Asthma
Oral contraceptives linked to asthma risk
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Some women who use oral contraceptives may have an increased risk for asthma, according to results of a Scandinavian study.
The effect depends on body mass index (BMI), with the rate of asthma increasing as BMI goes up, Dr. Ferenc Macsali of Haukeland University Hospital in Bergen, Norway, and colleagues report in the Journal of Allergy and Clinical Immunology.
From 1999 to 2001, the researchers mailed questionnaires to women ranging in age from 25-44 years in Denmark, Estonia, Iceland, Norway, and Sweden. Respondents included 4,728 women who did not use oral contraceptives and 961 who did.
Couch potato kids risk developing asthma
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Young children who watch TV for more than 2 hours a day run the risk of developing asthma before their 12th birthday, according to a study of more than 3,000 kids whose health and habits were tracked from birth.
“In children who had no wheezing symptoms up to age 3.5 years, those who reported watching TV for more than 2 hours per day were almost twice as likely to have asthma by age 11.5 years as those watching TV for 1 to 2 hours per day,” Dr. Andrea Sherriff told Reuters Health.
The amount of time spent in front of the TV was used as a measure for sedentary behavior because personal computers and video game consoles were not in widespread use at the time the study was conducted in the mid-1990s, explained Sherriff, who is at the University of Glasgow, UK.
New study raises concerns about screen time among urban children with asthma
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Urban children with asthma engage in an average of an hour more of screen time daily than the maximum amount American Academy of Pediatrics (AAP) recommends. This is the first study to examine screen time among children with asthma.
“We know that both asthma and excessive screen time can be associated with other difficulties, including behavior problems, difficulty with attention, poor school performance and obesity,” said Kelly M. Conn, M.P.H., of General Pediatrics at Golisano Children’s Hospital at Strong and lead author of the study, which was published recently in Academic Pediatrics. (Academic Pediatrics changed its name from Ambulatory Pediatrics this year.) The study was conducted out of the University of Rochester Medical Center.
As a part of a larger study on how to more effectively treat asthma, Conn and her colleagues surveyed parents of urban children with asthma in Rochester, NY, to better understand their screen time viewing habits. Screen time includes TV watching and video tapes, playing video and computer games and using the Internet. The study found that 74 percent of the 226 children whose parents were surveyed exceeded more than two hours of screen time per day. On average, these children with asthma watched 3.4 hours daily.
School-supervised asthma therapy improves control
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New research suggests that adherence with daily asthma “controller” medications among children with asthma can be enhanced with school-based supervised asthma therapy.
As reported in the February issue of the journal Pediatrics, researchers assessed asthma control in 290 children from 36 schools who were randomized to receive school-based, supervised therapy or usual care.
For their study, Dr. Lynn B. Gerald and colleagues from the University of Alabama, Birmingham defined poor asthma control as at least one of the following: 1) absence from school due to asthma or respiratory illness, 2) average use of “rescue” asthma medication more than 2 times per week, or 3) at least 1 red or yellow reading on a peak flow meter, a device that measures air flow.
School program helps kids manage asthma
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An asthma education program given in school may help urban, low-income children better manage the lung condition, a new study suggests.
Researchers found that an asthma education program offered at inner-city schools in Oakland, California, was able to improve students’ symptoms and reduce the number of visits to the emergency room for asthma attacks.
Over three years, nearly 1,000 middle school and high school students took part in the program, dubbed “Kickin’ Asthma.” The four-session program, led by a trained nurse, taught asthmatic students how to avoid symptom triggers, catch warning signs of an asthma attack and take their medication properly.
Researchers link C-section babies to asthma risk
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Babies born by Caesarean section are more likely to develop asthma than children delivered naturally, Swiss researchers said on Tuesday.
There has been conflicting evidence on the link between asthma and C-sections but the researchers said the number of children involved in their study and a long monitoring period strengthened their results.
The findings also underscore the potential risks of elective C-sections as more women in Western countries choose to avoid a natural birth, the researchers said in the medical journal, Thorax.
Kids take responsibility for asthma meds early
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Many children with asthma start taking their daily medication on their own at an early age, a new study finds.
The findings suggest that even young children should be included when doctors and parents discuss asthma management, researchers report in the journal Pediatrics.
In surveys of 351 parents of asthmatic children and teenagers, the researchers found that by the age of 7, children were giving themselves their daily controller medication nearly 20 percent of the time. By age 11, they were responsible for taking their medication about half of the time.
Daily controller medication refers to the drugs, such as inhaled corticosteroids, that asthma patients take to reduce airway inflammation and prevent attacks of breathlessness and wheezing.
Asthma may boost pneumococcal infection risk
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People with asthma are at increased risk of serious infection with pneumococcal bacteria, according to a new analysis of medical records.
The findings, along with the high fatality rate from such infections, suggest that adults with asthma would benefit from the pneumococcal vaccine, Dr. Young J. Juhn of the Mayo Clinic in Rochester, Minnesota and colleagues say. However, the ability of asthmatics to react normally to the vaccine must be determined before such recommendations can be made, they add.
