Positive Family History Of Asthma Research Articles

Asthma control among teenagers attending the respiratory outpatient clinic of an academic hospital in Pretoria, South Africa

Objectives: Bronchial asthma is characteristically a diverse illness that results from chronically inflamed bronchi. Adolescents are a particularly vulnerable group to asthma, and both its prevalence and death rate have increased in this patient population. Asthma care creates a particular set of difficulties for adolescents who are at a stage where there is a search for greater autonomy and changing social and emotional dynamics. The aim of this study was to describe the clinical characteristics of teenage asthmatics in an academic hospital. Materials and Methods: This was a cross-sectional study of patients between the ages of 13 and 18 who had consented to participate. The study consisted of face-to-face interviews and a review of their clinical and laboratory records. Data were analyzed using descriptive statistics and comparisons between groups made using Fisher’s test of exactness. Results: Eighty-seven teenagers were studied. The mean age was 15.5 ± 1.5 years. The majority (59%) were male. Ten study subjects (11.5%) were current smokers. A positive family history of asthma was found in 31% (n = 27) of the patients. All patients were on inhaled corticosteroid therapy. The majority of the study subjects (60.9%) had satisfactory asthma control as evidenced by a mean asthma control test score (ACT) of 19.2 ± 2.29. Fifteen patients (26.7%) had had an acute flare-up of the disease requiring hospitalization in the preceding 12 months, and 5.8% had had a previous intensive care unit admission. Conclusion: The majority of the teenagers studied had overall satisfactory asthma control, as determined by their ACT scores. The use of inhaled corticosteroids was standard, but the inhaler technique was largely unsatisfactory. The prevalence of tobacco use is a cause for concern.

Impact of Interleukin-17 Receptor A Gene Variants on Asthma Susceptibility and Clinical Manifestations in Children and Adolescents.

Several single nucleotide polymorphisms (SNPs) in multiple interleukin receptor genes could be associated with asthma risk and/or phenotype. Interleukin-17 (IL-17) has been implicated in tissue inflammation and autoimmune diseases. As no previous studies have uncovered the potential role of IL17 receptor A (RA) gene variants in asthma risk, we aimed to explore the association of four IL17RA SNPs (i.e., rs4819554A/G, rs879577C/T, rs41323645G/A, and rs4819555C/T) with asthma susceptibility/phenotype in our region. TaqMan allelic discrimination analysis was used to genotype 192 individuals. We found that the rs4819554 G/G genotype significantly reduced disease risk in the codominant (OR = 0.15, 95%CI = 0.05-0.45, p < 0.001), dominant (OR = 0.49, 95%CI = 0.26-0.93, p = 0.028), and recessive (OR = 0.18, 95%CI = 0.07-0.52, p < 0.001) models. Similarly, rs879577 showed reduced disease risk associated with the T allele across all genetic models. However, the A allele of rs41323645 was associated with increased disease risk in all models. The G/A and A/A genotypes have higher ORs of 2.47 (95%CI = 1.19-5.14) and 3.86 (95%CI = 1.62-9.18), respectively. Similar trends are observed in the dominant 2.89 (95%CI = 1.47-5.68, p = 0.002) and recessive 2.34 (95%CI = 1.10-4.98, p = 0.025) models. For the rs4819555 variant, although there was no significant association identified under any models, carriers of the rs4819554*A demonstrated an association with a positive family history of asthma (71.4% in carriers vs. 27% in non-carriers; p = 0.025) and the use of relievers for >2 weeks (52.2% of carriers vs. 28.8% of non-carriers; p = 0.047). Meanwhile, the rs4819555*C carriers displayed a significant divergence in the asthma phenotype, specifically atopic asthma (83.3% vs. 61.1%; p = 0.007), showed a higher prevalence of chest tightness (88.9% vs. 61.5%; p = 0.029), and were more likely to report comorbidities (57.7% vs. 16.7%, p = 0.003). The most frequent haplotype in the asthma group was ACAC, with a frequency of 22.87% vs. 1.36% in the controls (p < 0.001). In conclusion, the studied IL17RA variants could be essential in asthma susceptibility and phenotype in children and adolescents.

