Family History Of Asthma Research Articles

Machine Learning-Based Risk Prediction of Asthma

This paper will attempt to detect asthma early based on machine learning. This work utilizes a dataset consisting of 21 features such as family history of asthma, intake of drugs, smoking status, and quality of air and much more. The work tries to develop models with maximum precision, recall, and accuracy in asthma classification. These include several machine learning algorithms evaluated: SVM, Decision Trees, and Random Forest. This study focuses on both medical and environmental data when used in combination. The results here show that the Random Forest model performed well in achieving an overall high performance, with an accuracy of 0.926829. This has dire implications for evaluation and early diagnosis of Asthma. Key Words: Asthma detection, Machine learning, Patient history, Environmental factors, Support Vector Machines (SVM), Decision Trees, Random Forests, Predictive models, Air quality, Smoking habits, Medication usage, Family asthma history, Ac- curacy, Precision, Recall, Early diagnosis, Healthcare, Medical data, Environmental data, Predictive power

Cluster Analysis Identifies Patients With Severe Eosinophilic Asthma Who Achieve Super-Response and Remission With Mepolizumab.

This study identifies two distinct subgroups of patients with severe eosinophilic asthma who respond differently to mepolizumab. Cluster analysis reveals that patients with a family history of asthma, positive skin prick tests and higher baseline lung function have better treatment outcomes, highlighting the value of personalised treatment strategies.

Prevalence and Clinico-sociodemographic Factors of Asthmatic Children Aged 1 to 14 Years: A Prospective Descriptive Cross-sectional Study in Gandaki Province, Nepal

Introduction Pediatric asthma poses a significant public health challenge, impacting children’s health and quality of life. As asthma prevalence continues to rise globally, understanding its epidemiology is crucial for developing effective management strategies. This study aims to investigate the prevalence and associated demographic, socioeconomic, and clinical characteristics of pediatric asthma among children aged 1 to 14 years. Methods This study employed a prospective descriptive cross-sectional design. Data were collected from a diagnosed asthmatic children attending pediatric department of the GP Koirala National Respiratory Centre and Hospital, Tanahun, Ganaki, Nepal over three months from April 20, 2023 by assessing demographic factors (age, gender, residence), socioeconomic status, clinical history (family history and comorbid conditions), and asthma severity. Data were analyzed with SPSS version 23 using descriptive statistics. Results Prevalence rate of pediatric asthma was 3.08%. The demographic analysis revealed that most participants were aged 1-5 years (53%), predominantly male (64.9%), and resided in urban areas (59.6%). Socioeconomic data indicated that 59.6% came from low-income households, suggesting a potential link between socioeconomic status and asthma prevalence. Clinically, 53% had a family history of asthma, with 26.3% presenting with comorbid allergic rhinitis. Asthma severity assessments showed that 50% had mild asthma, 33.33% had moderate asthma, and 16.67% had severe asthma. Conclusion This study highlights a low prevalence of asthma in the pediatric population at GP Koirala National Respiratory Centre and Hospital, yet emphasizes the burden faced by younger children, especially those from low-income backgrounds. The correlations between asthma prevalence, socioeconomic status, and comorbid conditions underscore the need for targeted public health interventions and comprehensive management strategies. Further research is warranted to deepen understanding and enhance healthcare services for affected children.

Statistical Analysis of the Prevalence and Predictors of Asthma and Allergic Rhinitis in Nigeria

The incidence and prevalence of asthma and allergic rhinitis have increased worldwide over the past ten years and it places a burden on already poorly financed healthcare systems. This article explores the prevalence of asthma and allergic rhinitis in Nigeria, utilizing statistical analyses to investigate the prevalence, demographic predictors, and familial associations. Objectives include determining average ages of diagnosis, identifying significant predictors, examining the relationship between asthma and allergic rhinitis, and investigating familial associations. The study employed the use of statistical tools like logistics regression, chi-square test of independence, cross-tabulation, and descriptive statistics. The analysis reveals an average age of 22 for asthma and 28 for allergic rhinitis. Significant predictors influencing asthma include age, body mass index, years of smoking, level of education, and the number of cigarettes smoked per day. The study establishes a positive correlation between asthma and allergic rhinitis, emphasizing their interconnected nature. Importantly, a highly significant relationship is identified between a family history of asthma and individual diagnoses. The prevalence of asthma and allergic rhinitis in Nigeria is influenced by various demographic factors that should be looked into, emphasizing the importance of considering demographic factors and age in developing effective approaches to address and manage asthma in the Nigerian population.

