Male Asthmatic Patients Research Articles

Measuring the Burden of Climate-Related Asthma in Ireland via Microsimulation and Hybrid Costing

Abstract Asthma affects approximately 5.7% of EU citizens, with over 7.7% of Irish residents suffering from the condition. Climate change will significantly affect both the prevalence and severity of asthma via exposure to temporal stressors including fluctuating air quality, changing local vegetation patterns, and increasingly intense precipitation. Resulting asthma cases will result in significant additional costs and pressures on the healthcare sector, the magnitude of which however remains, to date, unclear. The current project will provide an econometric analysis of the public healthcare burden generated by climate-related asthma via a national longitudinal survey (n = 1,695) of asthma sufferers and semi-structured interviews with healthcare professionals. Current and future likely healthcare expenditures will be quantified using time-driven activity-based costing and microsimulation as a function of future demographic shifts and climate change scenarios. The indirect burden of climate-related effects will be calculated utilizing a hybrid set of physical, psychological, and economic burden-of-disease measures. Preliminary results indicate that asthma-related limitations on daily activities significantly impair males more than females (t = 2.937, p =.005), with decreases in quality of life significantly differing across age groups (F = 4.234, p =.003). The asthma-related toll on quality of life is further associated with presentation of adverse mental health effects including depression (r = -.301, p<.001) and anxiety (r = -.340, p<.001), indicating compounded physical and psychological health and economic susceptibilities within households with younger, male asthma patients. Findings will increase the current evidence-base for specific demographic groups across Ireland, enabling future budget allocation, surveillance, and healthcare management and providing a replicable model for surveillance of the economic burden of climate-related asthma across Europe. Key messages • The study will increase the evidence-base for budgetary allocation based on simulated health vulnerabilities and develop a baseline for research on climate-associated health outcomes. • The study will translate cross-sectoral health impacts into monetary “bottom lines” for elucidating health-related costs associated with specific climate change scenarios via hybrid costing.

Characteristics of patients with severe asthma in primary and secondary care settings considered eligible for biological therapy - the Bulgarian RECOGNISE study.

Asthma is a major non-communicable disease. It affects both children and adults, but is the most common chronic condition among the former. While inhaled controller drugs stabilize the disease in most asthma patients, there are a certain number of people who suffer from severe asthma, which requires treatment escalation. Oral corticosteroids are usually added, but they are associated with various side effects that may limit their application. The introduction of biologicals targeting inflammatory mediators has opened a new era of asthma treatment highlighting the importance of patient characterization.

Estrogen Receptor-α Exacerbates EGF-Inducing Airway Remodeling and Mucus Production in Bronchial Epithelium of Asthmatics.

Although estrogen receptors (ERs) signal pathways are involved in the pathogenesis and development of asthma, their expressions and effects remain controversial. This study aimed to investigate the expressions of ERα and ERβ as well as their mechanisms in airway remodeling and mucus production in asthma. The expressions of ERα and ERβ in the airway epithelial cells of bronchial biopsies and induced sputum cells were examined by immunohistochemistry. The associations of ERs expressions with airway inflammation and remodeling were evaluated in asthmatic patients. In vitro, the regulations of ERs expressions in human bronchial epithelial cell lines were examined using western blot analysis. The epidermal growth factor (EGF)-mediated ligand-independent activation of ERα and its effect on epithelial-mesenchymal transitions (EMTs) were investigated in asthmatic epithelial cells by western blot, immunofluorescent staining, and quantitative real-time polymerase chain reaction. ERα and ERβ were expressed on both bronchial epithelial cells and induced sputum cells, and the expressions showed no sex difference. Compared to controls, male asthmatic patients had higher levels of ERα on the bronchial epithelium, and there were cell-specific expressions of ERα and ERβ in induced sputum. The expression of ERα in the airway epithelium was inversely correlated to forced expiratory volume in 1 second (FEV1) % and FEV1/forced vital capacity. Severe asthmatic patients had significantly greater levels of ERα in the airway epithelium than mild-moderate patients. ERα level was positively correlated with the thickness of the subepithelial basement membrane and airway epithelium. In vitro, co-stimulation of interleukin (IL)-4 and EGF increased the expression of ERα and promoted its nuclear translocation. EGF activated the phosphorylation of ERα via extracellular signal-regulated kinase and c-Jun N-terminal kinase pathways. ERα knockdown alleviated EGF-mediated EMTs and mucus production in airway epithelial cells of asthma. ERα contributes to asthmatic airway remodeling and mucus production through the EGF-mediated ligand-independent pathway.

