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At least 865 records · Page 48Linked to original sources
PubMed1997

Genetics of asthma: the University of Toronto Program. University of Toronto Genetics of Asthma Research Group.

In 1991, we initiated a study to identify susceptibility gene(s) predisposing individuals to the development of asthma. Our strategy was to focus on the collection of inbred populations because (1) they are likely to exhibit greater homogeneity than outbred populations, potentially important in multigenic diseases, (2) there may be fewer genes explaining the asthma diathesis in families with a "founder effect," (3) it is possible to follow the pattern of inheritance more closely, and (4) environmental factors are likely to be more uniform in geographically isolated poulations. We have identified, and in some cases collected data on inbred and/or isolated populations in Brazil, China, Easter Island, Israel, and Tristan da Cunha. We have completed a genome-wide scan on samples from Tristan da Cunha based on a coverage of approximately 20 cM between markers. In addition, we have collected hundreds of outbred individuals from Canada; these data have been helpful in narrowing a linked region based on the transmission/disequilibrium test.

Adult↗
PubMed1993

An audit of hospital discharge letters in patients admitted with acute asthma. Tayside Asthma Audit Group.

The management of patients following discharge with acute asthma is dependent on effective communication with general practitioners. A retrospective audit was therefore performed on copies kept of 81 typed discharge letters with a diagnosis of acute asthma between March and October 1991. A subset of 42 interim (handwritten) letters were also audited where case notes could be retrieved. Details on clinic follow up were also obtained from the case notes (n = 42). In the typed letter documentation of severity and treatment of the acute attack was accurate in most cases. Information concerning a precipitating factor was provided in 54% of cases and a smoking history in 57%. Deficiencies were found in specifying inhaler delivery devices (40% recorded), and whether inhaler technique had been formally assessed whilst in hospital (17%). Drug prescribing on discharge was as follows: oral steroid (69%), inhaled steroids (77%), inhaled B2-agonists (92%), theophylline slow release (38%), salbutamol controlled release (20%), and antibiotics (30%). The implementation of a self-management plan and domiciliary peak flow was mentioned in 66% of the letters. The interim letter was generally poor in particular for mention if discharge peak flow (2%), clinic follow-up (64%) and prednisolone regime (61%). Mean +/- s.d. time for clinic follow-up (n = 42) was 4.7 +/- 1.7 weeks (range 1-13 weeks) with 24% non-attendance. Thus, improvements in discharge letters are clearly required for optimum continuity of care in the community.

Acute Disease↗
PubMed1982

Baker's asthma (grain-dust-induced asthma).

A 48-year-old black male with no underlying atopy developed asthma after working nine years at a bakery. The attacks of wheezing were preceded by nasal symptoms and usually occurred after several hours of work. Skin testing revealed reactivity to dust, molds, and wheat extracts; serum level of IgE was normal, and a RAST screen to common allergens was negative. A bronchial provocation test using commercial wheat extract was negative, but the same test using the patient's own bakery flour resulted in an immediate positive reaction. The pathogenesis and management of grain-dust-induced asthma are discussed.

Adult↗
PubMed1982

An experimental asthma model in unanesthetized rat, and the difference in effect of disodium cromoglycate between passive cutaneous anaphylaxis model and asthma model in rat.

We established here the experimental asthma model in unanesthetized rat, based on the observation of breathing. The effect of disodium cromoglycate (DSCG) was compared between the passive cutaneous anaphylaxis (PCA) model in rat and our experimental asthma model. The systemic anaphylaxis was elicited, in the rat passively sensitized with reaginic antibodies (reagin) against DNP-As, in response to challenge with antigen. The longer duration of expiration than that of inspiration was observed in the thoracic breathing of antigen-treated rats. The proportion of animals showing this respiratory distress in thoracic breathing (RDTB) was related to the concentration of antiserum used for the sensitization. The relation between RDTB and the concentration of antiserum was more manifest when the degree of RDTB was considered as a score. Inhibition of DSCG was dose-dependent on RDTB and reagin-induced PCA at more than 1 mg/kg. The maximal inhibition of DSCG (20 mg/kg, i.v.) on RDTB or PCA was observed when it was given 30 s before the challenge with antigen. The effect on RDTB decreased gradually with time after dose, and lasted beyond 60 min similar to the inhibitory activity of DSCG on antigen-induced asthmatic reaction in patients. Whereas, the effect on PCA decreased rapidly, and disappeared within 30 min after dose. These results indicate that RDTB is a principal indicator of respiratory distress induced by reagin, and that the effect of DSCG in asthmatics may be explained by its inhibitory activity on RDTB rather than that on PCA.

