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Asma , Oscilometría , Humanos , Asma/diagnóstico , Asma/fisiopatología , Asma/epidemiología , Preescolar , Femenino , Masculino , Pulmón/fisiopatología , Pruebas de Función Respiratoria , NiñoRESUMEN
PURPOSE: Montelukast is used extensively in children and adolescents for allergic rhinitis and asthma. However, concerns have been raised regarding the increased risk of neuropsychiatric adverse events (NPAEs) associated with montelukast use. Therefore, our case-crossover study was conducted to observe whether there is an increased risk of NPAEs associated with montelukast use in children and adolescents. MATERIALS AND METHODS: A population-based case-crossover study using the customised Health Insurance Review and Assessment (HIRA) dataset was conducted. Paediatric patients aged between 0 and 19 years diagnosed with allergic rhinitis and/or asthma with a history of at least one montelukast prescription between 1 January 2018 and 31 December 2021 were included. Exposure to montelukast was assessed during 3-, 7-, 14-, 28- and 56-day hazard periods prior to each patient's NPAE. Stratified analyses according to age group, gender and season for the risk of NPAEs associated with montelukast use in the previous 7 days and 14 days were performed, respectively. