Wanda Phipatanakul
BACKGROUND: Home-based interventions to improve indoor air quality have demonstrated benefits for asthma morbidity, yet little is known about the effect of environmental interventions in the school setting. OBJECTIVE: We piloted the feasibility and effectiveness of a classroom-based air cleaner intervention to reduce particulate pollutants in classrooms of children with asthma. METHODS: In this pilot randomized controlled trial, we assessed the effect of air cleaners on indoor air particulate pollutant concentrations in 18 classrooms (9 control, 9 intervention) in 3 urban elementary schools...
September 15, 2016: Journal of Allergy and Clinical Immunology in Practice
Annica Önell, Anna Whiteman, Björn Nordlund, Francesca Baldracchini, Giorgio Mazzoleni, Gunilla Hedlin, Hans Grönlund, Jon R Konradsen
BACKGROUND: Multiple allergic sensitizations are common in persistent childhood asthma, and thorough assessment of allergy is crucial for optimal care of these children. Microarray testing offers opportunities for improved sIgE characterization, which has been projected to be useful in the management of multi-sensitized patients. OBJECTIVE: The aim of this study was to investigate the accuracy and information obtained by two microarray platforms applied on a well-characterized pediatric asthma cohort...
September 17, 2016: Allergy
Jay M Portnoy, Morgan Waller, Stephen De Lurgio, Chitra Dinakar
BACKGROUND: Access to asthma specialists is a problem, particularly in rural areas, thus presenting an opportunity for management using telemedicine. OBJECTIVE: To compare asthma outcomes during 6 months in children managed by telemedicine vs in-person visits. METHODS: Children with asthma residing in 2 remote locations were offered the choice of an in-person visit or a telemedicine session at a local clinic. The telemedicine process involved real-time use of a Remote Presence Solution (RPS) equipped with a digital stethoscope, otoscope, and high-resolution camera...
September 2016: Annals of Allergy, Asthma & Immunology
V Plaza, P Rodríguez Del Río, F Gómez, A López Viña, J Molina, J A Quintano, S Quirce, R Soler, J R Villa, A Nieto
BACKGROUND: Based on the GEMA 2009 guidelines (Spanish Asthma Management Guidelines), this project identified and assessed the main deficiencies in the implementation of the guidelines and proposed initiatives for improvement. METHODS: The study gathered and evaluated the opinions of a multidisciplinary group of asthma experts (allergists, pulmonologists, pediatricians, and primary care physicians). The first step identified health care aspects of GEMA 2009 that could be improved (Phase I)...
2016: Anales del Sistema Sanitario de Navarra
I Maloča Vuljanko, M Turkalj, B Nogalo, S Bulat Lokas, D Plavec
BACKGROUND: Diagnosing asthma in children is a challenge and using a single biomarker from exhaled breath condensate (EBC) showed the lack of improvement in it. OBJECTIVE: The aim of this study was to assess the diagnostic potential of a pattern of simple chemical biomarkers from EBC in diagnosing asthma in children in a real-life setting, its association with lung function and gastroesophageal reflux disease (GERD). METHODS: In 75 consecutive children aged 5-7 years with asthma-like symptoms the following tests were performed: skin prick tests, spirometry, impulse oscillometry (IOS), exhaled NO (FENO), 24-hour oesophageal pH monitoring and EBC collection with subsequent analysis of pH, carbon dioxide tension, oxygen tension, and concentrations of magnesium, calcium, iron and urates...
August 31, 2016: Allergologia et Immunopathologia
Cristine E Berry, Dean Billheimer, Isaac C Jenkins, Zhenqiang J Lu, Debra A Stern, Lynn B Gerald, Tara F Carr, Stefano Guerra, Wayne J Morgan, Anne L Wright, Fernando D Martinez
RATIONALE: Low maximally attained lung function increases the risk of chronic obstructive pulmonary disease irrespective of the subsequent rate of lung function decline. OBJECTIVES: We aimed to determine if there were individuals with a distinct, persistently low lung function trajectory in the CRS (Tucson Children's Respiratory Study). METHODS: The CRS, an ongoing birth cohort study, enrolled 1,246 participants between 1980 and 1984. Latent class linear mixed effects modeling of the ratio of FEV1 to FVC was used to identify distinct lung function trajectories among participants with two or more spirometry measurements between ages 11 and 32 years...
September 1, 2016: American Journal of Respiratory and Critical Care Medicine
Helen L Petsky, Kayleigh M Kew, Cathy Turner, Anne B Chang
BACKGROUND: Asthma guidelines aim to guide health practitioners to optimise treatment for patients so as to minimise symptoms, improve or maintain good lung function, and prevent acute exacerbations or flare-ups. The principle of asthma guidelines is based on a step-up or step-down regimen of asthma medications to maximise good health outcomes using minimum medications. Asthma maintenance therapies reduce airway inflammation that is usually eosinophilic. Tailoring asthma medications in accordance with airway eosinophilic levels may improve asthma outcomes such as indices of control or reduce exacerbations or both...