A previous study found that Medicaid patients with asthma were more than twice as likely to contract invasive pneumococcal disease, in which pneumococcal pneumonia develops and the bacteria invades the bloodstream or the membranes surrounding the brain, Juhn and colleagues note.
Obesity, lack of exercise reported in asthmatics
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Study findings suggest less than one quarter of asthmatic adults meet national exercise guidelines and, among this group, obesity may be a greater exercise deterrent actual asthma symptoms.
People with asthma may get caught in a vicious cycle, note Dr. Carol A. Mancuso and colleagues from Weill Cornell Medical College and the Hospital for Special Surgery in New York City.
“Obesity leads to worse asthma, which can be associated with less exercise, which predisposes to obesity and long-term (worsening) asthma,” Mancuso told Reuters Health.
Efficacy, Dosage Concerns Unresolved on Sublingual Immunotherapy
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Although sublingual immunotherapy (SLIT) is used in Europe and other countries, experts at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Seattle say questions remain unanswered regarding its effectiveness, appropriate use, dosage, and safety of administration.
“Sublingual immunotherapy has gained wide acceptance in the treatment of allergic disease throughout Europe and South America, but the research studies in the United States have yet to show results that will convince the FDA to approve a product,” said Ira Finegold, M.D., clinical professor of medicine at Columbia University and chairman of the R.A. Cook Institute of Allergy, St. Luke’s-Roosevelt Hospital, New York.
“The main advantage of SLIT over traditional immunotherapy is patient convenience, since it is not an injection but oral drops or tablets that can be administered at home, and it appears to be safer than conventional immunotherapy,” he said.
Steroids Not as Effective in Obese Asthma Patients
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Glucocorticoids, the primary controller medication for asthma, are 40 percent less effective in overweight and obese asthma patients than in those of normal weight, according to researchers at National Jewish Health, in Denver. The study also identified a potential mechanism involved in the resistance, which suggests therapeutic targets for future medications.
The study, by Associate Professor of Medicine E. Rand Sutherland, M.D., M.P.H., and his colleagues at National Jewish Health, appears in the first issue for October of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
“This study identifies what could be a significant issue for the 20 million Americans with asthma; specifically, the main controller medication might be less effective if you are overweight or obese,” said Dr. Sutherland. “These findings should spur doctors to carefully evaluate response to treatment in overweight and obese asthmatics and consider optimizing therapeutic regimens as indicated. We also hope they will spur additional research into the treatment of obese patients with asthma.”
Asthma monitoring on the Web
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An inexpensive web-enabled device for measuring lung function in patients with asthma and other disorders is being developed by researchers at Texas Instruments, in Bangalore, India, and co-workers. Writing in the International Journal of Biomedical Engineering and Technology, the team explains how the devise could allow physicians to monitor their patients remotely and quickly instigate medical attention in an emergency.
Spirometers are commonly used to measure lung capacity and the response of breathing during therapy. However, the widespread application of spirometers is limited in the developing world and in remote regions because of the high instrument cost of the instrument and a lack of specialist healthcare workers trained in its use.
Texas Instruments researcher N.C.S. Ramachandran is an expert in high-speed and low-power digital design and is working with professor of electrical engineering Vivek Agarwal of the Indian Institute of Technology, Bombay, India, on the development of an inexpensive and easy to operate spirometer that can be quickly hooked up to an internet connection through built-in web and data encryption software.
Note to pediatricians: Taper meds in kids with stable asthma
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A study of how pediatricians prescribe asthma medications suggests that while most would readily increase a child’s medication if needed, many are reluctant to taper off drug use when less might be best. A report on the study, led by Johns Hopkins Children’s Center researchers, appears in the July issue of Pediatrics.
“Asthma medications can have serious, albeit infrequent, side effects, and while under-treatment is undeniably a big problem, not stepping down treatment when a child is doing well may be too,” says lead investigator Sande Okelo, M.D., an asthma specialist at Hopkins Children’s.
In the research, conducted among 310 pediatricians nationwide, 40 percent said they would not step down high-dose treatment even if a child’s symptoms were well controlled and infrequent.
Caregivers often expose asthmatic kids to smoke
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Secondhand exposure to cigarette smoke is an asthma trigger in children and a new study shows that smoking by the primary caregiver and daycare provider are important sources of smoke exposure in children with asthma.
In the study, children with asthma who were exposed to secondhand smoke “had as much smoke exposure as if their mother smoked,” Dr. Harold J. Farber told Reuters Health.
Children with a double hit of smoke exposure - from both their daycare provider and primary caregiver - had the highest levels of nicotine metabolites in their urine, said Farber, of Texas Children’s Hospital in Houston.
Aspirin may help prevent asthma in women
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In a large study of healthy women, taking low doses of aspirin reduced the occurrence of asthma, investigators at Harvard Medical School report.
Two recently reported studies among adult men and women have indicated a significant reduction in the risk of newly diagnosed asthma associated with regular aspirin use, lead investigator Dr. T. Kurth and colleagues note.
To further investigate, the Boston-based researchers analyzed data from the Women’s Health Study, in which more than 37,000 female health professionals age 45 and older with no previous history of asthma were randomly assigned aspirin 100 milligrams every other day or placebo.