Spatial, temporal and demographic patterns in asthma mortality in China: A systematic analysis from 2014 to 2020

BackgroundAsthma is an important contributor to the burden of non-communicable diseases in China. Understanding spatial, temporal, and demographic patterns in asthma mortality is relevant to the design and implementation of targeted interventions. MethodsThis study collected information on asthma deaths occurring across 605 disease surveillance points (DSPs) as recorded in the population-based national mortality surveillance system (NMSS) of China. Asthma was defined according to the International Classification of Diseases, 10th Revision code J45-J46. Estimates of age-standardized mortality rates and total national asthma deaths were calculated based on yearly population data. Statistical analysis was performed to investigate the influence of various factors on asthma mortality. ResultsBetween 2014 and 2020, a total of 40 116 asthma deaths occurred in DSPs. Standardized asthma mortality per 100 000 people decreased from 1.79 (95% CI: 1.74–1.83) in 2014 to 1.07 (95% CI: 1.03–1.10) in 2020 in China. In 2020, the overall asthma mortality rate was higher for male patients than for female patients, and asthma mortality rates increased substantially with age. Age-standardized asthma mortality per 100,000 people exhibited significant geographic variation, ranging from 0.93 (95% CI: 0.89–0.98) in Eastern China to 1.04 (95% CI: 0.98–1.10) in Central China and 1.37 (95% CI: 1.29–1.45) in Western China in 2020. Asthma mortality in urban areas appeared to be higher than in rural areas. Socioeconomic factors, including gross domestic product per capita and density of hospital beds per 10,000 population, may be related to asthma mortality. Male asthma patients who lived in rural areas and were aged 65 years and above were generally at high risk of asthma-related mortality. ConclusionsThis study found a spatial and temporal trend for a reduction in asthma deaths over seven years in China; however, there remain important sociodemographic groups that have not secured the same decrease in mortality rates. Trial registrationThis was a purely observational study and thus registration was not required.

Sphingolipid profiles and their relationship with inflammatory factors in asthmatic patients of different sexes

BackgroundAsthma is a heterogeneous disease with distinct prevalence and manifestation between sexes. This study was to identify sex-specific features of asthma via metabolomic analysis of sphingolipids. MethodsForty-two asthma patients (27 women and 15 men) admitted to the Peking University Third Hospital from January 2015 to December 2015 were enrolled. Peripheral venous blood was collected for metabolomic analysis by targeted liquid chromatography-mass spectrometry. Sex hormones(estradiol, progesterone, testosterone, and androstenedione) and multiple inflammatory factors (periostin, leptin, IgE, IL-4, IL-5, IL-10, IL-13, IL-17A, and IFN-γ) were also assessed. The eosinophil percentage in induced sputum was also detected. All these data were applied to comparative analysis between sexes. ResultsTestosterone was negatively related to periostin (ρ = −0.420, P = 0.009) and IL-5 (ρ = −0.540, P = 0.012), while estradiol was positively related to the blood eosinophil percentage (ρ = 0.384, P = 0.025). Among the eighteen species of sphingolipids detected in the 42 patients, five ceramide (Cer) species (Cer16:0, Cer:20:0, Cer22:0, Cer24:0, and Cer26:0) and one sphingomyelin (SM) species (SM38:0) were significantly higher in male than in female patients. Further investigation found that the correlation between Cer20:0 and IL-5 was positive in males (ρ = 0.943, P = 0.005) but negative in females (ρ = −0.561, P = 0.030). ConclusionsTestosterone was negatively correlated with eosinophil inflammatory factors, but estradiol was positively correlated. Male asthma patients had higher ceramide and sphingomyelin levels than female patients. Different sexes had opposite correlations with ceramide and IL-5, respectively, suggesting that therapeutic strategies targeting ceramide should be different between sexes.