September 1, 2016: Cochrane Database of Systematic Reviews
Robyn T Cohen, Mark Rodeghier, Fenella J Kirkham, Carol L Rosen, Jane Kirkby, Michael R DeBaun, Robert C Strunk
BACKGROUND: Significance of exhaled nitric oxide (FeNO) levels in children with sickle cell anemia (SCA) is unclear, but increased levels may be associated with features of asthma and thus increased morbidity. OBJECTIVES: To determine factors associated with FeNO and whether FeNO levels are associated with increased rates of acute chest syndrome (ACS) and pain. METHODS: All participants had SCA, were part of the prospective, observational Sleep and Asthma Cohort study, and had the following assessments: FeNO, spirometry, blood samples analyzed for hemoglobin, white blood cell count, eosinophils and total serum IgE, questionnaires about child medical and family history, and review of medical records...
August 9, 2016: Journal of Allergy and Clinical Immunology
C L Yang, E Simons, R G Foty, P Subbarao, T To, S D Dell
BACKGROUND: A correct diagnosis of asthma is the cornerstone of asthma management. Few pediatric studies have examined the accuracy of physician-diagnosed asthma. OBJECTIVES: We determined the accuracy of parent reported physician-diagnosed asthma in children sampled from a community cohort. METHODS: Nested case-control study that recruited 203 children, aged 9-12, from a community-based sample. Three groups were recruited: asthma cases had a parental report of physician-diagnosed asthma, symptomatic controls had respiratory symptoms without a diagnosis of asthma, and asymptomatic controls had no respiratory symptoms...
August 9, 2016: Pediatric Pulmonology
R J Saranz, A Lozano, A Valero, N A Lozano, M D P Bovina Martijena, F Agresta, L Ianiero, M F Ponzio
BACKGROUND: Subclinical spirometric abnormalities may be detected in patients with rhinitis without asthma, proportional to the severity established by ARIA (Allergic Rhinitis and Its Impact on Asthma) guidelines. New criteria of rhinitis classification were recently validated according to the ARIA modified (m-ARIA), which allow the discrimination between moderate to severe grades. The impact of rhinitis on lung function according to frequency and severity is unknown. OBJECTIVES: To investigate subclinical spirometric impairment in children and adolescents with allergic and non-allergic rhinitis without overt symptoms of asthma, according to the frequency and severity criteria of rhinitis classified by m-ARIA...
August 2, 2016: Allergologia et Immunopathologia
Paweł Majak, Joanna Jerzyńska, Magdalena Bojo, Agnieszka Brzozowska, Magdalena Koczkowska, Piotr Sielski, Włodzimierz Stelmach, Rafał Stelmach, Anna Janas, Iwona Stelmach
INTRODUCTION: Markers of exhaled breath condensate (EBC) correlate with lung function impairment, airway remodeling and different aspects of the disease such as exercise-induced bronchoconstriction (EIB). Aim of the study was to determine the cytokine profile in EBC of children with asthma after an exercise treadmill challenge in order to obtain clinically useful information about mechanisms of EIB; also, to assess correlations between cytokine concentrations in EBC and clinical characteristics of the patients...
August 1, 2016: Archives of Medical Science: AMS
Daphna Vilozni, Fahed Hakim, Galit Livnat, Miryam Ofek, Ronen Bar-Yoseph, Lea Bentur
A reversibility test by an increase of greater than 12% in FEV1 can support a diagnosis of asthma and alter a patient's treatment plan but may not be applicable to the young ages. We retrospectively gathered spirometric data from 85/271 asthmatic children having mild obstruction (FEV1 > 80% predicted), age 2.6-6.9 years. Spirometry was performed before and 20 min after inhalation of 200 mcg Albuterol. We defined a deviation below -1.64 z scores from control as obstruction and an increased above 1.64 scores from control as a positive response to bronchodilators...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Nualanong Visitsunthorn, Nawinda Mahawichit, Kittipong Maneechotesuwan
BACKGROUND AND OBJECTIVE: Fractional exhaled nitric oxide (FeNO) has been used as a marker for airway inflammation. We evaluated the association between FeNO levels and asthma exacerbations (AEs) in Thai children and young adults. METHODS: This was a prospective cohort study in patients with atopic asthma aged 7-20 years. Asthma control level and management were evaluated every 3 months for 1 year. Spirometry and FeNO measurements were performed at baseline, and 6 and 12 months...
July 20, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
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