Predictors of recurrent wheezing in late preterm infants.

Premature infants have an increased risk of respiratory morbidity, including the development of recurrent wheezing. We sought to determine perinatal factors in late preterm infants associated with an increased risk of recurrent wheezing in the first 3 years of life. A retrospective chart review of infants born between 32 and 36 weeks gestational age at a tertiary hospital from 2013 to 2016 was performed. Infants with any co-morbid medical conditions were excluded. Recurrent wheezing was identified by two or more visit diagnoses for reactive airway disease, wheezing-associated respiratory infection, wheezing, or asthma during the first 3 years of life. Those with recurrent wheezing were compared to matched preterm infants who did not develop wheezing. Three hundred and fourteen late preterm infants were included in this study;210 infants developed recurrent wheezing while 104 did not. Gender, sex, and race were comparable between both groups. Development of wheezing was associated with positive family history of asthma (p = .014), receiving antibiotics during the neonatal period (p < .001), requiring continuous positive airway pressure for <24 h (p = .019), and receiving supplemental oxygen during the newborn period (p = .023). This study retrospectively identified risk factors associated with development of wheezing in late preterm infants. Prospective studies are needed to determine whether these factors will predict recurrent wheeze in this patient population.

Assessing the Impact of Health Education Intervention on Asthma Knowledge, Attitudes, and Practices: A Cross-Sectional Study in Erbil, Iraq.

Asthma causes chronic coughing, wheezing, dyspnea, and chest pressure. This study assessed asthmatic patients' knowledge, attitudes, and practice (KAP) of bronchial asthma and proper education on its meaning, risk factors, symptoms, diagnosis, management, and prevention practices. We performed a cross-sectional interventional asthma KAP survey in Erbil, Iraq. We adapted a validated study questionnaire from KAP studies in other nations to the Erbil situation and culture. In Erbil, Kurdistan, Iraq, two major hospitals' asthma clinics were studied. We chose 250 asthmatic patients from October 2018 to July 2019. Health education was comprehensive. The health education program used a Kurdish PowerPoint with a printout. Twenty-five groups received two weeks of one-hour health education pre-intervention. Each group was questioned before, 2 weeks after, and 12 weeks after health education. All data were analyzed by SPSS v26. The mean age of the respondents was 37.52 ± 15.16, with 48.7% of the respondents having a positive family history of asthma. After 2 weeks of health education intervention, respondents had a higher knowledge score and positive attitudes compared to pre-education, and after 12 weeks of education, there was a significant difference (p < 0.001) with improvised prevention practice. Health education programs led to considerable improvements in asthmatic patients' knowledge, attitudes, and practices regarding their condition. After receiving health education for a period of two weeks, the majority of the participants answered correctly regarding asthma, its causes, and the elements that trigger asthma attacks.

DEMOGRAPHIC DETAILS COMPARISON OF ASTHMATIC PATIENTS IN THE DISTRICT OF SARGODHA

Asthma is a chronic respiratory disease affecting a significant portion of thepopulation worldwide, including Pakistan. This study aimed to compare the demographic details ofasthmatic patients in the district of Sargodha, Pakistan. A cross-sectional study was conducted on 300asthmatic patients attending two tertiary care hospitals in the district of Sargodha. Data on age, gender,residence, occupation, education, and family history of asthma were collected through a structuredquestionnaire. The data were analyzed using SPSS version 23.0. The majority of the patients werefemales (54.7%), and the mean age was 38.5 years. Most of the patients were from rural areas (61.3%),and the majority were housewives (38%). A significant association was found between gender andoccupation (p&lt;0.05). Moreover, a positive family history of asthma was reported by 28.7% of thepatients. The findings of this study suggest that asthma is more prevalent among females and peopleliving in rural areas in the district of Sargodha. The high percentage of positive family history indicatesa genetic predisposition to the disease. These results could be helpful for the development of effectiveasthma management strategies in the region.