Prognostic value of serum total IgE and FeNO levels in children with atopic constitution bronchiolitis

Bronchiolitis is a significant factor contributing to bronchial asthma in infants and young children. After treatment, recurrent wheezing symptoms often occur, especially in children with atopic constitution, who tend to have more severe conditions and poorer prognosis. Therefore, exploring the prognostic value of total serum immunoglobulin E (tIgE) and fractional exhaled nitric oxide (FeNO) levels in children with atopic constitution who suffer from bronchiolitis is of great significance. A total of 260 children with bronchiolitis admitted to our hospital from October 2020 to June 2022 were regarded as the research subjects with prospective study, according to whether the children had atopic constitution, they were grouped into non atopic constitution group (n = 156) and atopic constitution group (n = 104); after 6 months of treatment, children with atopic constitution were grouped into a good prognosis group (n = 58) and a poor prognosis group (n = 46) based on their prognosis; in addition, 260 healthy children who underwent physical examination and had clinical data consistent with those of children with bronchiolitis were regarded as the reference group. The serum tIgE and FeNO levels of each group were compared; multivariate Logistic regression was applied to analyze the prognostic factors of children with atopic constitution bronchiolitis; ROC curve was applied to analyze the predictive value of tIgE and FeNO levels after treatment for the prognosis of children with atopic constitution bronchiolitis. The tIgE levels in the control group, non-atopic group, and atopic group [(123.54 ± 29.62) IU/mL, (245.71 ± 30.59) IU/mL, (316.46 ± 31.78) IU/mL, respectively] increased sequentially, with statistically significant differences (F = 1766.954, P = 0.000). The FeNO levels in the control group, non-atopic group, and atopic group [(8.36 ± 3.57) ppb, (15.28 ± 3.69) ppb, (19.84 ± 3.58) ppb, respectively] also increased sequentially, with statistically significant differences (F = 765.622, P = 0.000). The tIgE, FeNO, proportion of patients with asthma family history, and proportion of patients with allergic family history in the poor prognosis group were obviously higher than those in the good prognosis group (P < 0.05). Multivariate Logistic regression analysis showed that family history of asthma, family history of allergies, tIgE, and FeNO were influencing factors for the prognosis of children with atopic bronchiolitis (P < 0.05). The AUC of the combination of tIgE and FeNO in predicting the prognosis of children with atopic constitutional bronchiolitis was 0.910, with a sensitivity of 78.26% and a specificity of 93.10%, which was superior to the independent prediction of tIgE and FeNO (Zcombined detection−tIgE = 2.442, Zcombined detection−FeNO = 3.080, P = 0.015, 0.002). The levels of tIgE and FeNO in children with atopic constitution bronchiolitis are obviously increased, and the combination of the two has high predictive value for the prognosis of atopic constitution bronchiolitis.

Association between dietary carotenoid intakes and the risk of asthma in children and adolescents: evidence from the National Health and Nutrition Examination Survey 2007-2016.

In recent years, the incidence of asthma in children has been increasing. As a chronic disease, in addition to drug treatment, dietary management is also important. However, studies of carotenoids and asthma have shown mixed results. This study aimed to evaluate whether the relationship between carotenoid intake and current asthma holds significant importance. We studied 9,118 children aged 6-16 years in the National Health and Nutrition Examination Survey (NHANES) of US from 2007 to 2016, and the relationship of dietary carotenoid and its subgroup with pediatric asthma. Current asthma was assessed by parent-reported, doctor-diagnosed, asthma using a standardized questionnaire. We used multivariate logistic regression to calculate the odds ratio (OR) for current asthma with a 95% confidence interval (CI). Total carotenoid intake was not associated with the risk of current asthma. Compared with the first quantile, the second quantile of β-cryptoxanthin intake was positively correlated with current asthma (Q2: 1.227; 95% CI: 1.025-1.470; P=0.03). The test of trend showed that, as the α-carotene intake increased, the risk of current asthma showed a decreasing trend, which was very close to the statistic confidence cutoff (Model I: P for trend =0.001; Model II: P for trend =0.003; Model III: P for trend =0.08). In subgroup analysis, family history of asthma interacted with carotenoid intake (P=0.005). The population without a family history of asthma, there were significant negative associations between carotenoid intakes and asthma (quartile 4: Model III: 0.720; 95% CI: 0.549-0.943; P=0.02). In this study, pediatric current asthma was not related to total carotenoids in our total participants. Total dietary carotenoid intake has a protective effect on children without a family history of asthma. Meanwhile, β-cryptoxanthin intake is positively correlated with asthma.

