Asthma, spirometry in children

BACKGROUND: Asthma control is suboptimal in Vietnam. Lack of knowledge of primary care physicians (PCPs) for asthma management may potentially be one of the causes. PURPOSE: The aim of this study was to assess the knowledge and practice of PCPs' asthma management based on the Global Initiative for Asthma (GINA) guidelines (2015 update). METHODS: A cross-sectional study with convenience sampling was conducted among PCPs in an urban and rural area of Vietnam using questionnaires related to asthma patients daily practice: use of spirometry and the asthma control test (ACT), prescription of asthma medications, and frequency of consultations...

BACKGROUND: It has been difficult to determine the individual impact of pre and post-natal childhood tobacco smoke exposure (TSE) on childhood lung function, as children are often exposed to both. AIMS: To determine the association between current TSE, as measured by serum cotinine levels, and airflow obstruction (defined as the ratio of forced expiratory volume in one second and the forced vital capacity (FEV1/FVC) less than the lower limit of normal), while adjusting for self-reported prenatal TSE...

SETTING AND OBJECTIVE: The International Study of Asthma and Allergies in Childhood (ISAAC) reported asthma prevalence in Peru to be among the highest in the world. We assessed the prevalence and morbidity of self-reported asthma in an underserved, peri-urban area of Lima, Peru, with limited medical access. DESIGN: The study was conducted in the outskirts of Lima from March to May 2011. Five hundred children aged 6-18 years were selected through cluster sampling...

BACKGROUND: Concerns have been expressed about asthma overdiagnosis. The UK National Institute of Health and Care Excellence (NICE) proposed a new diagnostic algorithm applying four lung function measures sequentially (ratio of forced expiratory volume in 1 s [FEV1] to forced vital capacity [FVC] <70%, bronchodilator reversibility ≥12%, fractional exhaled nitric oxide [FeNO] ≥35 parts per billion, and peak expiratory flow variability >20%). We aimed to assess the diagnostic value of three of the tests individually, and then test the proposed algorithm in symptomatic children...

BACKGROUND: Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known. OBJECTIVE: To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children. DESIGN: Observational study, comparing forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF25%-75%), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without...

BACKGROUND: Ambient and home exposure to nitrogen dioxide (NO2) causes asthma symptoms and decreased lung function in children with asthma. Little is known about the health effects of school classroom pollution exposure. OBJECTIVE: We aimed to determine the effect of indoor classroom NO2 on lung function and symptoms of inner-city schoolchildren with asthma. METHODS: Children enrolled in the School Inner City Asthma Study were followed for one academic year...

BACKGROUND: Rehabilitational programs at moderate altitude (1500m to 2500m) showed improvement of lung function and reduction of airways inflammation in asthmatic adults. Allergen avoidance was postulated as the major cause of these improvements. METHODS: Spirometries of 344 and fractional exhaled nitric oxide measurements (FeNO) of 124 asthmatic children and adolescents, staying in a rehabilitation hospital in Davos (1590m) with at least 14 days between admission and discharge, were analysed in associations with atopic sensitisation (skin-prick testing and/or specific IgE), level of asthma control, and inhalative corticosteroid (ICS) dose...

BACKGROUND AND OBJECTIVE: Selecting 'healthy' preschool-aged children for reference ranges may not be straightforward. Relaxing inclusion criteria for normative data does not affect spirometry z-scores. We therefore investigated the effect of similarly relaxing inclusion criteria in preschoolers on reference ranges for respiratory impedance (Zrs) using a modified forced oscillation technique (FOT). METHODS: The International Study of Asthma and Allergies in Childhood questionnaire classified 585 children into a healthy and five mutually exclusive groups...

BACKGROUND: Recent studies have highlighted the possible involvement of leptin in inflammation. The leptin receptor is also expressed by alveolar macrophages, T lymphocytes and bronchial epitelial cells, suggesting a possible role in the cascade of airway inflammation. OBJECTIVES: The aim of the study was to evaluate the levels of leptin in exhaled breath condensate (EBC) from asthmatic, normal- and overweight children, in relationship with airway inflammation. METHODS: 15 asthmatic non-obese children, 15 healthy non-asthmatic non-obese children, 11 obese children with asthma (OA) and 20 obese children without asthma (ONA) were enrolled...

OBJECTIVE: Fractional exhaled nitric oxide (FeNO), bronchial nitric oxide (JawNO) and alveoar nitric oxide (CANO) are biomarkers of eosinophilic inflammation, usually measured simultaneously with spirometry and bronchodilation. Our aim was to investigate the effect of bronchodilation and spirometry on FeNO, CANO and JawNO in children and young adults with well-controlled asthma and in healthy volunteers. METHODS: FeNO was measured in 95 subjects (62 controls, 33 asthmatics)...

