Asthma OR Research Articles

Polymorphism Of Orosomucoid-Like 3 ORMDL3 Rs4795405 C>T In Iraqi Patients with Asthma

The aim of this study was to investigate the association of polymorphism of Orosomucoid-like 3 ORMDL3 rs4795405 C/T gene to the susceptibility of asthma among Iraqi asthmatic patients. Forty-five asthmatic patients (23 males and 22 females), their age 19-70 years and 35 healthy controls( 18 males and 17 females) ,their age 18-71years were selected from Wasit Province using a convenient sampling method. Genetic polymorphism of Orosomucoid-like 3 ORMDL3 rs4795405 C>T was carried out using TaqMan -PCR. both patients and control groups, the distribution frequencies of genotypes and alleles of the rs4795405 C/T gene were in Hardy-Weinberg equilibrium (P<0.05) .The most common genotype in both control and asthma patients was the heterozygous genotype CT with a percentage of 67% and 66% respectively. The genotype CC was higher in the asthmatic group (20%) compared to the control group (14%). In contrast, genotype TT, the less predominant genotype, was less in the asthmatic group were less in asthmatic group (13%) compared control group (20%).The C allele was more frequent in asthma patients than in healthy controls (53.33%vs47.14%), whereas the T allele was frequent in healthy controls than in asthma patients (52.86% vs 46.67%) with no significant differences. The association analysis displayed that the individuals carrying the homozygous CC genotype were more likely to have a increased risk of asthma with OR=1.5(CI95% 0.4537to4.9593) ,P=0.5063.The heterozygous genotypes CT was not associated with asthma with OR=1.0 (CI95%0.4103 to2.6538 ),P=0.9288 . The TT genotype decreases the association with asthma OR=0.6 (CI950.1865 to2.0302), P =0.4253. These results suggested that the T allele might play a protective role against asthma whereas the C allele might consider a risk factor in asthma. The subgroup analysis revealed that the asthma risk of females with ORMDL3 CC genotype was 2.4 fold increases the risk of asthma OR=2.4889 (CI95% 0.5478to11.3081), P= 0.2377 The TC and TT genotype decreases the association with the disease with with OR = 0.8485 (CI 95% 0.2312to3.1142), P = 0.8044 and OR= 0.2121(CI95% 0.02 to2.2473)P =0.1979 respectively. Among males, ORMDL3 CT genotype ncreased asthmatic risk among patients’ males 1.3 fold, OR= 1.3333 (CI95%0.3433 to 5.1781), P=0.6777. The genotype CC decreases the association with the disease OR=0.3810 (CI95%0.0317to 4.5813), P=0.4469. While, the homozygous TT genotype was not associated with the disease OR=1.0294 (CI95% 0,2313 to4.5814), P=0.9696. The analysis of genetic model for Orosomucoid-lik 3 ORMDL3 rs4795405 showed the recessive model (CC+CT/ TT ) increased the association with the asthma OR=1.6250 P=0.4253.The Over-dominant model(CT+TT/ CC) and the dominant model(CT+TT/ CC) decreased the association with asthma OR=0.9583,P=0.9288and OR= 0.6667 ,P=0.5063 respectively.

Occupational exposure and new-onset asthma in the population-based Telemark study: a 5-year follow-up

ObjectivesThis study aimed to estimate the incidence of asthma and assess the association between job exposure matrix (N-JEM) assigned occupational exposure, self-reported occupational exposure to vapour, gas, dust and fumes...

Uptake of COVID-19 vaccines and association with hospitalisation due to COVID-19 in pregnancy: Retrospective cohort study