Anaphylaxis↗
PubMed1982

Asthma: the yoga perspective. Part II: Yoga therapy in the treatment of asthma.

The integral yoga approach to asthma (and other psychosomatic disorders) is briefly outlined as meeting all of the requirements for an optimal, holistic, somatopsychic therapy (as outlined in Part I), including correction of distorted posture and faulty breathing habits, teaching a system of general muscle relaxation, techniques for the release of suppressed emotion and for reducing anxiety and self-conscious awareness, as well as special methods for the expectoration of mucus. Yoga practices are described in detail and the available psychophysiological research on yoga practice, as well as clinical-therapeutic studies on yoga as asthmatic therapy, are reviewed. It can therefore be concluded that yoga therapy is most effective with asthma.

Asthma↗
PubMed1993

Relationship between pulmonary test variables and asthma and wheezing: a validation of self-report of asthma.

We investigated the relationship between the pulmonary test variable measurements and self-reported asthma and wheezing from a cross-sectional study conducted in Saskatchewan. Based on the responses to the questionnaire, the subjects were classified into asthmatic, wheezing, and asymptomatic groups. For both male and female subjects the mean values of forced expiratory volume in 1 s (FEV1), forced expiratory flow during the middle half of the forced vital capacity (FEF25-75), and FEV1/FVC ratio were lowest in asthmatics, followed by wheezing and asymptomatic groups, respectively. This trend was also observed in forced vital capacity (FVC) for men but not for women. After adjusting for current smoking status, the trend in the means across the three groups was statistically significant in men for FEV1 (p = 0.03), FEF25-75 (p = 0.002), and FEV1/FVC ratio (p = 0.002) and in women for FEF25-75 (p < 0.001) and FEV1/FVC ratio (p < 0.001). The differences in the adjusted means of FVC, FEV1, FEF25-75, and FEV1/FVC ratio between asymptomatic subjects and the other two groups were significant in both male and female subjects. Significant differences were also observed between asthmatics and wheezing groups in the adjusted means of FEF25-75 and FEV1/FVC ratio in male and female subjects. We conclude that the self-report of asthma has a high level of validity against the criterion of concurrently measured pulmonary test variables.

Adult↗
PubMed1996

Acceptability and feasibility of a community approach to asthma management: the Neighborhood Asthma Coalition (NAC).

Understanding of asthma and co-management between patient and physician improves outcome. Feasibility of programs to achieve these goals in underserved settings is not documented. We used the Precede-Proceed model to document (a) community acceptance of a program to engage peer support of asthma management and care; (b) program revision to emphasize greater attention to availability of care and promotional events as channels for education; (c) engagement of intended audiences in planning and implementation; (d) participation of parents in program activities; and (e) peer-based education/support to reach parents, including socially isolated parents whose children experience heightened morbidity.

Adult↗
PubMed1999

The Childhood Asthma Management Program (CAMP): design, rationale, and methods. Childhood Asthma Management Program Research Group.

The Childhood Asthma Management Program (CAMP) is a multicenter, randomized, double-masked clinical trial designed to determine the long-term effects of three inhaled treatments for mild to moderate childhood asthma: budesonide (a glucocorticoid used daily) and albuterol (a short-acting beta-agonist bronchodilator used as needed); nedocromil (a nonsteroid anti-inflammatory agent used daily) and albuterol; and placebo and albuterol. One thousand forty-one children (32% from ethnic minority groups), aged 5 to 12 years at screening, are currently participating. The primary outcome measure is lung growth as indicated by postbronchodilator forced expiratory volume in 1 second (FEV1) percent of predicted, observed over 5- to 6-year period. The trial also assesses differences between treatment groups with respect to airway responsiveness, morbidity, physical growth and development, and psychological growth and development. This report describes the design of the trial, the rationale for the design choices made, and the methods used to carry out the trial.

Albuterol↗
PubMed1999

Recruitment of participants in the childhood Asthma Management Program (CAMP). I. Description of methods: Childhood Asthma Management Program Research Group.

The Childhood Asthma Management Program (CAMP), a multicenter clinical trial sponsored by the Division of Lung Diseases of the National Heart, Lung, and Blood Institute (NHLBI), is the largest outcome study of mild to moderate asthma in children to be undertaken, with eight clinical centers in the United States and Canada participating. The initial recruitment goal was 960 children within an 18-month recruitment period. Recruitment was extended to 23 months, with 1041 children randomized from late December, 1993, to early September, 1995. In this time interval each of the eight centers met the recruitment goal of 120 using a variety of self-selected recruitment strategies. The goal for minority recruiting was 33%, or 320 of the planned 960 children to be recruited. CAMP achieved the overall goal for the number of minorities, with 330 patients. Three centers recruited at or above the expected rate from the beginning. The other five centers had significant delays in recruitment. Examination of the recruitment experiences of the centers with and without delays did not indicate any single recruitment strategy that was certain to be successful. The most commonly cited factors for success were a cohesive staff, endorsement of participation by the child's primary care provider, and ability of the staff to be flexible and honest in assessing progress and the value of recruiting methods being used.

Asthma↗
PubMed1999

Prevalence of asthma, rhinitis, and eczema in Northern Thai children from Chiang Mai (International Study of Asthma and Allergies in Childhood, ISAAC).

The Phase One International Study of Asthma and Allergies in Childhood (ISAAC) was developed for geographical and temporal comparisons of the prevalence and severity of asthma and allergic diseases in childhood within and between countries. In Thailand, a study was carried out in Bangkok and this is a further study undertaken in Chiang Mai. Using the ISAAC questionnaire, schoolchildren of two age groups were studied: 6-7 years old (n = 3,828) and 13-14 years old (n = 3,927). The data were entered and analyzed using the Epi-info computer program. The prevalence over the past 12 months, in 6-7 and 13-14 years olds, respectively, are as follows; wheezing, 5.5% and 12.6%; rhinitis, 18.5% and 38.3%; rash at flexural areas, 12.9% and 10.7%. The prevalence of these three conditions was found to be close to, but slightly lower than, that from Bangkok, except for eczema in older children.

Adolescent↗
PubMed2000

A school-based asthma clinic: a partnership model for managing childhood asthma.

Childhood asthma is a major public health problem. It is the leading cause of childhood hospitalizations and school absences despite recent advances in management. Current standards of care call for client education as partners in disease management. In pediatrics, this calls for shared decision making between health care provider, parent, and child. Traditional care delivery systems often fall short of meeting this standard. This article describes a nurse practitioner-run school-based asthma clinic, designed as a pilot study, to fill these gaps. Characteristics of the community that affected outcomes are described.

Asthma↗
PubMed2001

[Asthma and scuba diving Absolute contraindication? in all asthma patients?].

Physical and psychological fitness are required for scuba diving, leading to medical contraindications in certain subjects. Asthma, a condition exhibiting increasing prevalence in the general population is currently considered an absolute contraindication for scuba diving by the French Federation for Submarine Sports and Education (FFESSM). There is however no documented evidence demonstrating a higher risk in asthmatic divers. Our English-speaking colleagues have suggested that certain asthmatic subjects could participate in scuba diving sports under certain conditions without any higher risk compared with non-asthmatic divers. We recall here the impact of diving on respiratory function and potential consequences in asthmatic subjects, proposing that the formal contraindication against scuba diving should be maintained for asthmatic patients who experience frequent symptoms (step 2 or more of the International Consensus Report on Diagnosis and Treatment of Asthma) and/or have a baseline obstructive syndrome. It would appear reasonable to discuss the contraindication concerning patients with rare acute episodes and who have a perfectly normal respiratory function. The question of bronchodilator inhalation prior to diving may be a question to debate. However, such a proposal cannot be considered to be valid unless well-conducted studies of the clinical manifestations are available (frequency and severity of the acute episodes, triggering factors) for the diver candidate. Because of the highly restrictive nature of the contraindication notification and the absence of arguments backing up the decision, the question should be put to competent authorities (sports federations, learned societies) in order to ascertain the pathophysiological mechanisms involved and collect reliable epidemiological data before proposing a consensus discussion. This process may lead to the delivery of scuba diving authorizations for selected asthmatic subjects without a higher risk than non-asthmatic subjects.

Acute Disease↗
PubMed1992

[Does breast feeding prevent asthma and allergies? Results of the Munich asthma and allergy study].

The relationship of breast feeding to atopic diseases is studied in a population-based cross sectional study in Munich and Bavaria 1989/1990 in 6,535 german ten year old children. According to the questionnaire answers 1914 (29.3%) children were not breast fed, 2,368 (36.2%) shorter than 2 months, 1,744 (26.7%) 2 to 6 months and 509 (7.8%) more than 6 months. Compared to controls without any allergic disease the relative risk of later asthma, hayfever, atopic dermatitis and of allergic skin sensitization was not diminished by breast feeding. The same result pertained to high risk subgroups defined by positive family history of asthma or hayfever. It is concluded that breast feeding alone has no long term protective effect against atopic diseases.

Asthma↗
PubMed2003

[Construction and operation of Internet Search Engine specialized in information on asthma. A Search Engine-based investigation to identify asthma-related information needed by Internet users].

To support asthmatic patients in collecting information through the Internet, we have constructed and operated a search engine specialized in asthma-related information making use of the search engine software available free of charge and other programs. A questionnaire was attached to the bottom of the Web page presenting the search results, asking the users to respond to several questions. During the three-year period since its start of operation on June 1, 2000, there was 66689 visits to this site and 786 responses to the questionnaire were collected. Of all respondents, 19.3% were medical professionals, 63.7% were patients or their family members, and 11.3% belonged to the other categories (5.3% did not specify their position). In each of these three user groups, only about half of the users were able to find a route to the information they needed. This seems to reflect the absence of adequate asthma-related information sources on the Internet in Japanese language. However, more than 70% of all users in each group answered that this search engine site was useful.

Asthma↗
PubMed2003

Asthma control and prior medical care of patients presenting with acute asthma at the emergency department.

Seventy patients presented with acute asthma at the emergency department of the University of Malaya Medical Centre, Kuala Lumpur were recruited over a two-week period in July 2001. Fifty-one (73%) patients belonged to the poorly controlled group. Fifty-seven (81%) patients were using inhaled salbutamol but 21 (30%) were still using oral short acting salbutamol. Only 32 (46%) patients used inhaled corticosteroids. In the poorly controlled group, 22 (43.1%) patients were not on regular inhaled corticosteroids, 35 (68.6%) were not receiving "add-on" medication and 18 (35%) did not have regular follow up. The emergency department should implement a protocol for asthma management and follow up to achieve better long term patient care.

Acute Disease↗
PubMed1992

A novel asthma camp intervention for childhood asthma among urban blacks. The Pediatric Lung Committee of the American Lung Association of the District of Columbia (ALADC) Washington, DC.

Following a needs assessment, the American Lung Association of the District of Columbia (ALADC) began a 3-year pilot program (1986 to 1989) to improve the health status of 5- to 10-year-old urban black asthmatic children. The authors hypothesized that participation in a 1-day asthma camp curriculum, using a collaborative multidisciplinary team approach between university and community-based staff, would provide an effective educational intervention to teach children and their families daily management strategies for asthma. The 84 participants (mean age: 9.6 years) were predominantly black (93%), male (73%), and from single-parent or single-guardian homes (52.7%). Follow-up interviews suggested that a high percentage of the children were using new techniques such as aerosol/inhalers (78%) and breathing/warm-up exercises (55%). Overall, participation in this novel program was associated with a clinically significant, 36% to 69% reduction in school absences, emergency room visits, and hospitalizations.

Black or African American↗
PubMed1992

[Infection and asthma. V. Study of childhood asthma and viral infection by cytological analysis of nasal smears].

Cytological analysis of nasal smears was carried out for 295 asthmatic children aged 2 to 15 years old at the time of asthma attack and non-attack, in combination with blood tests and chest roentgenograms. Damaged ciliated cells (ciliocytophhthoria, CCP) were looked for as a marker of viral infections. The appearance rate of greater than 2+ of CCP was higher among children during attack (38/70, 54.3%) than that among children not suffering an attack (6/29, 20.7%); this was pronounced among young children under five. However, the results of blood examinations and chest roentgenograms did not correlate with the rate of positive signs of infections in CCP positive- or negative-attack. These results suggest that the cytological examination of nasal smears in useful in evaluating the presence of viral infections during asthma aggravation among young children, whereas evaluation of these infections may be difficult by blood tests or chest roentgenograms.

Adolescent↗
PubMed2006

Aspirin induced asthma (AIA) with nasal polyps has the highest basal LTE4 excretion: a study vs AIA without polyps, mild topic asthma, and normal controls.

UNLABELLED: Cysteinil Leukotrienes (LTs) are products of the arachidonic acid cascade which are synthetised by 5-lipoxigenase in inflammatory cells, particularly in eosinophils. Urinary leukotriene E4 concentration (LTE4), that reflects the whole body production of cysteinil-leukotrienes, is particularly increased in patients with aspirin-intolerant asthma (AIA). Aim of the present study was to assess basal urinary LTE4 levels from AIA patients with nasal polyps to those from AIA patients with only rhinitis (without polyps), and those from mild atopic asthmatics and normal controls. SUBJECTS & METHODS: 34 normal subjects (N; 19 - 57y, FEV1 = 102.1% pred. +/- 8.2 sd; negative MCh challenge; negative prick test); 39 mild-persistent atopic asthmatics (A; 18-66y, FEV1 = 92.1 %pred. +/- 14.6 sd; PD20 FEV1 = 380.7mcg +/- 481.2 sd); 24 subjects with AIA with rhinitis (AIA/R; 18 - 56y, FEV1 = 71.6%pred +/- 15.5 sd; reversibility = 15.1% bsln +/- 2.1 sd after salbutamol 200mg), and 10 subjects with AIA and nasal polyposis (AIA/NP; 22-49 y; FEV1 = 70.6%pred. +/- 7.1 sd; reversibility = 13.2% bsln +/- 1.6 sd after salbutamol 200 microg) were studied. After their informed consent, urine were collected in the morning for the LTE4 quantitative immunoenzimatic assay (pg/mg creatinine; Cayman Chemical, Ann Arbour, Mi, USA). STATISTICS: Wilcoxon signed rank test was used, and p<0.05 accepted as the lowest level of statistical significance. RESULTS: AIA/NP subjects had the highest levels of urinary LTE4 (432.3 pg/mg +/- 88.1 sd) compared to AIA/R (330.7 pg/mg +/- 72.3s, p < 0.01), to A (129.1 pg/mg +/- 74.8sd, p < 0.001), and to N controls (66.5 pg/mg +/- 20.6 sd, p < 0.001). Moreover, urinary LTE4 levels measured in AIA/R subjects proved significantly higher than those measured in A (p < 0.001) and in N controls (p<0.001), while LTE4 levels in A proved significantly higher than those in N controls (p<0.001). Furthermore, basal LTE4 levels seem inversely related to those of basal FEV1 (102.1 % pred. +/- 8.2sd in N, 92.1 % pred +/- 14.6 sd in A, 71.6 % pred. +/- 15.5 sd in AIA/R, 70.6 % pred +/- 7.1 sd in AIA/P, respectively). Respiratory function in the two sub-groups of AIA patients proved reduced than in atopic asthmatics (p<0.001) and in normal controls (p < 0.001), even though the difference between these two subgroups of subjects did not reach the statistical significance. CONCLUSIONS: Cys-LTs confirm their relevant pathogenetic role in AIA, but also in early stages of atopic asthma. Urinary LTE4 exexcretion proves directly proportional to the extent of nasal structural changes occurring in ASA-intolerant asthmatics, being subjects with nasal polyps those with the highest LTE4 values, immediately followed by those with hypertrophic rhinitis. Routinary measurements of urinary LTE4 should be regarded as a sensitive indicator in monitoring the clinical evolution of nasal involvement in AIA.

Adult↗