Immunoglobulin Ige Levels And Clinical Dynamics Of Asthma In Children And Adolescents.

The involvement of IgE in type 1 hypersensitivity reactions, including asthma and allergic rhinitis, is widely recognized, and established. However, within this region, there exists a dearth of research exploring the relationship between serum IgE levels and the severity of asthma within the pediatric population. Consequently, the primary objective of this study was to compare the IgE status among children and adolescents diagnosed with asthma, and to examine its association with asthma exacerbations and hospitalizations. By investigating these parameters, we aimed to shed light on the potential role of IgE in influencing disease outcomes in this specific population. A retrospective study was conducted at The Aga Khan University Hospital from January 2015 to December 2020. Children and adolescents aged 6-18 years who were diagnosed and admitted with asthma, and who had measurement of IgE levels during asthma exacerbation were included in the study. The participants were stratified into two groups based on their IgE levels: normal IgE levels and high IgE levels. Various parameters, including the number of asthma exacerbations, emergency room (ER) visits, hospitalizations, average length of stay, as well as other clinical characteristics such as the presence of allergic rhinitis in the past and a family history of asthma were assessed. A total of 122 patients were included in the study. Of them 57 patients (46.72%) were found to have high IgE levels, and 65 patients (53.28%) had normal IgE levels based on their age group. The average number of exacerbations per year was significantly greater the in high IgE group (3.6±1.09), in comparison to the normal IgE group (2.49±1.22). Higher serum IgE levels correlated with increased asthma exacerbations, emergency room visits, hospitalizations, and a positive family history of asthma, suggesting a potential link between IgE and asthma severity in the pediatric population of Pakistan.

CLINICAL PROFILE OF ASTHMA IN MALE SMOKERS

Introduction: st Asthma is traditionally dened as a functional abnormality with reversibility in forced expiratory volume in 1 second of more than 15% as opposed to irreversible or xed airway limitation in chronic obstructive pulmonary disease (COPD).This study aims to the assess the clinical symptoms, physical ndings and laboratory results in smoker patients reporting with symptoms suggestive of bronchial asthma . Material and method: This study was conducted in department of Respiratory Medicine of National institute of Medical sciences and research, Jaipur on 50 outdoor male smokers presented with respiratory complaints during period of September 2020 to May 2021. Result: 100 patients enrolled in this study. And 50 patients were diagnosed as bronchial asthma on the basis of steroid trial. Mean age of patients in our study is 48.00+10.41. Shortness of breath (48%) was the commonest complaint followed by cough(24%), expectoration (20%) and last was chest pain (8%). There were more current smokers (48%) followed by ex smokers (32%0 and least were reformed (20%).The most common symptoms in past history of patient was seasonal variation (96%) followed by eye itching (32%), chest tightness (60%), sneezing (56%), dust allergy(32%), non respiratory allergy and wheeze (24%) and last was positive family history of asthma or allergy. Past history showed different variation in which any one symptoms was present in 100% of patients, followed by 2 symptoms (95%), 3 symptoms (84%) and 4 symptoms (52%). Conclusion: This study concludes that presence of any two of the above described past symptoms or variables suggestive of asthma in past are diagnostic of asthma in smoker patients even in the presence of irreversible or partially reversible airway obstruction

Work-related Asthma in Crop Farmers

AIM: The objective of the study was to evaluate the influence of occupational exposure on asthma development among crop farmers. METHODS: A cross-sectional study was performed, comprising 87 crop farmers, and 80 office workers, matched by gender and age. Evaluation of subjects included completion of a standard questionnaire on chronic respiratory symptoms, spirometry tests, histamine challenge, serial peak expiratory flow rates (PEFR) measurements, and skin prick tests to occupational and common inhalant allergens. RESULTS: The prevalence of chronic respiratory symptoms in the past 12 months was higher, while the mean values of spirometric parameters were lower in crop farmers. Sensitization to workplace and common inhalant allergens was similar in both groups, whereas frequencies of bronchial hyperresponsiveness (BHR) and asthma were non-significantly higher in crop farmers. The prevalence of allergic was significantly higher compared to non-allergic asthma in both groups. Asthma was registered in 8% of crop farmers and was significantly associated with atopy, and positive family history of asthma. Occupational allergic asthma (OA) was registered in 2.3% of crop farmers, while the frequency of work-aggravated asthma was 5.7%. A causal relationship between workplace and asthma, suggesting allergic OA, was documented in two crop farmers with asthma, based on serial PEFR monitoring, but specific workplace agent causing asthma in the affected subjects was not identified. CONCLUSION: The obtained results can contribute in the detection of critical points for action, and serve as a predictive factor in the development of work-related asthma, indicating the need for reduction of adverse occupational exposures through adequate preventive measures, regular health examinations, obligatory use of respiratory protective equipment, and implementation of engineering controls.

Assessment of medication knowledge among patients with asthma

Abstract Objectives Asthmatic patient's knowledge about their treatment can affect asthma control and adherence level. This study investigated the level of medication knowledge, the level of adherence and factors affecting both knowledge and adherence in adult patients with asthma. Methods A cross-sectional study was carried out in Jordan between 2017 and 2018. A face-to-face interview was conducted by a clinical pharmacist with asthma patients attending hospital pharmacies for refilling their prescriptions. Key findings A total of 218 adults with asthma were included into the study and 60.6% were knowledgeable about their medications. University degree education (OR = 3.67; P value &amp;lt; 0.001), positive family history of asthma (OR = 1.89; P value = 0.04) and longer asthma duration (OR = 1.03; P value = 0.049) were significantly associated with a high medication knowledge. On the other hand, married participants were less knowledgeable than single ones (OR = 0.30; P value = 0.041). High medication knowledge score (OR = 4.76, P value = 0.008), older age (OR = 1.06, P value = 0.004) and male gender (OR = 3.82, P value = 0.01) were significant predictors of high medication adherence. Conclusions These findings highlight the importance of educational programmes that should be conducted in primary healthcare settings, such as community pharmacies, where pharmacists should educate patients about their medication and the importance of adherence.

Predictors of response to medications for asthma in pediatric patients: A systematic review of the literature.

There has been no systematic review of studies aimed to predict differential responses to medication regimens for asthma controller therapies in pediatric patients. The aim of the present study was to summarize those identifying biomarkers for the different asthma controller therapies. Studies published by June 2019 that report phenotypic or genotypic characteristics or biomarkers that could potentially serve as response predictors to asthma controller therapies in pediatric patients were included. The quality of studies was assessed using the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale tool. Of 385 trials identified, 30 studies were included. Children with asthma and a positive family history of asthma, with more severe disease, of the white race, with allergy biomarkers, nonobese, with lower lung function, high bronchial hyperresponsiveness to methacholine, or having variants in the FCER2 and CRHR1 gene respond better to inhaled corticosteroids (ICS). Younger age (<10 years), short disease duration (<4 years), high cotinine and urinary leukotriene E4 (LTE4) levels, and 5/5 ALOX5 were associated with a better response to leukotriene receptor antagonist (LTRA). For patients that remain symptomatic, white Hispanics were more likely to respond to LTRA, blacks to ICS, white non-Hispanics to LTRA or LABA, and children without a history of eczema, regardless of race or ethnicity to LABA set-up therapy. In severe persistent asthma, those with atopy and body mass index greater than or equal 25 were more likely to benefit from omalizumab. Several phenotypic characteristics, biomarkers, or pharmacogenomics markers could be useful for predicting the best drug for asthma treatment.

Differences in the Clinical Characteristics of Early- and Late-Onset Asthma in Elderly Patients.

Differences between early-onset and late-onset asthma in elderly subjects have not been comprehensively described in China. We conducted a cross-sectional study to determine the phenotypic differences between early-onset asthma (EOA) and late-onset asthma (LOA) in elderly patients. We collected clinical and physiological data from 176 elderly patients with asthma. Participants were divided into two groups: EOA group and LOA group. Demographics, comorbidities, inflammatory parameters, lung function, severity, asthma control, and medication use among EOA and LOA elderly patients were compared. Elderly subjects with EOA had more atopic disease, a stronger positive family history of asthma, higher IgE, and exhaled nitric oxide levels as compared to those with LOA. In contrast, elderly subjects with LOA had lower lung function and more marked fixed airflow obstruction (FAO). Elderly subjects with LOA had a higher incidence of chronic obstructive pulmonary disease (COPD). No differences were observed in age, gender, BMI, history of smoking, severity, and asthma control between the two groups. Both similarities and differences exist between elderly subjects with EOA and those with LOA in China. Further work is required to determine the pathophysiological, clinical, and therapeutic implications for different asthma phenotypes in elderly subjects.

Clinical and Demographic Profiles of Patients Diagnosed as Cough Variant Asthma attended at Tertiary Referral Hospital

Background: Cough variant asthma is presented with different clinical and demographic characteristics.Objectives: The purpose of the present study was to see the clinico-demographic profiles of cough variant asthma patients.Methodology: This descriptive type of cross-sectional study was carried out in theDepartment of Respiratory Medicine at National Institute of Diseases of the Chest and Hospital (NIDCH), Dhaka, Bangladesh from September 2014 to August 2015 for a period of one year. Patients presented with cough variant asthma attending in NIDCH were selected as study population. Methacholine challenge test was performed to diagnosis of Cough Variant Asthma. Result: A total number of 50 patients were recruited for this study. The mean age±SD was found 19.1±7.6 years. Male was predominant than female with a ratio of 1.4.:1. Among the study population positive family history of asthma was found in 39.0% cases and associated allergic rhinitis was reported in 58.0% cases. Eczema was associated with 16.0% patients;however, only 4% patients had associate conjunctivitis. Conclusion: In conclusion young male is more commonly affected by cough variant asthma of which majority have family history of asthma. Journal of National Institute of Neurosciences Bangladesh, 2016;2(1):30-33

Breastfeeding is associated with a decreased risk of childhood asthma exacerbations later in life.

Breastfeeding has been suggested to influence the risk of asthma and asthma severity in children. However, the conclusions from epidemiologic studies are inconsistent. We used data from 960 children (aged 4-12years) using regular asthma medication who participated in the PACMAN study. Breastfeeding exposure was based on questionnaire data and stratified into (i) ever vs never, and (ii) ≥6 vs <6months duration of breastfeeding. Asthma severity was based on the occurrence of asthma exacerbations in the preceding year and/or poorly controlled asthma symptoms during the last week of study visit. Odds ratios (ORs) were derived from univariate and multivariable logistic regression analyses. Breastfeeding was associated with a decreased risk of asthma exacerbations; adjusted (adj.) OR: 0.55 (95% confidence interval [CI]: 0.35-0.87). After stratification for duration of breastfeeding, the adj. ORs were 0.48 (95% CI: 0.27-0.84) for duration <6months and 0.71 (95% CI: 0.43-1.20) for duration ≥6months breastfeeding. When we stratified the analysis by family history of asthma, the association between breastfeeding and asthma exacerbations was strong and statistically significant only in children with a positive family history of asthma; adj. OR: 0.34 (95% CI: 0.18-0.66). There was no association between breastfeeding and risk of poor asthma control; adj. OR: 1.04 (95% CI: 0.76-1.41). In a pediatric population with asthma, children who had been breastfed had a statistically significantly lower risk of asthma exacerbations later in life compared to asthmatic children who had not been breastfed.

Toxocariasis and childhood asthma: A case-control study

ABSTRACTObjective: The objective of this study is to investigate the association between anti-Toxocara IgG seropositivity and asthma in children. Methods: This was a case-control study conducted in a university hospital in south Brazil between May 2012 and June 2013. Were recruited 208 children up to 12 years old of whom 156 had asthma (cases) and 52 did not have asthma (controls), with a case-control ratio of 3:1 matched by age. Children's parents or guardians were interviewed using a structured questionnaire with closed questions. Serology was performed using enzyme-linked immunosorbent assay (ELISA) with excretory-secretory antigen of Toxocara canis (TES). Results: The seroprevalence of IgG anti-T. canis antibodies was 12.8% in the cases and 7.7% in the controls. There was no significant association between seropositivity to T. canis and risk of asthma (adjusted odds ratio [OR]: 1.89, 95% CI: 0.52 to 6.89, p = 0.33). Household income < 2 minimum salaries, paternal school years < 9, allergic rhinitis in children, a positive family history of asthma and rhinitis and contact with cats were significantly associated with asthma, with adjusted ORs (95% CIs) of 3.05 (1.21 to 7.73), 2.83 (1.11 to 7.18), 10.5 (4.32 to 25.6), 2.65 (1.14 to 6.17), 2.49 (1.07 to 5.78) and 2.73 (1.03 to 7.27), respectively. Conclusions: This study did not find a statistically significant association between seropositivity to Toxocara sp. and risk of asthma in children. Low family income, low paternal education level, concomitant allergic rhinitis, family history of asthma and allergic rhinitis and contact with cats were independent factors associated with childhood asthma.

Expression of Basophil Activation Markers in Pediatric Asthma.

Asthma is very common in children and its diagnosis is based on clinical manifestations, which can be misdiagnosed as other respiratory diseases with similar signs and symptoms. To analyze the expression of ST2L and CD203c in the diagnosis of pediatric asthma. Basophils were purified from whole blood samples of patients and healthy controls using Ficol-Paque gradient and Basophil Isolation Kit. RNA extraction was done by RNX-Plus solution and after synthesis of cDNA, the gene expression was analyzed by means of real time PCR. Patients expressed significantly higher levels of CD203c than healthy controls (p=0.01). Although there was an increase in the transcription level of ST2L gene in patients, the results were not statistically significant compared to those obtained from the healthy controls (p>0.05). A Specificity of 60% and a sensitivity of 73% were found using ROC curve for CD203c expression. Patients with positive family history of asthma exhibited more CD203c and ST2L expression (p<0.05). It is proposed that determining CD203c expression by real time PCR may be an effective technique for diagnosis of pediatric asthma.

Epidemiology of bronchial asthma in school children (10-16 years) in Srinagar.

Objectives:To assess the epidemiological profile of asthma in school going children in Srinagar, Kashmir.Study design:Cross-sectional study.Setting:Thirty-one schools with proportionate representation from both government and private schools as well as from primary, middle, and high schools.Participants:School children aged 10–16 years with equal representation of sex and all ages.Main Outcome Measure:Prevalence of current and past asthma.Methods and Results:After administering a modified pretested questionnaire, peak expiratory flow measurement was carried. Children who had asthma-like symptoms or positive family history of asthma or physician-labeled asthma were subjected to spirometry and bronchodilator reversibility. Out of 806 children, bronchial asthma was seen in 60 (prevalence of 7.4%) which included 34 boys and 26 girls. Majority of asthmatic children (78.3% [n = 47]) had probable asthma; 6.7% (n = 4) had definite asthma; and 15% (n = 9) had physician-diagnosed asthma. Majority of children had intermittent asthma (78.3% [n = 47]). Mild persistent asthma was seen in 12.7% (n = 7) and 10% (n = 6) had moderate persistent asthma. None of the children had severe persistent asthma. The prevalence of current asthma was 3.2% (n = 26). On univariate analysis, the factors found to be statistically significant were family history of asthma (odds ratio [OR] =8.174; confidence interval [CI] =4.403–15.178), seasonal cough (OR = 4.266; CI = 2.336–7.791), allergic rhinitis (OR = 2.877; CI = 1.414–5.852), atopic dermatitis (OR = 6.597; CI = 2.72–16.004), and obesity (OR = 6.074; CI = 2.308–18.034). On multivariate analysis, family history, seasonal cough, allergic rhinitis, atopic dermatitis, and obesity were found to be significant independent risk factors.Conclusions:Srinagar qualifies as a low prevalence area for bronchial asthma in the age group of 10–16 years. Majority of children had mild intermittent asthma resulting in under diagnosis and wrong treatment.

