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Asthma Outcomes (asthma + outcome)
Selected AbstractsAsthma Outcomes at an Inner-City School-Based Health CenterJOURNAL OF SCHOOL HEALTH, Issue 1 2001Nicole Lurie§ ABSTRACT Childhood asthma has reached near-epidemic levels in the US cities. Innovative strategies to identify children with asthma and prevent asthma morbidity are needed. This study measured asthma outcomes after initiation of an inner-city elementary school health center with a schoolwide focus on asthma detection and treatment. The site was an inner-city elementary school in Minneapolis, Minn. The study design incorporated a pre and post comparison with a longitudinal cohort of children (n=67) and a cross-sectional cohort of children before (n=156) and after (n=114) the intervention. Hospitalization rates for asthma decreased 75% to 80% over the study period. Outpatient visits for care in the absence of asthma symptoms doubled (p<.01), and the percentage of students seeing a specialist for asthma increased (p<.01). Use of peak flow meters, use of asthma care plans, and use of inhalers also improved (p<.01). While no change occurred in school absenteeism, parents reported that their children had less awakening with asthma and that asthma was less disruptive to family plans. This schoolwide intervention that included identification of children with asthma, education, family support, and clinical care using an elementary school health center was effective in improving asthma outcomes for children. [source] Fitness, daily activity and body composition in children with newly diagnosed, untreated asthmaALLERGY, Issue 11 2009S. Vahlkvist Background:, Information about how the asthma disease affects the life style and health in children is sparse. Aim:, To measure fitness, daily physical activity and body composition in children with newly diagnosed, untreated asthma and healthy controls, and to assess the association between the level of asthma control and these parameters. Methods:, Daily physical activity measured using accelerometry, cardiovascular fitness and body composition (per cent fat, per cent lean tissue and bone mineral density) were measured in 57 children with newly diagnosed, untreated asthma and in 157 healthy age- and sex-matched controls. The level of asthma control was assessed by measurements of a variety of asthma outcomes. Results:, Children with asthma were less fit (35.1 vs 39.3 ml O2/min/kg) (P < 0.001), had a higher body per cent fat (22.8 vs 19.5%) (P < 0.01) and a higher frequency of overweight (24.6 vs 14.2%) (P < 0.05) than healthy controls. Per cent body fat correlated negativly to overall daily activity (P < 0.001) and to time spent in high or vigorous activity (P < 0.001). Fitness corrrelated positively to time spent in high and vigorous activity (P < 0.001). Within the asthma group, the level of asthma control, fitness and the time spent in vigorous activity correlated positively (P < 0.02). Conclusion:, Children with untreated asthma are less fit and have a higher body per cent fat and frequency of obesity than their healthy peers. Uncontrolled asthma is associated with a reduced fitness and daytime spent in intensive activity. Overweight children are physically less active than normal weight children. [source] Adherence to the Mediterranean diet and fresh fruit intake are associated with improved asthma controlALLERGY, Issue 7 2008R. Barros Background:, The traditional Mediterranean diet is claimed to possess antioxidant and immune-regulatory properties in several chronic diseases. Typical Mediterranean foods have recently been associated with improvement of symptoms of asthma and rhinitis in children. However the effect of adherence to Mediterranean diet on adult asthma outcomes is unknown. We aimed to investigate the association between adherence to Mediterranean diet and asthma control. Methods:, Cross sectional study of 174 asthmatics, mean (SD) age of 40 (15) years. The patients were defined as controlled, in contrast to noncontrolled, if they showed FEV1 , 80% of predicted, exhaled nitric oxide (NO) ,35 ppb, and Asthma Control Questionnaire score <1. Dietary intake was obtained by a food frequency questionnaire, and Mediterranean diet was assessed by alternate Mediterranean Diet (aMED) Score. Logistic regression models adjusting for confounders were performed to estimate the association between Mediterranean diet and asthma control. Results:, Controlled asthmatics (23%) had significantly higher aMED Score, intake of fresh fruit, and lower intake of ethanol compared to noncontrolled (77%). High adherence to Mediterranean diet reduced 78% the risk of noncontrolled asthma after adjusting for gender, age, education, inhaled corticosteroids and energy intake (OR = 0.22; 95% CI = 0.05,0.85; P -trend = 0.028). The higher intake of fresh fruit decreased the probability of having noncontrolled asthma (OR = 0.29; 95% CI = 0.10,0.83; P -trend = 0.015), while the higher intake of ethanol had the opposite effect (OR = 3.16; 95% CI = 1.10,9.11; P -trend = 0.035). Conclusion:, High adherence to traditional Mediterranean diet increased the likelihood of asthma to be under control in adults. The study introduces a novel link between diet and asthma control, as measured by symptoms, lung function and exhaled NO. [source] Relationships between asthma and work exposures among non-domestic cleaners in OntarioAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2009Maya Obadia MSc Abstract Background Cleaners have been reported to have increased risk for work-related asthma symptoms but few studies have studied non-domestic