Asthma
Parent mentors can improve the asthmatic care of minority children, UT Southwestern researchers find
UT Southwestern Medical Center researchers have found that informed adults can help families stave off complications associated with asthma. The findings, available online and in the December issue of Pediatrics, suggest that interventions by parent mentors – caregivers of asthmatic children who have received specialized topical training – can effectively reduce wheezing, asthma attacks, emergency room visits and missed adult workdays.
“Childhood asthma disproportionately affects urban minority children,” said Dr. Glenn Flores, professor of pediatrics and the study’s lead author. “Asthma mortality among African-American children alone is almost five times higher than for white children. The goal for this study was to determine whether parent mentors would be more effective than traditional asthma care in improving asthma outcomes for minority children.”
Mentors in the study were parents or caregivers who got professional training from a nurse asthma specialist and a program coordinator on a variety of asthma-related topics. Training sessions and a manual were used to present examples of improving asthmatic care and focused on the importance of consistent treatment. The manual also discussed keeping asthmatic children out of hospitals, asthma medications and triggers, and cultural issues that can affect care.
Sweet! Sugared Polymer a New Weapon Against Allergies and Asthma
Scientists at Johns Hopkins and their colleagues have developed sugar-coated polymer strands that selectively kill off cells involved in triggering aggressive allergy and asthma attacks. Their advance is a significant step toward crafting pharmaceuticals to fight these often life-endangering conditions in a new way.
For more than a decade, a team led by Bruce S. Bochner, M.D., director of the Division of Allergy and Clinical Immunology at the Johns Hopkins University School of Medicine, has studied a unique protein known as Siglec-8. This protein, whose name is an acronym for Sialic Acid-binding, Immunoglobulin-like LECtin number 8, is present on the surfaces of a few types of immune cells, including eosinophils, basophils and mast cells. These different cell types have diverse but cooperative roles in normal immune function and allergic diseases. When functioning correctly, they are a valuable aid to keeping the body healthy and infection-free. However, in allergic reactions and asthma attacks, the cells unleash an overwhelming response that typically harms the body more than it helps.
Asthma: Epidemiology, etiology and risk factors
An article http://www.cmaj.ca/press/cmaj080612.pdf on the epidemiology, cause and risk factors of asthma is the first in a special report on asthma in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca designed for clinical practitioners. This review looks at risk factors for persistent asthma at different ages, including prenatal, infancy, childhood and adulthood.
Genetics, environment and host characteristics are risk factors for asthma. The significant increases in the incidence of asthma and geographic variation in prevalence rates support the idea that the environment plays a large role in the current asthma epidemic. As well, environmental triggers may affect asthma differently during various life stages and risk factors may change over time.
The report comes from the researchers conducting the Canadian Healthy Infant Longitudinal Development (CHILD) Study, a multicentre Canadian study involving 5000 pregnant women with the aim of better understanding the development of allergy and asthma in children.
Traffic pollutants may fuel adult asthma: study
A new study provides more evidence that breathing in traffic-related pollutants is unhealthy—for kids and adults.
The study, report in the journal Thorax, suggests a link between asthma that develops in adulthood and increased exposure to traffic-related pollutants. Previous research linked childhood-onset asthma with traffic pollutants.
In the current study, researchers looked at associations between traffic-related air pollution and “new-onset” asthma among 2725 Swiss adults. None of them had ever smoked.
Parent stress, air pollution up kids’ asthma risk
Children with stressed-out parents may be more prone to developing asthma associated with environmental “triggers” such as high levels of traffic-related pollution and tobacco smoke, hints a study published today.
In the study, researchers found that children whose parents reported high levels of psychological stress and who were exposed to cigarette smoke in the womb and to traffic-related pollution early in life had a much higher risk of developing asthma, compared to children only exposed to pollution.
“We found that it was children exposed to the combination of air pollution and life in a stressful environment who were at highest risk of developing asthma,” Dr. Rob McConnell, deputy director of the Children’s Environmental Health Center at University of Southern California, Los Angeles, told Reuters Health.
Inactivity, Obesity Factors in Adult Asthmatics Higher Health Care Use
Health care use is higher in adult asthmatic patients when compared with non-asthmatic patients, and inactivity and obesity are contributing to this increase, according to a report published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).
Shilpa Dogra, MSc, of the Lifespan Health and Performance Laboratory at York University in Toronto, Ontario, Canada, and colleagues, also found that overnight hospital stays were more common in inactive asthmatic patients regardless of body mass index (BMI), whereas both BMI and physical activity were important determinants of physician consultations.
Investigators analyzed self-reported data of an adult population of 6,835 with asthma and 78,051 without asthma from the 2005 Canadian Community Health Survey (CCHS), a nationally representative population-based cross-sectional survey. Their findings include:
Oral contraceptives linked to asthma risk
Some women who use oral contraceptives may have an increased risk for asthma, according to results of a Scandinavian study.
The effect depends on body mass index (BMI), with the rate of asthma increasing as BMI goes up, Dr. Ferenc Macsali of Haukeland University Hospital in Bergen, Norway, and colleagues report in the Journal of Allergy and Clinical Immunology.
From 1999 to 2001, the researchers mailed questionnaires to women ranging in age from 25-44 years in Denmark, Estonia, Iceland, Norway, and Sweden. Respondents included 4,728 women who did not use oral contraceptives and 961 who did.