ObjectivesTo determine demographic and clinical characteristics associated with uptake of COVID-19 vaccines among pregnant women, and quantify the relationship between vaccine uptake and admission to hospital for COVID-19. BackgroundPregnant women are at increased risk of severe adverse outcomes from COVID-19. Since April 2021, COVID-19 vaccines were recommended for pregnant women in the UK. Despite this, evidence shows vaccine uptake is low. However, this evidence has been based only on women admitted to hospital, or on qualitative or survey-based studies. MethodsRetrospective cohort study including all pregnancies ending between 18 June 2021 and 22 August 2022, among adult women registered with a Northwest London general practice. Statistical analyses were mixed-effects multiple logistic regression models. We conducted a nested case-control analysis to quantify the relationship between vaccine uptake by end of pregnancy and hospitalisation for COVID-19 during pregnancy. ResultsOur study included 47,046 pregnancies among 39,213 women. In 26,724 (57%) pregnancies, women had at least one dose of vaccine by the end of pregnancy. Uptake was lowest in pregnant women aged 18–24 (33%; reference group), Black women compared with White (37%; OR 0.55, 95% CI: 0.51 to 0.60), and women in more deprived areas (50%; reference group). Women with chronic conditions were more likely to receive the vaccine than women without (Asthma OR 1.21, 95% CI: 1.13 to 1.29). Patterns were similar for the second dose. Women admitted to hospital were much less likely to be vaccinated (22%) than those not admitted (57%, OR 0.22, 95% CI: 0.15 to 0.31). ConclusionsWomen who received the COVID-19 vaccine were less likely to be hospitalised for COVID-19 during pregnancy. COVID-19 vaccine uptake among pregnant women is suboptimal, particularly in younger women, Black women, and women in more deprived areas. Interventions should focus on increasing uptake in these groups to improve health outcomes and reduce health inequalities.

Venous thromboembolism associated with severe dyspnoea and asthma in 102 792 adults.

The most recent guideline on acute pulmonary embolism (PE) indicates possible long-term sequelae such as dyspnoea and chronic thromboembolic pulmonary hypertension after a PE event. However, effects on lung function or asthma risk have not been evaluated in the general population. We tested whether individuals with a venous thromboembolism (VTE) encompassing PE and deep vein thrombosis (DVT) have reduced lung function, or greater risks of dyspnoea and asthma using data from 102 792 adults from the Copenhagen General Population Study. Diagnoses of PE, DVT and asthma were collected from the national Danish Patient Registry. Factor V Leiden and prothrombin G20210A gene variants were determined using TaqMan assays. Prevalences of PE, DVT and VTE were 2.2%, 3.6% and 5.2%, respectively. Individuals with VTE had forced expiratory volume in 1 s of 92% predicted compared with 96% pred in individuals without VTE (p<0.001). Individuals with VTE versus those without had adjusted OR (95% CI) for light, moderate and severe dyspnoea of 1.4 (1.2-1.6), 1.6 (1.4-1.8) and 1.7 (1.5-1.9), respectively. Individuals with VTE versus those without had an adjusted OR for asthma of 1.6 (95% CI 1.4-1.8). Factor V Leiden and prothrombin G20210A genotype also associated with increased risk of asthma (p for trend=0.002). Population-attributable fractions of severe dyspnoea and asthma due to VTE were 3.5% and 3.0%, respectively, in the population. Individuals with VTE have worse lung function and higher risks of severe dyspnoea and asthma, and may account for 3.5% and 3.0% of people with severe dyspnoea and asthma, respectively, in the general population.

Association between adult food insecurity and self-reported asthma in the United States: NHANES 2003–2018

Objective Asthma is a chronic disease of the lungs. The development of asthma is related to various risk factors. Food insecurity is a critical social determinant of health, although there is little information on the association between adult food insecurity and asthma. The purpose of this study is to explore the potential correlation in US adults. Methods The study population data were extracted from NHANES 2003–2018. Food insecurity was measured using the USDA FSSM and categorized as full, marginal, low, or very low food security. The assessment of self-reported asthma was determined by self-report questionnaires. The self-reported positive outcomes were that participants had asthma and a history of asthma attacks and asthma-related ER visits in the past year. We developed two multivariate logistic regression models. Stratified analyses were performed by gender and age. Results A total of 38,077 participants were considered in our final analysis. Compared to participants with FFS, the ORs (95% CIs) for asthma were 1.16 (1.00–1.33), 1.42 (1.23–1.64), and 1.56 (1.34–1.80) for participants with MFS, LFS, and VLFS, respectively (Model II). Additionally, after full adjustment, individuals with VLFS had 49% greater risks of asthma attacks (OR = 1.49; 95% CI 1.13–1.97). The ORs (95% CIs) for asthma-related ER visits were 1.59 (1.14–2.23) and 1.98 (1.36–2.87) for participants with LFS and VLFS, respectively (Model II). The positive correlations remained robust when stratified by gender and age. Conclusion Our research showed that food insecurity among US adults was associated with asthma, asthma attacks, and asthma-related ER visits.