Caregiver burden among parents of school-age children with asthma: a cross-sectional study.

To investigate the caregiver burden of parents of school-age children with asthma and analyze the factors influencing their caregiver burden. A convenience sampling method was used to select 366 parents of school-age children with asthma who visited the outpatient departments of three tertiary hospitals in Sichuan Province, China, from January 2021 to July 2021. A general information questionnaire and the Caregiver Burden Inventory (CBI) were used to assess the current caregiver burden and analyze the influencing factors. The caregiver burden score of parents of school-age children with asthma was 27 (17, 39), with 40.43% of parents experiencing moderate to high levels of burden. Detailed results of univariate analysis showed that there were significant differences in caregiver burden scores based on parents' gender, highest education level, number of children, occupation, family history of asthma, monthly family income, annual medical expenses for the child, child's gender, whether the child had undergone lung function tests, number of emergency visits due to asthma exacerbation in the past 3 months, and whether the child had missed school due to asthma exacerbation in the past 3 months (p < 0.1). Detailed results of multivariate analysis showed that parents' gender, occupation, family history of asthma, monthly family income, annual medical expenses for the child, number of emergency visits due to asthma exacerbation in the past 3 months, and whether the child had missed school due to asthma exacerbation in the past 3 months were independent risk factors for caregiver burden in parents of school-age children with asthma (p < 0.05). Parents of school-age children with asthma experience a certain level of caregiver burden, with over one-third of parents experiencing moderate to high levels of burden. Being a mother, being a worker, having no family history of asthma, having low monthly family income, having high annual medical expenses for the child, having frequent emergency visits due to asthma exacerbation in the past 3 months, and having missed school due to asthma exacerbation in the past 3 months are independent risk factors for caregiver burden in parents of school-age children with asthma, healthcare providers should develop feasible coping strategies, such as paying attention to caregivers' psychological condition to reduce the burden of caring for parents of school-age children with asthma. The entire society should also make efforts in improving social support and strengthening healthcare coverage in order to achieve the aforementioned goals.

Smoking and Real Life Results of Children and Adolescents

Aim: Smoking is a chronic disease and children are the most affected group. In this study, we aimed to question the smoking habits of children and their parents and examine the level of exhaled carbon monoxide (eCO) to evaluate the usefulness of the method in an outpatient allergy clinic. Methods: A questionnare was applied to 29 children who were smoker or exposed to second-hand smoke (SHS) and their parents separately. eCO levels of the participants were measured with CO Smokerlyzer. Results: The median eCO level of children who smoked was 10 (7-14) ppm and was significantly higher than children exposed to SHS (P &amp;lt;0.001). The children who smoked were significantly older, the more they had friends who smoked. Children who were not exposed to tobacco products had lower rates of hospitalization due to recurrent lower respiratory tract infections, and family history of asthma was lower than children exposed to SHS (p &amp;lt;0.05). All the children were aware of the harmful effects of smoking. 34.5% of the parents were never questioned by their physicians about tobacco and its products and were not informed about smoking. Conclusions: Using eCO in the clinic is a useful method to predict smoking status in daily practice. Children's attitudes towards smoking and peer relationships and parents' ignorance of smoking and SHS are still an unresolved issue.

The role of 14-3-3β in acute asthma in children and analysis of the risk factors for asthma exacerbation