Couch potato kids risk developing asthma
Young children who watch TV for more than 2 hours a day run the risk of developing asthma before their 12th birthday, according to a study of more than 3,000 kids whose health and habits were tracked from birth.
“In children who had no wheezing symptoms up to age 3.5 years, those who reported watching TV for more than 2 hours per day were almost twice as likely to have asthma by age 11.5 years as those watching TV for 1 to 2 hours per day,” Dr. Andrea Sherriff told Reuters Health.
The amount of time spent in front of the TV was used as a measure for sedentary behavior because personal computers and video game consoles were not in widespread use at the time the study was conducted in the mid-1990s, explained Sherriff, who is at the University of Glasgow, UK.
New study raises concerns about screen time among urban children with asthma
Urban children with asthma engage in an average of an hour more of screen time daily than the maximum amount American Academy of Pediatrics (AAP) recommends. This is the first study to examine screen time among children with asthma.
“We know that both asthma and excessive screen time can be associated with other difficulties, including behavior problems, difficulty with attention, poor school performance and obesity,” said Kelly M. Conn, M.P.H., of General Pediatrics at Golisano Children’s Hospital at Strong and lead author of the study, which was published recently in Academic Pediatrics. (Academic Pediatrics changed its name from Ambulatory Pediatrics this year.) The study was conducted out of the University of Rochester Medical Center.
As a part of a larger study on how to more effectively treat asthma, Conn and her colleagues surveyed parents of urban children with asthma in Rochester, NY, to better understand their screen time viewing habits. Screen time includes TV watching and video tapes, playing video and computer games and using the Internet. The study found that 74 percent of the 226 children whose parents were surveyed exceeded more than two hours of screen time per day. On average, these children with asthma watched 3.4 hours daily.
School-supervised asthma therapy improves control
New research suggests that adherence with daily asthma “controller” medications among children with asthma can be enhanced with school-based supervised asthma therapy.
As reported in the February issue of the journal Pediatrics, researchers assessed asthma control in 290 children from 36 schools who were randomized to receive school-based, supervised therapy or usual care.
For their study, Dr. Lynn B. Gerald and colleagues from the University of Alabama, Birmingham defined poor asthma control as at least one of the following: 1) absence from school due to asthma or respiratory illness, 2) average use of “rescue” asthma medication more than 2 times per week, or 3) at least 1 red or yellow reading on a peak flow meter, a device that measures air flow.
School program helps kids manage asthma
An asthma education program given in school may help urban, low-income children better manage the lung condition, a new study suggests.
Researchers found that an asthma education program offered at inner-city schools in Oakland, California, was able to improve students’ symptoms and reduce the number of visits to the emergency room for asthma attacks.
Over three years, nearly 1,000 middle school and high school students took part in the program, dubbed “Kickin’ Asthma.” The four-session program, led by a trained nurse, taught asthmatic students how to avoid symptom triggers, catch warning signs of an asthma attack and take their medication properly.
Researchers link C-section babies to asthma risk
Babies born by Caesarean section are more likely to develop asthma than children delivered naturally, Swiss researchers said on Tuesday.
There has been conflicting evidence on the link between asthma and C-sections but the researchers said the number of children involved in their study and a long monitoring period strengthened their results.
The findings also underscore the potential risks of elective C-sections as more women in Western countries choose to avoid a natural birth, the researchers said in the medical journal, Thorax.
Kids take responsibility for asthma meds early
Many children with asthma start taking their daily medication on their own at an early age, a new study finds.
The findings suggest that even young children should be included when doctors and parents discuss asthma management, researchers report in the journal Pediatrics.
In surveys of 351 parents of asthmatic children and teenagers, the researchers found that by the age of 7, children were giving themselves their daily controller medication nearly 20 percent of the time. By age 11, they were responsible for taking their medication about half of the time.
Daily controller medication refers to the drugs, such as inhaled corticosteroids, that asthma patients take to reduce airway inflammation and prevent attacks of breathlessness and wheezing.
Asthma may boost pneumococcal infection risk
People with asthma are at increased risk of serious infection with pneumococcal bacteria, according to a new analysis of medical records.
The findings, along with the high fatality rate from such infections, suggest that adults with asthma would benefit from the pneumococcal vaccine, Dr. Young J. Juhn of the Mayo Clinic in Rochester, Minnesota and colleagues say. However, the ability of asthmatics to react normally to the vaccine must be determined before such recommendations can be made, they add.
A previous study found that Medicaid patients with asthma were more than twice as likely to contract invasive pneumococcal disease, in which pneumococcal pneumonia develops and the bacteria invades the bloodstream or the membranes surrounding the brain, Juhn and colleagues note.
Obesity, lack of exercise reported in asthmatics
Study findings suggest less than one quarter of asthmatic adults meet national exercise guidelines and, among this group, obesity may be a greater exercise deterrent actual asthma symptoms.
People with asthma may get caught in a vicious cycle, note Dr. Carol A. Mancuso and colleagues from Weill Cornell Medical College and the Hospital for Special Surgery in New York City.
“Obesity leads to worse asthma, which can be associated with less exercise, which predisposes to obesity and long-term (worsening) asthma,” Mancuso told Reuters Health.