FUNGUS AMONG US? THE ASSOCIATION BETWEEN FUNGAL DERMATOPHYTES AND ALLERGIC HYPERSENSITIVITY REACTIONS

<h3>Introduction</h3> The dermatophyte <i>Trichophyton rubrum t</i>ypically infects human skin, hair, and nails and causes common cutaneous manifestations such as athlete's foot and fungal nail infections. However, it has been proposed that sensitization, characterized by high levels of circulating IgE, to this allergen is a risk factor for future development of severe asthma. We surveyed the current literature to find clinical associations. <h3>Methods</h3> A systematic review was conducted using PubMed, Embase, and Web of Science using the search terms "<i>Trichophyton rubrum</i> AND rhinosinusitis OR asthma OR rhinitis OR conjunctivitis OR allergic fungal sinusitis OR allergic bronchopulmonary aspergillosis". Only studies with clinical data were used. <h3>Results</h3> Four studies met inclusion criteria with 356 total patients. They consisted of a case report presenting bronchial asthma and dystrophic toenails whose KOH scrapings isolated <i>Trichophyton rubrum</i> (n=1)<i>,</i> a case series of patients with positive skin-prick- tests and bronchial reactivity to <i>Trichophyton</i> with moderately severe asthma (n=11), a cohort which completed allergen sensitization for <i>Trichophyton</i> with high positivity rates associated with moderate asthma (n=258), and a case series investigating the role of inhaling <i>Trichophyton</i> and its association with asthma (n=86). In these studies, patients treated with systemic steroids (n=12) showed minimal change in pulmonary function tests. After treatment with both oral and topical antifungals (n=12), patients reported a resolution of asthma symptoms leading to a concurrent cessation of allergy medications. <h3>Conclusions</h3> This systematic review identified rare but important association of hypersensitivity to <i>Trichophyton rubrum</i> and the development of severe asthma. Treatment with antifungal agents was more effective than allergy medications.

HOW ALLERGISTS ARE SAVING MARRIAGES: A REVIEW ON SEXUAL INTERCOURSE PRESENTING AS EXERCISE-INDUCED ASTHMA

<h3>Introduction</h3> Exercise has been long associated as a trigger for asthma. Exercise induced symptoms have been attributed to 40-90% of asthmatic patients. However, sexual intercourse is uncommonly associated as exercise. The purpose of this review is to investigate sexual intercourse as an underdiagnosed trigger for asthma exacerbations. <h3>Methods</h3> We collected in this review the available literature on this subject. The PUBMED database was searched by a combination of keywords and MESH terms: sexual intercourse OR honeymoon asthma OR sexual behavior AND allergy OR allergic reaction.The studies retrieved were independently evaluated by the authors and included in this review based on their clinical correlation and pertinence. No IRB was required. <h3>Results</h3> Several case studies have reported post-coital asthma exacerbations however more cases have been reported of allergic reactions to coital activity such as seminal fluid or latex. The few reported cases allude to underreporting of this condition given the intimate nature of this subject. Disclosure relies on the patient's comfortability with their provider and the provider's awareness of characterizing sexual activity as exercise. It is estimated the energy expenditure of sexual activity is approximately equivalent to walking up two flight of stairs. When sexually activity induced asthma is properly identified and treated, allergists are placed in a position where they can improve their patients' quality of life. <h3>Conclusion</h3> Properly investigating all causes of asthma exacerbations, including sexual intercourse, which shares its pathogenesis with exercise-induced asthma, can place allergists in a position of positively improving their patient's lives, including their marriages.

Plasma adiponectin and risk of asthma: observational analysis, genetic Mendelian randomisation and meta-analysis

BackgroundAdiponectin, an adipocyte-secreted protein-hormone with inflammatory properties, has a potentially important role in the development and progression of asthma. Unravelling whether adiponectin is a causal risk factor for asthma is...

The Asthma Family Tree: Evaluating Associations Between Childhood, Parental, and Grandparental Asthma in Seven Chinese Cities.

Objective: To evaluate the associations between childhood, parental, and grandparental asthma.Methods: We studied 59,484 children randomly selected from 94 kindergartens, elementary, and middle schools in seven Chinese cities from 2012 to 2013, using a cross-sectional survey-based study design. Information on their and their family members' (parents, paternal grandparents, and maternal grandparents) asthma status were reported by children's parents or guardians. Mixed effects logistic regressions were used to assess hereditary patterns of asthma and mediation analysis was performed to estimate the potential mediation effect of parents on the association between grandparental asthma and childhood asthma.Results: The magnitude of ORs for childhood asthma increased as the number of family members affected by asthma increased. Among children who had one family member with asthma, childhood asthma was associated with asthma in maternal grandmothers (OR: 2.08, 95% CI: 1.67–2.59), maternal grandfathers (OR: 2.08, 95% CI: 1.71–2.53), paternal grandmothers (OR: 2.40, 95% CI: 1.93–2.99), and paternal grandfathers (OR: 2.59, 95% CI: 2.14–3.13). Among children who had two family members with asthma, the highest asthma risk was found when both parents had asthma (OR: 15.92, 95% CI: 4.66–54.45). Parents had a small proportion of mediation effect (9–12%) on the association between grandparental asthma and childhood asthma.Conclusions: Grandparents with asthma were associated with childhood asthma and parents with asthma partially mediated the association.

Fast food and sweet intake pattern is directly associated with the prevalence of asthma in a Qatari population

ObjectiveThe relationship between dietary patterns and the prevalence of asthma is not well understood. We aimed to investigate the association between dietary patterns and asthma in adults in Qatar.MethodsIn this study, cross-sectional data from the Qatar Biobank were used (n = 986). Participants were Qatari or long-term Qatar residents aged ≥20 years old. A food frequency questionnaire was used to collect dietary intakes. Three dietary patterns were identified using factor analysis. Multivariable logistic regression was used to assess the association between dietary patterns scores and asthma.ResultsAmong 986 eligible participants, 6.6% (n = 65) reported that they were diagnosed with asthma. Three dietary patterns were identified. These were (1) “Traditional” (high intake of rice, chicken/meat/fish, and breads); (2) “Prudent” (high intake of fruits, vegetables, and fish); and (3) “Fast Food/Sweets” (high intake of desserts, fast food, and soft drinks). The fast food/sweet dietary pattern was associated with increased likelihood of having asthma [comparing high vs. low tertile, OR for asthma = 1.25; 95% CI (1.02–1.54); p = 0.035]. Traditional and Prudent dietary patterns were not associated with the prevalence of asthma.ConclusionThe fast food/sweet dietary pattern was directly associated with the prevalence of asthma among adults in Qatar. Reducing the fast foods and sugary-rich foods may be beneficial for respiratory health.

Modification of caesarean section on the associations between air pollution and childhood asthma in seven Chinese cities

It is unknown whether giving birth via caesarean section (c-section) is a modifier for the association between air pollution and asthma. From 2012 to 2013, 59,754 children between the ages of 2 and 17 were randomly selected from 94 middle schools, elementary schools and kindergartens in seven Chinese cities for a cross-sectional study. The children's parents or guardians completed questionnaires, from which data on asthma as well as asthma-related symptoms were obtained. Participants' exposure to particles with an aerodynamic diameter ≤1.0 μm (PM1), ≤2.5 μm (PM2.5), and ≤10 μm (PM10) and exposure to nitrogen dioxide (NO2) were estimated using random forest models. We used mixed effects logistic regression models and added an interaction term between mode of delivery and ambient air pollution into the model to estimate effect modification from c-sections after appropriate adjustments for potential confounding variables. Among children delivered by c-section, the adjusted ORs for asthma and its symptoms per interquartile range (IQR) increase of PM1, PM2.5, PM10 and NO2 (1.20 95% CI: 1.07–1.34 to 2.04 95% CI: 1.87–2.24) were significantly higher than those of children delivered vaginally (1.05 95% CI: 0.92–1.19 to 1.33 95%CI: 1.21–1.47). The interactions between c-sections and ambient air pollution were statistically significant for all studied respiratory disorders, except current wheeze. Delivery via c-section may increase the risks of air pollution on asthma and its symptoms in Chinese children.

Association of two polymorphisms of miRNA-146a rs2910164 (G > C) and miRNA-499 rs3746444 (T > C) with asthma: a meta-analysis

Objective To conduct a meta-analysis to determine the association between two single nucleotide polymorphisms (SNPs) miRNA146a rs2910164 (G > C) and miRNA-499 rs3746444 (T > C) and asthma risk. Data Sources PubMed and Embase (updated May 17, 2019). Keywords (microRNA OR microRNAs) AND (polymorphism OR polymorphisms) AND (Asthmas OR Bronchial Asthma OR Asthma, Bronchial). Results Six eligible case-control studies (2441 asthma cases and 3044 controls) met our inclusion criteria. A trend of increased asthma risk was indicated by the heterozygote model (miR-499: TC versus TT, OR = 1.38, 95% CI = 1.06–1.79, P < 0.01) and the dominant model (miR-499: TC + CC versus TT, OR = 1.60, 95% CI = 1.07–2.39, P < 0.01) of miRNA-499 rs3746444. Polymorphisms rs2910164 in miRNA-146a of the allele model (miR-146a: C versus G, OR = 0.84, 95% CI = 0.74–0.96, P = 0.238), homozygote model (miR-146a: CC versus GG, OR = 0.68, 95% CI = 0.51–0.91, P = 0.213), recessive model (miR-146a: CC versus GC + GG, OR = 0.75, 95% CI = 0.60–0.94, P = 0.149) indicated a decreased risk of asthma. Conclusions The miR-499 rs3746444 (T > C) polymorphism is associated with asthma susceptibility and miRNA-146a rs2910164 (G > C) polymorphism has a protective role against susceptibility to asthma.

Lifestyle, sick leave and work ability among Norwegian employees with asthma-A population-based cross-sectional survey conducted in Telemark County, Norway.

To investigate whether physician-diagnosed asthma modifies the associations between multiple lifestyle factors, sick leave and work ability in a general working population. A cross-sectional study was conducted in Telemark County, Norway, in 2013. A sample of 16 099 respondents completed a self-administered questionnaire. We obtained complete data on lifestyle, work ability and sick leave for 10 355 employed persons aged 18-50 years. We modelled sick leave and work ability using multiple logistic regression, and introduced interaction terms to investigate whether associations with lifestyle factors were modified by asthma status. Several lifestyle risk factors and a multiple lifestyle risk index were associated with sick leave and reduced work ability score among persons both with and without physician-diagnosed asthma. A stronger association between lifestyle and sick leave among persons with asthma was confirmed by including interaction terms in the analysis: moderate lifestyle risk score * asthma OR = 1.4 (95% CI 1.02-2.1); high lifestyle risk score * asthma OR = 1.6 (95% CI 1.1-2.3); very high lifestyle risk score * asthma OR = 1.6 (95% CI 0.97-2.7); obesity * asthma OR = 1.5 (95% CI 1.02-2.1); past smoking * asthma OR = 1.4 (95% CI 1.01-1.9); and current smoking * asthma OR = 1.4 (95% CI 1.03-2.0). There was no significant difference in the association between lifestyle and work ability score among respondents with and without asthma. In the present study, we found that physician-diagnosed asthma modified the association between lifestyle risk factors and sick leave. Asthma status did not significantly modify these associations with reduced work ability score. The results indicate that lifestyle changes could be of particular importance for employees with asthma.

Adiposity and asthma in adults: a bidirectional Mendelian randomisation analysis of The HUNT Study

BackgroundWe aimed to investigate the potential causal associations of adiposity with asthma overall, asthma by atopic status or by levels of symptom control in a large adult population and stratified...

Risk Factors for Herpes Zoster Infection: A Meta-Analysis.