Objective To investigate the role of 14-3-3β in acute asthma exacerbations in children and analyze the risk factors for asthma exacerbations. Methods This study recruited 101 children with acute asthma exacerbations, 101 children with stable asthma, and 65 healthy children. Serum 14-3-3β was compared among the three groups. Factors such as asthma family history, skin prick test, serum-specific IgE test, coinfections, and clinical indicators (FeNO, FEV1, white blood cells, eosinophils, and serum IgE level) were compared between the asthma groups. Risk factors associated with acute asthma exacerbations were identified using multivariate logistic regression models. ROC curve was drawn to determine the diagnostic sensitivity and specificity of 14-3-3β. Results Serum 14-3-3β was significantly greater in the acute asthma group than in the stable asthma and control groups. Serum 14-3-3β was higher in severe acute asthma group than in mild-moderate asthma group. There were no significant differences in serum 14-3-3β levels between stable asthma and control groups (p > .05). Multivariate logistic regression analysis revealed that serum 14-3-3β level, FeNO, coinfection, and FEV1 z-score significantly increased the odds of acute asthma exacerbations in children. The optimal 14-3-3β cutoff value (39.79 ng/mL), had a sensitivity of 69.3% and specificity of 94.1% for predicting acute asthma exacerbations. Conclusions 14-3-3β is elevated in children with acute exacerbations of asthma, and increases with exacerbation severity. 14-3-3β, FeNO, FEV1, and coinfection could be independent risk factors for predicting asthma exacerbations. The optimal 14-3-3β cutoff value for predicting asthma exacerbations was 39.79 ng/mL.

Exploring the Clinical Characteristics, Chromosomal Analysis, and Emotional and Social Considerations in Parents of Children with Down Syndrome

Down syndrome, also known as trisomy 21, is a common chromosomal disorder that affects one in every 750/1000 live births. It is characterized by delayed milestones and repeated chest infections, with most children having microcephaly, low set ears, flat nasal bridge, simian crease, umbilical hernia, CVS findings, and repeated ear infections. The risk of Down syndrome increases to 1:20 for mothers over 40 years old. A study examined 30 children with phenotype suggestive of Down syndrome, with a male to female ratio of 0.76:1. The median age at presentation was 7 years, with a minimum of 3 years and a maximum of 12 years. The mean maternal age at child birth was 32 years, with 13.3% of the children born out of consanguineous marriage. The study found that none of the mothers had a history of abortions, and 6.7% had complications during pregnancy. The most common complaint was delay in attainment of mile stones (96.7%) followed by recurrent LRTI &amp; URTI (13.2%), with 2 having heart disease and 1 having family history of asthma. Physical characteristics included microcephaly (86.7%), low set ears, a flat nasal bridge (96.7%), half of the children had simian crease and umbilical hernia (50%), excessive skin on the back (76.7%), muscular hypotonia (66.7%), dermatoses (26.7%), and hypothyroidism (10%). Cerebral findings were found in 15 children (50%), with endocardial cushion defects being the most common. ASD (13.04%) was most common in 12 children, followed by VSD (10.86%), and PDA (4.3%) was present in 4.3%.

Clarifying the relationship and analyzing the influential factors of bronchial asthma in children with attention-deficit hyperactivity disorder.

Bronchial asthma is closely related to the occurrence of attention-deficit hyperactivity disorder (ADHD) in children, which can easily have adverse effects on children's learning and social interactions. Studies have shown that childhood asthma can increase the risk of ADHD and the core symptoms of ADHD. Compared with children with ADHD alone, children with asthma and ADHD are more likely to show high levels of hyperactivity, hyperactive-impulsive and other externalizing behaviors and anxiety in clinical practice and have more symptoms of somatization and emotional internalization. To explore the relationship between ADHD in children and bronchial asthma and to analyze its influencing factors. This retrospective cohort study was conducted at Dongying People's Hospital from September 2018 to August 2023. Children diagnosed with ADHD at this hospital were selected as the ADHD group, while healthy children without ADHD who underwent physical examinations during the same period served as the control group. Clinical and parental data were collected for all participating children, and multivariate logistic regression analysis was employed to identify risk factors for comorbid asthma in children with ADHD. Significant differences were detected between the ADHD group and the control group in terms of family history of asthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergy medications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationship status (P < 0.05). Out of the 183 children in the ADHD group, 25 had comorbid asthma, resulting in a comorbidity rate of 13.66% (25/183), compared to the comorbidity rate of 2.91% (16/549) among the 549 children in the control group. The difference in the asthma comorbidity rate between the two groups was statistically significant (P < 0.05). The results of the multivariate logistic regression analysis indicated that family history of asthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergy medications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationship status are independent risk factors increasing the risk of comorbid asthma in children with ADHD (P < 0.05). Children with ADHD were more likely to have comorbid asthma than healthy control children were. A family history of asthma, adverse maternal factors during pregnancy, and parental relationship status were identified as risk factors influencing the comorbidity of asthma in children with ADHD. Clinically, targeted interventions based on these factors can be implemented to reduce the risk of comorbid asthma. This information is relevant for results sections of abstracts in scientific articles.