Age- and sex-specific prevalence of chronic comorbidity in adult patients with asthma: A real-life study

The presence of comorbidity can be associated with poorer asthma outcomes. Previous prevalence studies focused on a limited selection of comorbid conditions in asthma only. We aimed to determine age- and sex-specific prevalence estimates for the full range of chronic comorbid conditions in adult asthma patients by performing a retrospective cohort study based on 32,787 medical records of patients aged ≥16 years with asthma from 179 general practices in the Netherlands. Age- and sex-specific prevalence estimates of 76 chronic comorbidities and 14 disease categories based on International Classification of Primary Care codes were determined. Chronic comorbidity was present in 65.3% of male asthma patients and 72.8% of female asthma patients, with female patients having a higher mean (SD) of 2.0 (2.1) comorbidities compared to male patients (1.7 (2.0)). This mean increased to 5.0 (2.7) conditions in the 75+ age group. Most prevalent comorbidities were hypertension (20.1%), osteoarthritis (11.5%), eczema (11.5%) and dyspepsia (10.7%). Compared to male asthma patients, female asthma patients showed higher odds for the presence of other chronic conditions in eight disease categories. Neurological (odds ratio [OR]; 95% confidence interval 2.01; 1.76–2.29), blood forming/lymphatics (OR 1.83; 1.38–2.42) and musculoskeletal diseases (OR 1.82; 1.69–1.95) showed the highest association with female sex. In conclusion, the presence of chronic comorbidity is the norm in adults with asthma and it is more prevalent in female than in male asthma patients. The odds of having a specific comorbid condition may differ between the sexes. Attention in guidelines on how to handle comorbidities may lead to a more targeted treatment for comorbidities and more patient-centred asthma management.

Association between asthma and risk of benign prostatic hyperplasia: a retrospective population-based study

Objective The association between asthma and benign prostatic hyperplasia (BPH) has rarely been explored. We investigated whether male asthmatic patients had an increased risk of BPH by conducting this retrospective nationwide population-based study. Methods We utilized data derived from the National Health Insurance Research Database (NHIRD) in Taiwan. A total of 9778 male patients aged >40 years who were newly diagnosed with asthma between 2000 and 2006 were included in the asthma group. Male enrollees without asthma were selected as the non-asthma group from the same database. Both the groups were followed up until the end of 2013. We performed Cox proportional hazard regression analysis to estimate the risk of BPH and transurethral resection of the prostate (TURP) in the male patients with asthma compared with that in those without asthma. Results The risk of BPH and TURP in the asthma group was 1.40-fold (95% confidence interval [CI] = 1.30–1.42) and 1.30-fold (95% CI= 1.31–1.50) higher than that in the non-asthma group, respectively, after adjusting for comorbidities, relevant medications and number of annual outpatient visits. Conclusions The male patients with asthma were found to have a higher risk of BPH than did those without asthma.

Asthma control, lung function, nutritional status, and health-related quality of life: differences between adult males and females with asthma.

ABSTRACTObjective:To evaluate health-related quality of life in asthma patients treated at a referral center in southern Brazil, identifying differences between male and female patients, as well as to evaluate differences between the males and females in terms of asthma control, lung function, and nutritional status. Methods:This was a cross-sectional study involving patients ≥ 18 years of age treated at an asthma outpatient clinic. We evaluated clinical parameters, lung function, nutritional status, and quality of life. Results:A total of 198 patients completed the study. The mean age was 56.2 ± 14.8 years, and 81.8% were female. The proportion of patients with uncontrolled asthma was higher among females than among males (63.0% vs. 44.4%; p = 0.041). The body mass index (BMI) and percentage of body fat were higher in females than in males (30.2 ± 5.8 kg/m2 vs. 26.9 ± 4.5 kg/m2 and 37.4 ± 6.4% vs. 26.5 ± 7.4%; p = 0.002 and p < 0.001, respectively). Quality of life was lower in females than in males in the following domains: symptoms (3.8 ± 1.5 vs. 4.6 ± 1.7; p = 0.006); activity limitation (3.6 ± 1.3 vs. 4.4 ± 1.5; p = 0.001); emotional function (3.6 ± 1.9 vs. 4.5 ± 1.7; p = 0.014); and environmental stimuli (3.2 ± 1.6 vs. 4.3 ± 1.9; p = 0.001). Conclusions:Male asthma patients appear to fare better than do female asthma patients in terms of health-related quality of life, asthma control, BMI, percentage of body fat, and comorbidities.