BackgroundThe burden of herpes zoster (HZ) is significant worldwide, with millions affected and the incidence rising. Current literature has identified some risk factors for this disease; however, there is yet to be a comprehensive study that pools all evidence to provide estimates of risk. Therefore, the purpose of this study is to identify various risk factors, excluding immunosuppressive medication, that may predispose an individual to developing HZ.MethodsThe literature search was conducted in MEDLINE, EMBASE, and Cochrane Central, yielding case control, cohort, and cross-sectional studies that were pooled from January 1966 to September 2017. Search terms included the following: zoster OR herpe* OR postherpe* OR shingle* AND risk OR immunosupp* OR stress OR trauma OR gender OR ethnicity OR race OR age OR diabetes OR asthma OR chronic obstructive pulmonary disease OR diabetes. Risk ratios (RRs) for key risk factors were calculated via natural logarithms and pooled using random-effects modeling.ResultsFrom a total of 4417 identified studies, 88 were included in analysis (N = 3, 768 691 HZ cases). Immunosuppression through human immunodeficiency virus/acquired immune deficiency syndrome (RR = 3.22; 95% confidence interval [CI], 2.40–4.33) or malignancy (RR = 2.17; 95% CI, 1.86–2.53) significantly increased the risk of HZ compared with controls. Family history was also associated with a greater risk (RR = 2.48; 95% CI, 1.70–3.60), followed by physical trauma (RR = 2.01; 95% CI, 1.39–2.91) and older age (RR = 1.65; 95% CI, 1.37–1.97). A slightly smaller risk was seen those with psychological stress, females, and comorbidities such as diabetes, rheumatoid arthritis, cardiovascular diseases, renal disease, systemic lupus erythematosus, and inflammatory bowel disease compared with controls (RR range, 2.08–1.23). We found that black race had lower rates of HZ development (RR = 0.69; 95% CI, 0.56–0.85).ConclusionsThis study demonstrated a number of risk factors for development of HZ infection. However, many of these characteristics are known well in advance by the patient and clinician and may be used to guide discussions with patients for prevention by vaccination.

Greenness Availability and Respiratory Health in a Population of Urbanised Children in North-Western Italy.

Paediatric Asthma contributes in paediatric global burden of diseases, as the most common chronic disease in children. Children are exposed to many environmental risk-factors, able to determine or worsen respiratory diseases, and contributing to asthma and asthma-like symptoms increases, especially in metropolitan areas. In urban settings, surrounding vegetation (greenness) may provide important benefits to health, including the promotion of physical activity and the mitigation of air and noise pollution. The aim of this study was to investigate the association between greenness and respiratory health. A total of 187 children (10–13 yrs old) were recruited in Turin, the north-western part of Italy. The prevalence of asthma and asthma-like symptoms was calculated from self-reported data collected by SIDRIA questionnaire. Spirometry test was performed to obtain respiratory flow measurements. Greenness was measured at individual level through the Normalised Difference Vegetation Index (NDVI) estimations from remote-sensing images. Higher exposure (3rd tertile vs. 1st tertile) to NDVI was associated to significantly lower ORs for asthma [0.13 CI 95% 0.02–0.7, p = 0.019], bronchitis [0.14 CI 95% 0.05–0.45, p = 0.001], and current wheezing [0.25 CI 95% 0.09–0.70, p = 0.008]. A significative positive association was found between greenness and FEF25–75, since children exposed to the 2nd tertile of NDVI reported a significantly decreased FEF25–75 compared to those in the 3rd tertile [B: −2.40; C.I.95%: −0.48–0.01; p = 0.049]. This cross-sectional study provided additional data on still inconsistent literature referring to respiratory health in children and green spaces, attesting a positive effect of greenness in a specific area of Italy. Further research is still needed.

Using Scotland-wide record linkage to investigate the educational and health outcomes of children treated for chronic medical conditions: a retrospective population cohort study