The Determinants of Eosinophilia in Patients With Severe Asthma.

Asthma is defined by the Global Initiative for Asthma (GINA) as a heterogeneous disease characterized by chronic airway inflammation. The pathogenesis of the disease is better understood with the comprehension of immunological pathways. These pathways differ by the type of recruited cells and released interleukin (IL). Thus, asthma can be classified into subtypes based on the underlying immune mechanism: eosinophilic asthma (EA) and non-eosinophilic asthma (NEA). Patients with EA tend to respond better to inhaled corticosteroid as compared to those with NEA. The distinction of EA is very important in the light of emergent type 2 inflammation targeted therapies. We performed a 1-year (2018) retrospective cohort analysis of the Nationwide Inpatient Database (NIS). We included all adult patients presenting with severe asthma. Patients were stratified into two groups: eosinophilic severe asthma and non-eosinophilic severe asthma. The primary outcomes measures were the prevalence of chronic steroid use, status asthmaticus, family history of asthma, food, drug and environmental allergies, presence of nasal polyps, allergic rhinitis, allergic dermatitis, need for mechanical ventilation, need for oxygen supplementation, gastroesophageal reflux disease, in-hospital mortality, and length of stay. We performed descriptive statistics. Continuous parametric variables were reported using a mean and standard deviation. Continuous nonparametric variables were reported using a median and interquartile range. To compare the characteristics of the two groups, we used the independent t-test for continuous parametric variables and the Mann-Whitney U test for continuous nonparametric variables. The Chi-square test was used to assess differences in categorical variables. A total of 2,646 patients were included, out of which 882 belonged to the eosinophilic group and 1,764 were in the non-eosinophilic group. Comparing EA versus NEA, we have found that eosinophilic group was characterized by higher percentage of steroid use (18.3% vs. 9.5%, P < 0.001). This group also had higher rates of status asthmaticus and positive family history (P = 0.009 and 0.004, respectively). The presence of allergies, allergic rhinitis, nasal polyps, and allergic dermatitis was higher among patients with eosinophilia. The need for mechanical ventilation and supplemental oxygen was also higher among this group (P < 0.001 for both); however, there was no significant difference in mortality rate (P = 0.347) and the length of hospital stay was similar in both groups (P < 0.001). We showed herein that the eosinophilic subtype of asthma differs widely from the non-eosinophilic phenotype. Clinically, patients with eosinophilia might exhibit different symptomatology, more atopy, and concomitant comorbidities. However, this group might have better response to steroid therapy and might benefit from the new emergent T2 immune targeted therapy. The identification of EA is crucial for better disease control.

Bronchiolitis in Infants and Children before the Surge of COVID-19: Predictors of Outcome and Length of Stay

Background:: Despite the available clinical practice guidelines, many management decisions in bronchiolitis are made subjectively, resulting in variable length of stay and unplanned ICU admissions. We hypothesized that certain independent predictors would affect the length of stay (LOS) and care escalation. Objectives:: To identify predictors for increased LOS and ICU admissions in acute bronchiolitis. Methods:: We conducted a retrospective descriptive cohort study involving 589 children admitted to MZH with acute bronchiolitis in 2 years. Predictors evaluated were age, gender, family history of asthma, prematurity, fever, hypoxemia, comorbidities, RSV, and medications (salbutamol, steroids, and antibiotics). Results:: Acute bronchiolitis comprised 8.75% of Pediatric admissions and 2.9% of total hospital admissions. The mean age is 8.28±6.1(2-30 months); 83% were infants, 39.2% were girls, 15% were preterm, and 25.1% had a family history of asthma. Despite 84.9% having X-rays, significant findings were present in 21.3%. RSV positive 22.5%. The mean LOS was 3.6±1.6(1-11 days). Age less than 2 months(P=0.029 OR=1.8, CI1.1 - 3.3), family history of asthma (P=0.03 OR=1.8, CI1.14 - 2.9), hypoxemia on admission (P&lt;0.001 OR=3, CI1.8 - 4.9), presence of comorbidity (P=0.012), and significant radiographic findings (P&lt;0.002, OR=2.7, CI1.6 - 4.6) were predictors of longer LOS. Prematurity (P&lt;0.001, OR 8.8, CI 2.7-28.4), RSV bronchiolitis (P&lt;0.002, OR=3.02, CI=1.5 – 6.03), and hypoxemia on admission (P&lt; 0.042 OR=4.6, CI1.1 - 14.9) are qualified as independent predictors for escalated care. Conclusion(s):: RSV bronchiolitis, especially in preterm infants, may prompt a low threshold for admission and escalate the care. Evidence-based treatments, respiratory support, and treatment of comorbidities help to achieve optimal LOS.

