Asthma, spirometry in children

BACKGROUND: Indoor allergens are risk factors for asthma: thus, the characterization of indoor air quality is important for studying environment-health relationships in children. In particular, Dermatophagoides pteronyssinus is the dominant allergen for asthma. We cross-sectionally investigated the relationships among respiratory symptoms and function, airway inflammation, allergen sensitization and indoor allergen concentration. METHODS: One hundred thirty two children aging 10-14 years and living in a Southern Mediterranean area were evaluated by parental questionnaires...

BACKGROUND: In children, exercise-induced dyspnea is a common symptom that can be due to dysfunctional breathing. EVH test has bee used especially in elite athletes as bronchoprovocation test. Currently, there are only few studies on the EVH test. New research methods are required alongside the traditionally used tests especially due to dysfunctional breathing disorder. PURPOSE: The purpose of the "pilot study" was to study the usability of the EVH test with real time biofeedback in children of 10-16 years of age in the diagnostics of exercise-induced dyspnea...

BACKGROUND: Obesity is increasing worldwide among children and adolescents, and has been associated with an increased incidence of asthma. However, the mechanisms underlying this association are incompletely understood. OBJECTIVE: In this cohort study we aimed to investigate whether being overweight in childhood and adolescence is associated with an increased risk of airway hyperresponsiveness (AHR), a hallmark of asthma, in early adulthood. METHODS: Of 527 subjects from a random population sample of children and adolescents (7-17 years) examined at baseline, a total of 184 subjects completed the follow-up visit 20 years later and were included in the present analysis...

PURPOSE: The purpose of this study was to compare (i) the exercise capacity and (ii) lung function prior to and immediately post cardiopulmonary exercise tests (CPET) of children who underwent early life lung resection for Congenital Pulmonary Airway Malformations (CPAM) to healthy control children. METHOD: Eight children with CPAM (four males, age 9.6 ± 1.8 years) and eight control children without respiratory disease (three males, age 9.4 ± 1.4 years) performed a CPET on a cycle ergometer, during which maximal oxygen consumption (V̇O2max ) and heart rate were measured...

Asthma is a common chronic respiratory diseases in children. Understanding the immune mechanisms of epigenetic factors may contribute to a better control of asthma. This study seeks to determine the effects of serum vitamin D and urine cotinine on asthma severity and on T regulatory cells (Tregs) and other immune-related factors such as CD3, CD4, CD8, CD19, CD16/56, and anti-CD3 HLA-DR3. The study involved 34 children with asthma. Disease severity was assessed with the Asthma Control Test, spirometry, and the fractional exhaled nitric oxide (FeNO)...

BACKGROUND: Breath-actuated inhalers (BAI) eliminate the need for hand-breath coordination and, therefore, simplify thedelivery of inhaled medication. OBJECTIVE: To evaluate the efficacy and safety of beclomethasone dipropionate BAI and metered-dose inhaler (MDI) versus placebo in pediatric patients ages 4-11 years with persistent asthma. METHODS: In this double-blind, double-dummy, phase III study, 628 children with persistent asthma were randomly assigned(1:1:1:1:1) to twice-daily beclomethasone dipropionate (BAI 80 micrograms/day, BAI 160 micrograms/day, MDI 80 micrograms/day, or MDI 160 micrograms/day) or to placebo...

BACKGROUND: Treatment decisions in asthma are currently based on clinical assessment and spirometry. Sputum eosinophil, being a marker of airway inflammation, can serve as a tool for assessing severity and response to treatment in asthma patients. OBJECTIVES: To measure eosinophil percentage in induced sputum in children with asthma and correlate it with clinical asthma parameters. METHODS: A prospective observational study was performed at tertiary care hospital on 91 children aged 7-18 years with newly diagnosed mild or moderate persistent asthma...

OBJECTIVE: To determine the effectiveness of the Spirometry 360™ distance learning quality improvement (QI) program for enhancing the processes and outcomes of care for children with asthma. METHODS: Cluster randomized controlled trial involving 25 matched pairs of pediatric primary care practices. Practices were recruited from two practice-based research networks: the Slone Center Office-based Research Network at Boston University, Boston, MA and the Puget Sound Pediatric Research Network in Seattle, WA...

Due to the increased incidence of allergic diseases and emerging effects of unsatisfactory control of asthma, new mechanisms for supervising the immune system should be searched. The aim of the study was to analyze the percentage of CD3, CD4, CD8, CD19, CD16/56, NKT, CD3 anti-HLADR3 and Foxp3 regulatory lymphocytes in patients with asthma. Additionally the correlation between immune parameters, severity of asthma and serum concentration of vitamin D was performed. 25 children diagnosed with asthma were enrolled...