Development of Salbutamol Sulphate Sublingual Films in Pullulan Matrix for Enhanced Bioavailability & Clinical Efficacy.

Salbutamol sulphate (SS) is a model short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm having poor bioavailability (50%) due to its extensive first-pass effect. Formulation of SS as fast dissolving sublingual films (FDSFs) using a biocompatible and biodegradable Pullulan polymer to bypass its metabolism in liver and offers a fast relieve of asthma. Films were prepared by solvent casting technique adopting 32 factorial design to study the effect of two independent variables namely; polymer type (HPMC E5, Pullulan, and L-HPC) and polymer to Maltodextrin ratio (3:0, 3:1 or 5:1). Films physicomechanical properties, disintegration time and in-vitro dissolution of the prepared formulations were evaluated. Formula F3 containing Pullulan with Maltodextrin in a ratio 3:1 has the least disintegration time (26±2.6 seconds) and the highest dissolution rate (100%±0.5%) after four minutes. Pharmacokinetic study of the optimum formula F3 in healthy human volunteers revealed a shorter tmax (0.75±0.25 hour) compared to Ventolin® tablet 2 mg (2.1±0.37 hour). Clinical evaluation of F3 in 14 male asthmatic patients using ZAN Spirometry showed clinical improvement in lung function parameters when compared with Ventolin® tablets. FDSFs significantly improved the bioavailability of SS and resulted in dramatic improvement in its clinical efficacy.

Rs12603332 is associated with male asthma patients specifically in urban areas of Lahore, Pakistan

ABSTRACTObjective: rs12603332, an important regulatory site variant, is known to alter the regulatory motif E2A that is involved in the maturation of B-lymphocytes. The study was designed to check whether different environmental exposures alter its risk allele association with asthma or not. Methods: 200 Physician-diagnosed asthma patients and 108 healthy individuals were enrolled from hospitals of Lahore. After quantitation of DNA extracted from peripheral blood, amplification of genomic region with rs12603332, followed by single base extension (SBE), was performed. Allele and genotype frequencies were calculated by SHEsis and Haploview software packages. Statistical analyses on PLINK were also performed, taking different factors as covariates. HaploReg analysis was done to predict the effect of risk allele on different regulatory motifs. Results: Risk allele for rs12603332 i.e., “C” allele was found to be significantly associated with male patients residing in urban localities. Conclusion: The finding suggests that on exposure with urban environment, risk allele carriers tend to develop asthma symptoms via epigenetic regulation of motif associated with maturation of B-lymphocytes.

A Study of Prevalence of Obesity in Patients of Bronchial Asthma Attending The Chest Department At Rims,Imphal,Manipur.India.

Objective: To study the prevalence rate of obesity in patients of bronchial asthma attending the chest department at Regional Institute of Medical Sciences,Imphal,Manipur.India. Methods: In a cross-sectional study, I recruited patients with age more than 18 years and older with confirmed bronchial asthma diagnosis at Respiratory Medicine department,RIMS,Imphal,Manipur.Nutritional status was classified by body mass index (BMI). Result: 150 patients were included in this study.Mean age was 35 ± 1.24 years and there were 82 (54.7 %) female patients. Among female,asthma was more common in housewife (30.7 %).Mean BMI was 26.87 ± 4.18 and 60 (40.00 %) were classified as normal weight,49 patients (32.67 %) as overweight and 41 patients (27.33 %) as obesity. Conclusion: The prevalence rate of obesity in this study was 27.33 %.Female asthma patients were more likely to be obese than male asthma patients.

Clinical significance of serum vascular endothelial growth factor in young male asthma patients.