Multivitamin consumption and childhood asthma: a cross-sectional study of the NHANES database

BackgroundDietary intakes of vitamins are associated with asthma. However, previous studies mainly explored the association between a single vitamin intake and asthma, which did not take the multivitamins into consideration. Herein, this study aims to explore the overall effect of dietary multivitamins consumption on childhood asthma.MethodsData of children and adolescents (aged 2-17 years old) were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2015-2018 in this cross-sectional study. Weighted univariate logistic regression analysis was used to screen covariates. The association between multivitamins (including vitamin A, C, D, E, B1, B2, B6, B12, K, niacin, folic acid, and choline) and childhood asthma was explored using univariate and multivariate logistic regression analyses. The evaluation indexes were odds ratio (OR) and 95% confidence interval (CI). We further introduced the Bayesian kernel machine regression (BKMR) to assess the joint effect of the twelve vitamins on childhood asthma, the impact of an individual vitamin as part of a vitamin mixture, and the potential interactions among different vitamins.ResultsAmong 4,715 eligible children and adolescents, 487 (10.3%) had asthma. After adjusting for covariates including race, family history of asthma, pregnant smoking, BMI Z-score, energy intake, breast feeding, and low birth weight, we found that for each 1-unit increase in vitamin K consumption, the odds of childhood asthma decreased 0.99 (P=0.028). The overall effect analysis reported a trend of negative relationship between the multivitamins and childhood asthma, especially at the 75th percentile and over. According to the BKMR models, when other vitamins are fixed at the median level, the odds of childhood asthma increased along with the elevated vitamin D (VD) and vitamin B2 (VB2), whereas along with the depressed vitamin C (VC). In addition, no potential interaction has been found between every two vitamins of multivitamins on childhood asthma.ConclusionAmong children and adolescents who have high-risk of asthma, it may be beneficial to increase dietary consumption of multivitamins. Our findings recommended that children and adolescents should increase the intake of VC-rich foods, whereas control the dietary consumption of VD and VB2 in daily life.

Factors Associated with Inhaled Bronchodilator and Oral Corticosteroid Use in Young Children with First Lower Respiratory Tract Infection

ObjectivesTo examine factors associated with claims for and potential overuse of inhaled bronchodilators (IB) and oral corticosteroids (OCS) for children < 2 years old at first lower respiratory tract infections (LRTI) . Study designRetrospective cohort study using Colorado All Payer Claims data from 2009 through 2019. Children with asthma were excluded. Primary outcomes were 1) IB and 2) OCS claims within 7 days of index LRTI. Primary predictors were previous IB or OCS claims for each outcome respectively. Covariates included demographics, atopy, family history of asthma, complex chronic conditions (CCC), prior inhaled corticosteroid (ICS) claim, and location of index LRTI. Separate multivariable logistic regression models were used for each outcome. ResultsOf 10,194 eligible children, 1468 (14.4%) had an IB and 741 (7.3%) an OCS claim at or within 7 days of index LRTI. Index LRTIs were most often at outpatient (OP) visits (64%). Adjusting for covariates, prior IB prescription was associated with the IB outcome (AOR 1.9; 95% CI 1.3, 2.8), and prior OCS prescription was associated with the OCS outcome (AOR 2.2; 95% CI (1.7, 2.9). Other variables associated with either outcome included age, sex, insurance, location, and atopy. Prior ICS claim, asthma family history, and CCC were not associated with either outcome. ConclusionsThis study identifies factors that might serve as opportunities for de-implementation strategies for IB and OCS overuse in young children with LRTI.