BackgroundChronic ill health can affect children's educational and health outcomes. Previous studies have reported poorer school outcomes among children with diabetes, asthma, epilepsy, attention deficit hyperactivity disorder (ADHD), and depression; however, many have limitations, very few have analysed multiple outcomes or population-wide data, and literature in Scotland and the UK is scarce. We aimed to identify children prescribed medication for these chronic medical conditions and investigate their educational and health outcomes compared with their peers. MethodsWe retrospectively linked Scotland-wide education records for children attending primary and secondary schools in Scotland between 2009 and 2013 to prescribing data, acute and psychiatric hospital admissions, maternity records, and deaths. School absenteeism, exclusion, and special educational need were analysed annually using generalised estimating equations. Academic attainment was analysed using generalised ordinal logistic regression and unemployment with binomial logistic regression. All-cause hospitalisation and mortality were analysed using Cox proportional hazards or Poisson piecewise regression. Analyses were restricted to singleton children born in Scotland and adjusted for sociodemographic or maternity factors and comorbid conditions Findings766 244 schoolchildren were included in the analyses. All conditions were associated with increased school absenteeism (diabetes incidence rate ratio [IRR] 1·34, asthma 1·25, epilepsy 1·50, ADHD 1·18, depression 1·95), special educational need (diabetes odds ratio [OR] 2·45, asthma 1·28, epilepsy 10·11, ADHD 8·77, depression 2·24], and all-cause hospitalisation (diabetes hazard ratio [HR] 3·97, asthma 1·69, epilepsy 3·72, ADHD 1·33, depression 2·56). All, excluding diabetes, were associated with poorer academic attainment (asthma OR 1·11, epilepsy 4·07, ADHD 3·64, depression 3·44] and all, excluding ADHD, were associated with increased all-cause mortality [diabetes HR 3·84, asthma 1·77, epilepsy 24·77, depression 6·21]. ADHD (IRR 5·82) and depression (1·65) were associated with increased exclusion from school, whereas epilepsy (OR 1·99), ADHD (1.42), and depression (1·98) were associated with subsequent unemployment. InterpretationIn addition to poorer health outcomes, schoolchildren with these chronic medical conditions have significant educational disadvantage compared with their peers. Interventions and further understanding of the relationships between health and education among children with these conditions is required. FundingHealth Data Research UK

Comorbidity associated with Severe Mental illness (The APNA study)

Abstract People with severe mental illness (SMI) that includes bipolar disorder or schizophrenia die on average 10-20 years sooner than the general population. Poor mental health can negatively affect quality of life and life expectancy more so than having multiple physical illnesses. The division between health services treating mental and physical health often means that patients suffering from both physical and mental conditions are at particular risk of poor care. Although more than 50 million people in the EU suffer multiple from more than one chronic disease, it is not well know the comorbidity associated with severe mental illness. Methods The study is a cross-sectional study within the APNA Study (Navarre primary health care prospective cohort) that included 470942 people over 18 years old in Navarre (Spain). Age, sex, chronic diseases diagnosis and SMI) that includes (bipolar disorder or schizophrenia were extracted. Lineal regression models for the number of chronic disease were computed. Logistic regression adjusted by sex and age, was computed for each chronic disease. Results Adjusting by age and sex, people with SMI have 1.47 (95% CI 1.44-1.50) more chronic diseases than people without SMI. Adjusting by age and sex, persons with SMI have a higher prevalence of comorbidity: OR = 13.29 (95% CI = 12.27-14.36). Patients with SMI have a higher prevalence of asthma OR = 1.41 (95% CI 1.21-1.64), COPD OR = 2.30 (95% CI 2.51-3.35), Type 2 DM OR = 1.50 (95% CI 1.31-1.70) hyperthyroidism OR = 1.63 (95% CI 1.26-2.10), Chronic kidney disease OR = 1.,43 (95% IC 1.10-1.88), Obesity OR = 1.68 (95% CI 1.47-1,92) and Hypothyroidism OR 1.63 (95% IC 1.43-1,85). Conclusions Patients with severe mental illness have a higher prevalence of comorbidity than the general population with an OR of 13.29. Health service should screen patient with severe mental illness for chronic diseases due to their high prevalence and mortality. Key messages Patients with severe mental illness die on average 10-20 years sooner than the general population this could be to a higher prevalence of comorbidity. Health services should screen patients with severe mental illness for chronic diseases due to their higher prevalence.