Background/AimsVascular endothelial growth factor (VEGF) is an important mediator of angiogenesis. However, little is known about the potential use of serum levels of VEGF as a biomarker for asthma. We investigated the differences in VEGF levels among normal controls, stable asthma patients, and those with exacerbation of acute asthma. All subjects were young males.MethodsWe measured VEGF levels in each patient group, and examined any serial changes in those with acute exacerbation.ResultsVEGF levels were significantly higher in stable asthmatic patients and even more so in acute asthmatic patients, compared to healthy controls. However, there was no correlation between VEGF levels and forced expiratory volume in 1 second in patients with stable asthma. In addition, there were no correlations between VEGF levels and asthma control test scores. In patients with acute exacerbation, VEGF levels significantly increased during the acute period; their levels decreased gradually at 7 and 14 days after treatment.ConclusionsCompared to normal control patients, the serum levels of VEGF were elevated in stable asthma patients and even more elevated in patients with acute exacerbation. However, the role of VEGF as a biomarker in stable asthma is limited. In patients with acute exacerbation, VEGF levels were associated with clinical improvements.

The relation between nonspecific hyperreactivity of the airways and atopic constitution in asthmatics.

Hyperreactivity of the airways caused by inflammation in asthmatics is the most important pathophysiological change. It represents a suitable ground that in the presence of risk factors and the drivers of asthma, asthmatic attack occurs. Atopic constitution is one of the most important risk factors for the development and expression of asthma. The aim of our study was to investigate the relationship between nonspecific airway hyperreactivity and atopic constituton in asthmatics. This retrospective analysis was conducted considering the results of nonspecific bronchoprovocative test with histamine, skin tests to inhalant allergens and total IgE levels in the serum of asthmatic patients with controlled bronchial asthma. The sample consisted of 162 asthmatics examined during one-year period. The examinees were male asthmatic patients, aged between 18 and 30 years. We found that the examinees with a pronounced non-specific hyperreactivity had more significant skin reaction to inhaled allergens and higher levels of total IgE in serum. The results of our study show that the intensity of airway hyperresponsiveness to histamine in asthmatics is directly related to atopic constitution.

Evaluation of proteasomal gene polymorphisms in Lithuanian patients with asthma

Objective: To investigate polymorphisms of proteasomal genes PSMA6 (rs1048990 and rs2277460), PSMC6 (rs2295826 and rs2295827) and PSMA3 (rs2348071) in Lithuanian patients with asthma. Methods: One-hundred forty-six asthma patients and 150 control subjects were studied. DNA was extracted from peripheral blood samples. Five single nucleotide polymorphisms (SNP’s) of the three proteasomal genes were analyzed using allele-specific amplification or the cleaved amplified polymorphic sequence method. Results: While certain alleles and genotypes of PSMA6 rs2277460 and rs1048990 and PSMA3 rs2348071 SNP’s occurred more frequently in asthma patients than in controls, no statistically significant differences in alleles or genotypes of PSMA6, PSMC6 or PSMA3 were observed between asthma patients and control subjects. However, when male and female study subjects were considered separately, we found that the CG genotype of PSMA6 rs1048990 is significantly more frequent in male asthma patients compared to male control subjects. Conclusions: We found no significant differences in frequencies of selected five proteasomal gene PSMA6, PSMC6 and PSMA3 SNP’s between asthma patients and control subjects overall. Among male subjects, however, the CG PSMA6 rs1048990 genotype was significantly more frequent in asthma patients compared with control subjects.

Reliability and validity of Persian version of perceived stress scale (PSS-10) in adults with asthma.

Asthma is a major public health problem in the world, and recent findings suggest that stress influences asthma and asthma morbidity. The 10-item Perceived Stress Scale (PSS-10) is one of the most frequently used instruments to measure psychological stress. This study was conducted to evaluate the psychometric properties of the Persian versions of the PSS-10 in adults with asthma. In this descriptive cross-sectional study as a methodological research, 106 asthmatic patients referring to several clinics in Sanandaj (western Iran) were selected through convenience sampling. The PSS-10 and the 21-item Depression anxiety and stress scale (DASS-21) were administrated to all patients. Cronbach's alpha was used to evaluate reliability of PSS-10, and confirmatory factor analysis (CFA) and convergent validity were used to evaluate its validity. The results of confirmatory factor analysis indicated that a two-factor structure of PSS-10 provided a good fit to data. The Cronbach's alpha coefficients for negative factor, positive factor and total score (PSS-10) were 0.86, 0.83, and 0.90, respectively. The PSS-10 was positively correlated with the DASS-21 and its subscales, indicating an acceptable convergent validity. Female asthmatic patients scored higher on PSS-10 in comparison with male asthmatic patients. The Persian version of PSS-10 is a valid and reliable instrument to measure perceived stress in adults with asthma.