Severe asthma: a great clinical challenge

Patients with severe asthma represent a significant unmet clinical need. At present, the underlying mechanisms of severe asthma have not been established yet but it is likely they reflect a heterogenous pattern rather than a single unifying process. The aim of this study is to assess the prevalence of severe asthma as well as the clinical and physiologic characteristics of patients and to establish a pattern occuring in comorbid diseases. Between the January and December of 2013, a total of 324 consecutive asthmatic adult patients (67% females) attended to at an out - patients clinic (Sezana) were involved in the study. The mean age in these patients was 57.3 +- 2.4 years. The diagnosis of severe asthma was assessed according to the International ERS/ATS guidelines. The demographic criteria, body mass index BMI (kg/m2), skin prick tests (Allergopharma, Germany), smoking habits and comorbidities were analysed. Severe asthma was present in 10% of patients. The mean age in patients was 67.3+- 1.7 years (59%females). Of them, 14% were active smokers and 24% were former smokers. Sixty- five percent patients had a positive family history of asthma. The average mean time of asthma duration was 14+- 3.2 years. The late onset of asthma (patients above 50 years of age) was observed in 60% of all cases. Atopy, which was estimated on the basis of at least one positive skin prick test, was observed in 66% of patients. In patients showing early onset, severe asthma involved significantly more allergen sensitivity (skin test positivity, 92% vs 26% p<0.01) than in patients with late- onset asthma. The average body mass index was 32.1+- 4.7 kg/m2. The obese patients were more frequently females (60% vs 40%). The comorbid diseases were present in 70% of patients. The most frequent were the comorbid conditions of the upper airways - nasal sinus diseases (54% of patients), mostly in females (44%). Next, there were aspirin sensitivity in females (10%) and OSA (obstructive sleep apnea) in males (10%). Both females and males suffered from GERD (gastroesophageal reflux disease) (15% males vs 10% females), and psychological dysfunction (82% females vs 61% males). The above results suggest than an adult asthmatic with severe asthma has a positive family history of asthma as well as a late onset of disease with less atopy by skin test and is also more obese (especially females). The prevalence of comorbidites is very high.

Influence of upper airway abnormalities on the control of severe asthma: a cross-sectional study.

A better understanding of severe uncontrolled asthma (UA) in the upper airways is needed. The aims of this study were to assess the prevalence of upper airway abnormalities and their associations with UA. An observational study enrolled individuals with severe asthma. Sociodemographic and clinical questionnaires regarding asthma, rhinosinusitis, and laryngopharyngeal reflux (LPR) were administered. Skin-prick tests and fiber optic nasolaryngoscopies were also performed. Descriptive statistical analysis was performed, using a multiple Poisson regression model to obtain adjusted prevalence ratios (PRs) and to identify the clinical profiles associated with the highest and lowest percentages of the dependent variable, lack of asthma control. The sample consisted of 64 participants who were divided into 2 groups according to asthma control. Thus, group I comprised 27 individuals with severe controlled asthma (CA), and group II consisted of 37 individuals with UA. Women represented 87.5% of the study population. The median age was 54 years, and 86% of the sample had rhinosinusitis. Relevant associations were detected between UA and hyposmia (PR = 2.04), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (PR = 1.45), arytenoids hyperemia (PR = 1.45), LPR (PR = 1.37), a positive family history of asthma (PR = 1.35), onset of asthma at age 10 years or older (PR = 0.59), and swelling of the vocal cords (PR = 0.54). This study found a very high prevalence of rhinosinusitis in patients with severe asthma as well as associations between UA and hyposmia, hypersensitivity to NSAIDs, arytenoids hyperemia, and LPR. Clinical profiles prone to UA were identified.