GAMBARAN STATUS KONTROL ASMA DAN KUALITAS HIDUP ANAK DENGAN ASMA DI RSUP PROF. DR. I.G.N.G NGOERAH DENPASAR DAN RSUD WANGAYA DENPASAR TAHUN 2020-2021

Asthma is a chronic and emergency disease in children. Uncontrolled asthma in children can affect the quality of life of children and even lead to death. Bali is the province with the third highest prevalence of asthma after the Special Region of Yogyakarta and East Kalimantan. However, data regarding the description of asthma control status and quality of life of children with asthma in Bali, especially in Denpasar, are still limited. Therefore, the authors want to know the overview of asthma control status and quality of life of children with asthma at Prof. Dr. I.G.N.G Ngoerah Hospital Denpasar and Wangaya Hospital Denpasar in 2020-2021. The design of this research is descriptive observational with a cross-sectional approach. After the approval of the constitutional ethics committee, all children aged 6-11 years with asthma at the Outpatient and Inpatient Respirology Pediatric Clinic Prof. Dr. I.G.N.G Ngoerah Hospital Denpasar and Wangaya Hospital Denpasar in 2020-2021 which is recorded in a complete medical record and has approval for participation in the study by parents/guardians (n=32) will be given a questionnaire containing the child and parent’s biodata, Childhood Asthma Control Test (C-ACT) to assess asthma control status, and Pediatric Quality of Life (PedsQL) to assess children's quality of life through an electronic form. Based on asthma control status, the results showed that 27 children (84.4%) had fully controlled asthma control status and 5 children (15.6%) had partially controlled asthma control status. In controlled asthma control status, all children were male. The majority of children (3 children) have poor nutritional status and some (2 children) have obese nutritional status. All children have a family history of asthma. Most of the children's parents have the latest education in college (3 children), senior high school (1 child), and elementary school (1 child). All parents of children have jobs and most of them (3 parents of children) have salaries above the minimum wage. Based on the quality of life, there were 4 children (12.5%) with a disturbed quality of life and 28 (87.5%) children with an undisturbed quality of life. In terms of quality of life, there were 2 children, male and female, respectively. The majority of these children had good nutritional status (2 children) and did not have a family history of asthma (3 children). The parents of the 2 children have the last education in elementary school, while the other 2 parents have the last education in college. All of the children's parents have jobs and the majority (3 parents of children) have salaries above the minimum wage. Further research is needed with a larger sample size and should be carried out prospectively so that the data obtained is more complete.

Exploring the Autoimmune Pathogenesis in Severe Asthma

Introduction: Severe asthma has a poor response to hormone therapy and a poor level of control, so the discovery of new pathogenetic mechanisms is important for diagnosing and treating severe asthma. IL-35 may play a protective role in autoimmune diseases by directly or indirectly inhibiting the secretion of IL-17, which is an important proinflammatory factor involved in the occurrence and development of autoimmune diseases. The autologous serum skin test (ASST) is a good sensitivity and specificity screening test for autoimmune functional autoantibodies. We compared the levels of IL-35 and IL-17 in serum samples, the positive rate of ASST, the level of exhaled nitric oxide (FeNO), and the atopic constitution in patients with severe asthma to those with mild-to-moderate asthma so as to explore the possible autoimmune pathogenesis of severe asthma. Methods: Patients with mild-to-moderate and severe asthma were enrolled. Their age, gender, smoking history, family history of asthma, history of allergic rhinitis, positive allergen results, serum total IgE (TlgE), allergen-specific IgE (slgE), routine blood, ASST results, and FeNO test results were compared and analyzed. The IL-35 and IL-17 levels in serum samples from both groups were measured by enzyme-linked immunosorbent assay for comparison and analysis. The SPSS 22.0 software package was used for statistical analysis. Results: A total of 50 patients with mild-to-moderate asthma and 31 patients with severe asthma were included in this study. The proportion of patients with a history of smoking and a family history of asthma was significantly higher in the severe asthma group compared to the mild-to-moderate asthma group (all p < 0.05); the number of positive allergen tests was significantly lower in patients with severe asthma compared to those with mild-to-moderate asthma (p < 0.001). The rate of positive ASST was significantly higher in patients with severe asthma than in patients with mild-to-moderate asthma (p < 0.05). Serum IL-17 levels were significantly higher in patients with severe asthma than in patients with mild-to-moderate asthma (p < 0.05), but serum IL-35 level between the two group was not significantly different (p = 0.113). ASST-positive patients had a statistically significant increase in the risk of developing severe asthma, while patients with allergen positive were less likely to develop severe asthma (positive ASST: OR = 5.277, p = 0.024; allergen positivity: OR = 0.123, p = 0.001). Conclusions: IL-35 has a weaker inhibitory effect on high IL-17 expression in patients with severe asthma, and the rate of positive ASST was significantly higher in patients with severe asthma, which all suggested the possibility of autoimmune pathogenesis in patients with severe asthma.