cleaners. In this study, we compared work-related asthma symptoms among cleaners and other building workers and determined associations with tasks. Methods School and racetrack workers in Ontario, Canada, completed a questionnaire to identify the prevalence of cleaning tasks, physician-diagnosed asthma, new-onset asthma, respiratory symptoms, and work-related asthma symptoms. Results Cleaners and controls had a similar prevalence of most asthma outcomes although female cleaners reported significantly more respiratory symptoms; odds ratio (OR), 2.59 confidence intervals (CI) 1.6,4.3, and work-related asthma symptoms, OR 3.90 (CI 2.1,7.4) compared with female controls with adjustment for age and smoking history. Male cleaners showed a non-significant trend to more physician-diagnosed asthma, adjusted OR 2.10 (CI 0.9,4.8) and work-related asthma symptoms, adjusted OR 1.53 (CI 0.8,3.0). The work-related asthma symptoms among men were significantly associated with waxing floors, OR 2.19 (CI 1.0,4.4); wax-stripping floors, OR 2.54 (1.2,5.2); spot-cleaning carpets, OR 2.20 (1.3,3.8); and cleaning tiles, OR 4.46 (1.0,19.3) and grout, OR 2.12 (1.1,4.0). Conclusions Female cleaners have more asthma symptoms worse at work than controls. Work-related asthma symptoms among male cleaners were associated with a number of specific cleaning tasks. Findings suggest the need for school cleaners to have reduced exposure to cleaning chemicals and need for protective strategies during performance of tasks expected to exacerbate asthma, such as wax stripping. Am. J. Ind. Med. 52:716,723, 2009. © 2009 Wiley-Liss, Inc. [source] Effectiveness of early budesonide intervention in Caucasian versus Asian patients with asthma: 3-year results of the START studyRESPIROLOGY, Issue 6 2006Wan C. TAN Objective and background: Few studies have assessed the effectiveness of inhaled corticosteroid therapy exclusively in Asian patients with asthma. The present analysis compared the efficacy of early intervention with inhaled budesonide in Caucasian and Asian patients over the first 3 years of the inhaled Steroid Treatment As Regular Therapy in early asthma study. Methods: Patients aged 5,66 years with mild persistent asthma of ,2 years' duration were randomized to 3 years of double-blind treatment with once-daily budesonide 200 µg (for patients aged <11 years) or 400 µg administered via Turbuhaler or placebo, plus usual asthma therapy. Results: Budesonide significantly improved asthma outcomes in both Caucasian (n = 4661) and Asian (n = 1995) patients compared with reference therapy (placebo plus usual asthma therapy). Budesonide reduced the risk of a first severe asthma-related event by 42% and 49% in Caucasian and Asian patients, respectively, over the 3-year treatment period (P < 0.001 for both). Moreover, budesonide significantly increased symptom-free days, decreased nights with sleeping problems, improved pre- and postbronchodilator FEV1 and reduced the need for additional asthma medications of particular drug classes compared with reference therapy. Except for differences in the patterns of use of additional asthma medications, outcomes with budesonide and overall adverse events were similar in the Caucasian and Asian patient populations. Conclusion: Inhaled budesonide administered once daily in Asian patients with recent-onset, mild persistent asthma significantly improved asthma control and pulmonary function compared with reference therapy. Moreover, this effectiveness paralleled that observed in Caucasian patients. [source] Understanding the reasons for poor asthma outcomes in ethnic minorities: welcome progress, but important questions remainCLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2007C. R. Simpson No abstract is available for this article. [source] The effectiveness of intranasal corticosteroids in combined allergic rhinitis and asthma syndromeCLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2004P. Taramarcaz Summary Background Allergic rhinitis (AR) and asthma often coexist and may represent two manifestations of the same disease recently named combined AR and asthma syndrome (CARAS). Aim To review the common pathophysiology of combined AR and asthma and to investigate the efficacy of intranasal corticosteroids (INCS). Methods Medline was used to identify articles relevant to mechanisms. A Cochrane systematic review was performed to assess the efficacy of INCS in CARAS. Results There is cross-talk, evidence of a common inflammatory response in both sites, linked by a systemic component. The efficacy of anti-inflammatory INCS on asthma outcomes was assessed in a systematic review of 12 randomized controlled trials involving 425 subjects. After INCS there were non-significant trends for improvement in asthma symptom score (standardized mean difference (SMD) of 0.61; P=0.07), forced expiratory volume in 1 s (SMD of 0.31; P=0.08), and morning peak expiratory flow (weighted mean difference of 36.51; P=0.06). There was no impact on methacholine airways responsiveness (SMD of ,0.20; P=0.4). The review identified two promising new treatment options in united airway disease such as INCS as monotherapy in rhinitis and mild asthma, and a combined intranasal and intrabronchial corticosteroid (IBCS) deposition technique. Conclusion Common mucosal inflammatory responses occur in CARAS. This systematic review shows trends for a benefit of INCS in CARAS, but recognizes that more research is needed. At this stage, the current best practice is to treat asthma conventionally with IBCS with or without ,2 -agonist and to add INCS to improve specific rhinitis symptoms. [source] | ||||||||||