Clinical characteristics of asthma combined with COPD feature.

PurposeIn clinical practice, some patients with asthma show incompletely reversible airflow obstruction, resembling chronic obstructive pulmonary disease (COPD). The aim of this study was to analyze this overlap phenotype of asthma with COPD feature.Materials and MethodsA total of 256 patients, over the age of 40 years or more with a diagnosis of asthma, based on either 1) positive response to bronchodilator: >200 mL forced expiratory volume in 1 s (FEV1) and >12% baseline or 2) positive methacholine or mannitol provocation test, were enrolled. Among the asthma patients, we defined the overlap group with incompletely reversible airflow obstruction [postbronchodilator FEV1/forced vital capacity (FVC) <70] at the initial time of admission and continuing airflow obstruction after at least 3 months follow up. We evaluated clinical features, serum eosinophil counts, serum total immunoglobulin (Ig) E with allergy skin prick test, spirometry, methacholine or mannitol provocation challenges and bronchodilator responses, based on their retrospective medical record data. All of the tests mentioned above were performed within one week.ResultsThe study population was divided into two groups: asthma only (62%, n=159, postbronchodilator FEV1/FVC ≥70) and overlap group (38%, n=97, postbronchodilator FEV1/FVC <70). The overlap group was older, and contained more males and a higher percentage of current or ex-smokers than the asthma only group. Significantly lower FEV1 and higher total lung capacity, functional residual capacity, and residual volume were observed in the overlap group. Finally, significantly lower serum eosinophil count and higher IgE were seen in the overlap group.ConclusionOur results showed that the overlap phenotype was older, male asthmatic patients who have a higher lifetime smoking intensity, more atopy and generally worse lung function.

Diagnosis of hidden bronchial obstruction using computer‐assessed tracheal forced expiratory noise time

Increased forced expiratory time was first recognized as a marker of obstruction half a century ago. However, the reported diagnostic capabilities of both auscultated forced expiratory time (FET(as)) and spirometric forced expiratory time are contradictory. Computer analysis of respiratory noises provides a precise estimation of acoustic forced expiratory noise time (FET(a)) being the object-measured analogue of FET(as). The aim of this study was to analyse FET(a) diagnostic capabilities in patients with asthma based on the hypothesis that FET(a) could reveal hidden bronchial obstruction. A group of asthma patients involved 149 males aged 16-25 years. In this group, 71 subjects had spirometry features of bronchial obstruction, meanwhile, the remaining 78 had normal spirometry. A control group involved 77 healthy subjects. Spirometry and forced expiratory tracheal noise recording were sequentially measured for each participant. FET(a) values were estimated by means of a developed computer procedure, including bandpass filtration (200-2000 Hz), waveform envelope calculation with accumulation period of 0.01 s, automated measurement of FET(a) at 0.5% level from the peak amplitude. Specificity, sensitivity and area under Receiver Operating Characteristic curve of FET(a) and its ratios to squared chest circumference, height, weight were indistinguishable with baseline spirometry index FEV1 /forced vital capacity. Meanwhile, acoustic features of obstruction were revealed in 41%-49% of subgroup of patients with asthma but normal spirometry. FET(a) of tracheal noise and its ratio to anthropometric parameters seem to be sensitive and specific tests of hidden bronchial obstruction in young male asthma patients.