Clinical and functional characteristics of patients with bronchial asthma depending on body mass index

The aim of the study was to investigate the relationship between body mass index (BMI) and clinical and anamnestic data in patients with bronchial asthma (BA). Material and methods. 553 patients with BA and 95 apparently healthy individuals without medical or family history of asthma, allergy or atopy symptoms were examined. Patients were divided into three groups depending on BMI: Group I included 152 patients with normal body weight (NBW), II – 206 overweight patients, III – 195 with obesity. BA control was assessed by using the ACQ-5 questionnaire, and the AQLQ was used to assess quality of life. The study was approved by the Bioethics Commission of the Medical Institute of Sumy State University. Statistical analysis of the obtained results was carried out using the SPSS-17 program. Results. There were no significant sex– and age-related differences (p &gt; 0.05) between clinical groups. Complaints, medical history, clinical and instrumental indicators, disease severity, control, and quality of life of patients were analyzed to identify features of BA associated with obesity. The study has found that BA patients with obesity experienced a higher frequency of positive family history (p = 0.004), exacerbations during the cold season (p = 0.001), sensitivity to weather changes (p = 0.001), acute respiratory diseases (p = 0.001), stress (p = 0.001), and a combination of non-specific triggers (p = 0.001) which could result in exacerbations compared to patients with NBW. Exacerbations caused by flowering plants were more common in BA patients with NBW (55.3 %) compared to those with obesity (43.1 %). When comparing BA in individuals with obesity to those with NBW, there were several distinctive features. These included a higher frequency of symptoms such as cough and shortness of breath at rest or with minor physical exertion, weakness, fatigue, sleep disturbances, heartburn; night and day symptoms when using salbutamol, a severe and uncontrolled course with more pronounced obstructive disorders and lower reversibility, pneumonia, exacerbation episodes, and lower quality of life. Conclusions. BA with obesity compared to BA with NBW is characterized by a number of differences such as non-allergic factors as triggers, more severe course, lower level of control and quality of life, pain, pronounced bronchial obstruction with lower reversibility.

Self-reported prevalence of asthma and its associated factors among adult rural population in Bangladesh: a cross-sectional study using WHO PEN protocol

ObjectiveFor over a decade, the prevalence of asthma remained unchanged at around 7% in Bangladesh. Although asthma causes significant morbidity among both children and adults, updates on epidemiological data are...

Parental knowledge and attitudes toward asthma in Jordanian children with asthma, a multi-center cross-sectional study

Objective We explored Jordanian caregivers’ knowledge, attitudes, and practices (KAP) toward asthma in their children. Methods This cross-sectional investigation was conducted on caregivers visiting the pediatrics clinic at the Jordan University Hospital and King Abdullah University Hospital between December 2021 and January 2023. KAP were measured using a literature-validated questionnaire. Differences in KAP scores across participants’ characteristics were examined using the student-t test and ANOVA. Results A total of 108 caregivers were included in the final analysis. Caregivers were aged 30 to 40 years (54.6%) and had at least secondary education (90.7%). The majority of participants displayed appropriate knowledge with respect to asthma’s clinical course. Furthermore, the greater portion of caregivers were knowledgeable about preventing asthma attacks and treating their children during said attacks. Factors affecting knowledge of asthma included age of mothers (p < .05). On the other hand, attitude scores were affected by occupation, type of medication, and family history of asthma (all p < .05). Moreover, employee mothers, children well controlled on both Asthma Control Test and Global Initiative for Asthma scores, and having no pediatric intensive care unit admissions were associated with higher practice treatment scores (all p < .05). Overall practice score was weakly, yet positively correlated with knowledge scores (r = 0.195, p = .043). Similarly, negative attitudes were weakly correlated with higher knowledge scores (r = 0.199, p = .039). Conclusion While the knowledge and practice scores were satisfactory, the clinical status of children with asthma was unsatisfactory. Future studies should examine factors associated with caregiver insecurity and measure their extent of applying asthma prevention guidelines.