BACKGROUND: Classic spirometry is effort-dependent and of limited value in assessing small airways. Peripheral airway involvement, and relation to poor control, in asthma, has been highlighted recently. Forced oscillation technique (FOT) offers an effort-independent assessment of overall and peripheral lung mechanics. We studied the association between lung function variables, obtained either by spirometry or multi-frequency (5, 11 and 19 Hz) FOT, and asthma diagnosis and control. METHODS: Spirometry measures, resistance at 5 (R5) and 19 Hz (R19), reactance at 5 Hz (X5), resonant frequency (fres ), resistance difference between 5-19 Hz (R5-R19) and Asthma Control Test scores were determined in 234 asthmatic and 60 healthy subjects (aged 13-39 years)...

BACKGROUND: Children with lower birth weight are at increased risk of asthma symptoms. We examined associations of fetal and infant growth with childhood lung function and asthma. METHODS: This study was embedded in a population-based prospective cohort study among 5,635children. Growth was estimated by repeated ultrasounds in 2nd and 3th trimester, and measured at birth and at 3, 6 and 12 months. At age 10 years, spirometry was performed and asthma was assessed by parental questionnaire...

BACKGROUND: There is evidence from existing literature that ambient air pollutant exposure in early childhood likely plays an important role in asthma exacerbation and other respiratory symptoms, with greater effect among asthmatic children. However, there is inconclusive evidence on the role of ambient air pollutant exposures in relation to increasing asthma prevalence as well as asthma induction in children. At the population level, little is known about the potential synergistic effects between pollen allergens and air pollutants since this type of association poses challenges in uncontrolled real life settings...

PURPOSE: Recent data indicate that sensitization to mold contributes to the severity and persistence of asthma. In this study, we investigated the relationships between sensitization to mold and lung function parameters in children with asthma. METHODS: We retrospectively reviewed clinical data from 551 asthmatic subjects. We selected subjects who met clinical diagnostic criteria of asthma. Their spirometry, methacholine challenge tests, and measurements of blood eosinophils, serum IgE, eosinophil cationic protein (ECP) and fractional exhaled nitric oxide (FeNO) results were included...

Spirometry and exhaled nitric oxide are two important complimentary tools to identify and assess asthma control in children. We aimed to determine the ability of a new suggested spirometry adjusted exhaled nitric oxide (NO) index in doing that. A random sample of 1602 schoolchildren were screened by a health questionnaire, skin-prick tests, spirometry with bronchodilation and exhaled NO. A total of 662 children were included with median (IQR) exhaled NO 11(14) ppb. ROC curves using exhaled NO equations from Malmberg, Kovesi and Buchvald, and spirometry adjusted exhaled NO values were applied to identify asthmatic children and uncontrolled asthma...

Obstructive sleep apnea (OSA) and asthma are common conditions in children with preventable long-term consequences. There is significant overlap in symptomatology and pathophysiology for pediatric OSA and asthma. Recent evidence supports clear associations between the two diseases; however, causality has not been demonstrated. Regardless, it is important to recognize the overlap and evaluate for the other condition when one is present. For example, in patients with severe OSA, clinical evaluation for asthma should be considered, including history for typical asthma symptoms and spirometry...

BACKGROUND: Elemental sulfur, "the oldest of all pesticides," is the most heavily used agricultural pesticide in California and Europe. Sulfur is considered relatively safe and is used in both conventional and organic farming systems. Adverse respiratory effects have been reported in applicators and animals, but the effect on residential populations, and especially on children living in proximity to fields treated with elemental sulfur, is not known. OBJECTIVES: We evaluated associations between residential proximity to elemental sulfur applications and respiratory symptoms and spirometry of children living in an agricultural community...

INTRODUCTION: Exercise training has been shown in numerous studies to improve lung function and asthma control in children with asthma. Swimming has been shown to be of benefit in children with asthma, but which form of exercise is better for asthmatics has not been determined to date. The aim of this study was to examine if swimming improved lung function and asthma symptoms in asthmatic children when compared with different forms of exercise and a control group. METHODS: Subjects with asthma were randomly assigned to either one of three different exercise training groups (swimming, football and basketball) or a control group...

OBJECTIVE: Asthma is a leading cause of pediatric emergency department (ED) use. Optimizing asthma outcomes is a goal of Nationwide Children's Hospital (NCH) and its affiliated Accountable Care Organization. NCH's Primary Care Network, comprised of 12 offices serving a predominantly Medicaid population, sought to determine whether an Asthma Specialty Clinic (ASC) operated within a single primary care office could reduce ED asthma rates and improve quality measures, relative to all other network offices...

BACKGROUND: Asthma severity and control can be measured both subjectively and objectively. Sputum analysis for evaluation of percentage of sputum eosinophilia directly measures airway inflammation, and is one method of objectively monitoring asthma. Using sputum analysis to adjust or tailor asthma medications is potentially superior to traditional methods based on symptoms and spirometry. OBJECTIVES: To evaluate the efficacy of tailoring asthma interventions based on sputum analysis in comparison to traditional methods (usually symptom-based with or without spirometry/peak flow) for asthma-related outcomes in children and adults...