2302. A Meta-Analysis of Risk Factors for Herpes Zoster Infection

BackgroundThe burden of herpes zoster (HZ) is significant worldwide, with millions affected and the incidence rising. Current literature has identified some risk factors for this disease; however, there is yet to be a comprehensive study that pools all evidence to provide estimates of risk. Therefore, The purpose of this study was to identify various risk factors, excluding immunosuppressive medication, that may predispose an individual to developing herpes zoster.MethodsThe literature search was conducted in MEDLINE, EMBASE, Cochrane Central, Cochrane Systematic Reviews, Web of Science, CAB Direct, yielding case–control, cohort and cross-sectional studies that were pooled from January 1966 to September 2018. Search terms included: zoster OR herpe*OR postherpe*OR shingle*AND riskOR immunosupp*OR stress OR trauma OR gender OR ethnicity OR race OR age OR diabetes OR asthma OR chronic obstructive pulmonary disease OR diabetes. Risk ratios for key risk factors were calculated via natural logarithms and pooled using random effects modeling.ResultsFrom a total of 4417 identified studies, 93 were included in analysis (n = 3826134 HZ cases). Immunosuppression through HIV/AIDS (RR 3.25; 95% CI 2.47–4.27) or malignancy (RR 2.17; 95% CI 1.86–2.53) significantly increased the risk of HZ compared with controls. Family history was also associated with a greater risk (RR 2.48; 95% CI 1.70–3.60), followed by physical trauma (RR 2.01; 95% CI 1.39–2.91) and older age (RR 1.68; 95% CI 1.41–2.01). A slightly smaller risk was seen those with psychological stress, females, and comorbidities such as diabetes, rheumatoid arthritis, cardiovascular diseases, renal disease, SLE, and IBD compared with controls (RR range: 2.08 to 1.25). We found that black race had lower rates of HZ development RR 0.69 (95% CI 0.56–0.85).ConclusionThis study demonstrated patients with family history of HZ, older age, female sex, have particular comorbidities or are immunosuppressed have an elevated risk of herpes zoster. Patients with these characteristics are prime candidates for vaccination.Disclosures All authors: No reported disclosures.

Benefits of influenza vaccination on the associations between ambient air pollution and allergic respiratory diseases in children and adolescents: New insights from the Seven Northeastern Cities study in China

BackgroundLittle information exists on interaction effects between air pollution and influenza vaccination on allergic respiratory diseases. We conducted a large population-based study to evaluate the interaction effects between influenza vaccination and long-term exposure to ambient air pollution on allergic respiratory diseases in children and adolescents. MethodsA cross-sectional study was investigated during 2012–2013 in 94 schools from Seven Northeastern Cities (SNEC) in China. Questionnaires surveys were obtained from 56 137 children and adolescents aged 2–17 years. Influenza vaccination was defined as receipt of the influenza vaccine. We estimated air pollutants exposure [nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters ≤1 μm (PM1), ≤2.5 μm (PM2.5) and ≤10 μm (PM10)] using machine learning methods. We employed two-level generalized linear mix effects model to examine interactive effects between influenza vaccination and air pollution exposure on allergic respiratory diseases (asthma, asthma-related symptoms and allergic rhinitis), after controlling for important covariates. ResultsWe found statistically significant interactions between influenza vaccination and air pollutants on allergic respiratory diseases and related symptoms (doctor-diagnosed asthma, current wheeze, wheeze, persistent phlegm and allergic rhinitis). The adjusted ORs for doctor-diagnosed asthma, current wheeze and allergic rhinitis among the unvaccinated group per interquartile range (IQR) increase in PM1 and PM2.5 were significantly higher than the corresponding ORs among the vaccinated group [For PM1, doctor-diagnosed asthma: OR: 1.89 (95%CI: 1.57–2.27) vs 1.65 (95%CI: 1.36–2.00); current wheeze: OR: 1.50 (95%CI: 1.22–1.85) vs 1.10 (95%CI: 0.89–1.37); allergic rhinitis: OR: 1.38 (95%CI: 1.15–1.66) vs 1.21 (95%CI: 1.00–1.46). For PM2.5, doctor-diagnosed asthma: OR: 1.81 (95%CI: 1.52–2.14) vs 1.57 (95%CI: 1.32–1.88); current wheeze: OR: 1.46 (95%CI: 1.21–1.76) vs 1.11 (95%CI: 0.91–1.35); allergic rhinitis: OR: 1.35 (95%CI: 1.14–1.60) vs 1.19 (95%CI: 1.00–1.42)]. The similar patterns were observed for wheeze and persistent phlegm. The corresponding p values for interactions were less than 0.05, respectively. We assessed the risks of PM1-related and PM2.5-related current wheeze were decreased by 26.67% (95%CI: 1.04%–45.66%) and 23.97% (95%CI: 0.21%–42.08%) respectively, which was attributable to influenza vaccination (both p for efficiency <0.05). ConclusionsInfluenza vaccination may play an important role in mitigating the detrimental effects of long-term exposure to ambient air pollution on childhood allergic respiratory diseases. Policy targeted at increasing influenza vaccination may yield co-benefits in terms of reduced allergic respiratory diseases.