A Nationwide Survey of the Severity, Comorbidity, and Mortality of Hospitalized Patients with Asthma in Taiwan

To clarify the epidemiology of asthma admission in a nationwide survey, we analyze the characteristics of hospitalized patients in Taiwan. Data regarding asthma-associated hospitalizations were obtained from the National Health Insurance Research Database of Taiwan from January 2001 to December 2002. Patient characteristics in terms of severity, mortality, and cost were stratified by age, gender, and presence of comorbidities. A total of 59,983 hospitalizations with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 493.xx and asthma-related treatment were included in the current analysis. When stratified by age, the number and duration of hospitalizations were distributed in J-shape distribution, with the nadir located in the range of 8-18 years of age. The severity of asthma was found to increase with age (p<0.001) and was more severe in men compared with women (p<0.001). The severity of in-hospital patients was significantly greater in subjects with underlying respiratory disease compared to patients with other comorbidities, such as cardiovascular disease and infectious disease. The mortality rates of all hospitalized asthma patients and pediatric hospitalized asthma patients were 0.77% and 0.02%, respectively. The risk factor for mortality of asthma was older age and male gender in multiple regression. The severity of asthma increased after 18 years of age. Increased comorbidities inelderly patients might contribute to asthma severity. The mortality rate was low in pediatric patients and significantly increased in males and the elderly. The above findings suggestthatadditional effort is required in the treatment of elderly and male asthmatic patients.

Prevalence of food intolerance in bronchial asthma in India

Background and Objective : Food intolerance is an adverse reaction to food in which there is no involvement of defense (immune) system. There is some evidence for the use of food-specific immunoglobulin G (IgG) levels as a guide to identify food intolerance. The current study was thus planned to study the prevalence of IgG-based food intolerance in bronchial asthma (BA) patients and healthy controls in Indian population. Materials and Methods: A total of 65 subjects were recruited for the study comprising 50 cases of BA and 15 healthy controls. These were assessed for food intolerance using specific IgG against selected food items. The results were graded as specific IgG against the selected food item: >30 U/mL - elevated and <30 -normal as per manufacturer`s recommendation. Results: The BA group had highest food intolerance against the vegetables, whereas in control subjects the food intolerance was highest for nuts. The prevalence of food intolerance was higher in male asthmatic patients, but in the control group females showed higher intolerance. The common food items to which food intolerance test was positive in descending order were cow milk (56%), casein (48%), tiger nut (48%), almond (46%), amaranth (46%), peanut (46%), soybean (44%), alga wakame (44%), scallop (44%), mulberry (42%) in asthmatic patients and almond (80%), cowmilk (73%), casein (66.6%), peanut (60%), cashew nut (60%), tiger nut (53.3%), carrot (53.3%), flax seed (53.3%), quino (53.3%), clan (53.3%), sunflower seed (53.3%) in control subjects. Conclusion: The specific IgG is a test to evaluate food intolerance. The common food items to which food intolerance test was positive in descending order were cow milk (56%), casein (48%), tiger nut (48%), almond (46%), amaranth (46%), peanut (46%), soybean (44%), alga wakame (44%), scallop (44%), mulberry (42%) in asthmatic patients.

Environmental and occupational respiratory diseases – 1047. Trend of asthma and attention deficit – a 5-year population survey

Methods This study was based on continuous data from the Taiwanese National Health Insurance Research Database which contained 98% of registry files of all 22.60 million populations. Asthma was selected with code 493.xx of the International Classification of Disease, 9th Revision, and Clinical Modification. Asthma case was defined that the diagnosis occurred more than three times within 6 months. A total 139,629 (74,603 in male, 65,026 in female) patients newly diagnosed with asthma in 2003 were enrolled in this cohort and follow-up. Attention deficit was defined as patients with first diagnosis ICD-9 code of 314.xx. Results There were 0.3% of asthma patients suffering from attention deficit in year 2003 and increased to 1.0% in year 2008. The male asthma patients suffered from attention deficit increased from 0.46% to 1.69% in, which is more common than females (from 0.12 to 0.40, p<0.001). The male asthma patients had 4-fold risk than females to have this problem. Comparing to non-asthma populations, both genders asthma patients presented with almost equivalent risk, though statistical significantly, to have attention deficit (p<0.001). Conclusions Asthma patients significantly increased to develop attention deficit, and male patients had increasing trend within 5 years follow-up period.