Asthma Heredity, Cord Blood IgE and Asthma-Related Symptoms and Medication in Adulthood: A Long-Term Follow-Up in a Swedish Birth Cohort

Cord blood IgE has previously been studied as a possible predictor of asthma and allergic diseases. Results from different studies have been contradictory, and most have focused on high-risk infants and early infancy. Few studies have followed their study population into adulthood. This study assessed whether cord blood IgE levels and a family history of asthma were associated with, and could predict, asthma medication and allergy-related respiratory symptoms in adults. A follow-up was carried out in a Swedish birth cohort comprising 1,701 consecutively born children. In all, 1,661 individuals could be linked to the Swedish Prescribed Drug Register and the Medical Birth Register, and 1,227 responded to a postal questionnaire. Cord blood IgE and family history of asthma were correlated with reported respiratory symptoms and dispensed asthma medication at 32–34 years. Elevated cord blood IgE was associated with a two- to threefold increased risk of pollen-induced respiratory symptoms and dispensed anti-inflammatory asthma medication. Similarly, a family history of asthma was associated with an increased risk of pollen-induced respiratory symptoms and anti-inflammatory medication. However, only 8% of the individuals with elevated cord blood IgE or a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication at follow-up. In all, 49 out of 60 individuals with dispensed anti-inflammatory asthma medication at 32–34 years of age had not been reported having asthma at previous check-ups of the cohort during childhood. Among those, only 5% with elevated cord blood IgE and 6% with a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication as adults. Elevated cord blood IgE and a positive family history of asthma were associated with reported respiratory symptoms and dispensed asthma medication in adulthood, but their predictive power was poor in this long-time follow-up.

Respiratory symptoms and lung function patterns in workers exposed to wood smoke and cooking oil fumes (mai suya) in Nigeria.

Background:‘Mai suya’ is a common job in the most northern Nigeria in which there is significant exposures to wood smoke and oil fumes. The respiratory impact of these dual exposures on workers engaged in this work has not been previously documented, hence this study was carried out.Aim:The aim is to study the prevalence, patterns and respiratory function assessment among this group.Subject and Methods:This is a case controlled study involving mai suya and workers who are not exposed to wood smoke and oil fumes in an occupational setting. All consenting mai suya and matched controls were recruited. Both groups underwent an interviewer administered questionnaire followed by on spot spirometric test measuring forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR). Results are presented using descriptive statistics. Chi square was used to test for association between respiratory symptoms and the job categories. Student's t-test was used to compare values of continuous variables. Odd ratios were determined for the risk of respiratory symptoms and exposure to wood smoke and oil fumes.Results:Both groups are similar in their demographic characters except in their smoking status, so current smokers were excluded from further analysis. The test group had significantly increased occurrence of chest tightness: 59% (19/32), nasal congestion: 37% (12/32), cough: 32% (10/32), and wheeze: 12% (4/32) compared with the control group, odds ratio (OR) 3.1, 95% confidence interval CI (0.1-5.8), P value 0.04, OR 1.2,95% CI (1.04-1.8), P value = 0.02, OR 0.9 95% CI (0.9-1.4), P value = 0.3, and OR 1.2,95% CI (1-1.3), P value = 0.04, respectively. Occurrences of some respiratory symptoms were associated with duration on the job, while a positive family history of asthma is not associated with increased occurrence of symptoms. The mean (SD) FEV1 and FVC were significantly lower among the test group compared with the control group; 2.5L/s (0.55) versus 3.02L/s (0.51), P value = 0.007 and 2.7L (0.7) versus 3.16L (0.51), P value = 0.04.Conclusion:Mai suya’ have increased risk of respiratory symptoms and altered pulmonary functions. There is a need for protective equipment and periodic evaluation.