OBJECTIVES: American Thoracic Society/European Respiratory Society (ATS/ERS) spirometry interpretation guidelines recommend ≥15 min between pre- and post-bronchodilator testing to evaluate for a bronchodilator response. We aimed to lengthen the time between albuterol administration and post-bronchodilator testing to adhere to ATS/ERS guidelines and evaluated if lengthening this wait time would increase the percentage of patients classified as bronchodilator responsive. METHODS: We compared the proportion of patients with a positive bronchodilator response between two groups of children with asthma, one group in which post-bronchodilator administration wait times were not standardized (pre-intervention) to another in which the wait time was extended to 15 min to adhere to ATS/ERS standards (post-intervention)...

Theoretical non-linear modeling of exhaled nitric oxide has revealed extended flow-independent parameters that could explain where or how nitric oxide is produced in the lung and transferred to the airway gas stream. We aimed to evaluate the associations of bronchial hyperresponsiveness and bronchodilator response with extended flow-independent nitric oxide parameters. Nitric oxide (30, 50, 100, 200 mL/s) was measured in 432 children with asthma on the same day as either methacholine challenge test (n=156) or spirometry with bronchodilator (n=276; 96 previously diagnosed with asthma and treated with inhaled corticosteroid, 37 with acute exacerbation treated with systemic corticosteroid)...

Sport is an essential part of childhood, with precious and acknowledged positive health effects but the impact of exercise-induced bronchoconstriction (EIB) significantly reduces participation in physical activity. It is important to recognize EIB, differentiating EIB with or without asthma if the transient narrowing of the airways after exercise is associated with asthmatic symptoms or not, in the way to select the most appropriate treatment among the many treatment options available today. Therapy is prescribed based on symptoms severity but diagnosis of EIB is established by changes in lung function provoked by exercise evaluating by direct and indirect tests...

BACKGROUND AND OBJECTIVE: Physical activity is defined as any bodily movement produced by a muscle contraction with increased energy expenditure. The aim of this study was to assess the physical activity, asthma control level, spirometric measurements and quality of life in children and adolescents with asthma. METHODS: We included all children and adolescents aged 7-17 years who had a diagnosis of atopic asthma and who attended the Pediatric Pulmonology Outpatient Clinic of the State University of Campinas, Brazil...

OBJECTIVE: To provide a clinical rationale for including impulse oscillometry (IOS) as a part of standard office-based asthma assessment. DATA SOURCES: PubMed and Google search, limited to English language and human disease, with the keywords IOS and asthma. STUDY SELECTIONS: Articles included in this review were based on the expert opinion and previous publications by the authors. RESULTS: In children, IOS was more useful than spirometry in identifying asthma and uncontrolled asthma and predicting loss of control and exacerbations...

BACKGROUND: Breastfeeding reduces the risk of asthma in early childhood, but it is not clear whether its effect on respiratory morbidity is still present in later childhood. OBJECTIVE: To examine the associations of any breastfeeding, breastfeeding duration, and breastfeeding exclusiveness with lung function and asthma in school-aged children and whether associations were influenced by respiratory tract infections and maternal or child's atopic status. METHODS: This study of 4,464 children was embedded in a population-based prospective cohort study...

The forced oscillation technique (FOT) can provide unique and clinically relevant lung function information with little cooperation with subjects. However, FOT has higher variability than spirometry, possibly because strategies for quality control and reducing artifacts in FOT measurements have yet to be standardized or validated. Many quality control procedures either rely on simple statistical filters or subjective evaluation by a human operator. In this study, we propose an automated artifact removal approach based on the resistance against flow profile, applied to complete breaths...

BACKGROUND: Childhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity. OBJECTIVE: To investigate the correlation between anthropometric indices and pulmonary function test results in children without asthma. METHODS: Children without any respiratory disorders were enrolled in this study. Anthropometric measurements, such as height, weight, neck circumference (NC), and waist circumference, were obtained from the enrollees and body mass index was calculated...

OBJECTIVES: Examine (1) the extent to which changes in objectively measured asthma-related lung function (forced expiratory volume in 1 second) within a sleep period are associated with sleep quality and sleep duration during that sleep period in a group of urban children with persistent asthma, (2) associations between morning and evening asthma-related lung function and sleep quality and duration on the adjacent night, and (3) whether these associations differ by ethnic group. DESIGN: Cross-sectional, multimethod approach...

BACKGROUND: High fractional exhaled nitric oxide (FeNO) is an indicator of poor asthma control and has been proposed as a non-invasive assessment tool to guide asthma management. OBJECTIVE: We aimed to describe the prevalence of and factors associated with high FeNO among US youth with asthma. METHODS: Data from 716 children and adolescents with asthma ages 6-19 years who participated in the 2007-2012 National Health and Nutrition Examination Survey were analyzed...

BACKGROUND: We wanted to compare cold dry air challenge (CACh) induced changes in spirometric parameters with changes in nitrogen multiple breath washout (N2 MBW) parameters in pediatric asthma patients during clinical remission over the past year (ie, with "inactive asthma"). As N2 MBW assesses ventilation heterogeneity we expected to gain detailed information about peripheral airways contribution. METHODS: In subjects with normal spirometry N2 MBW, spirometry and body plethysmography were performed at baseline, after CACh, and after salbutamol inhalation...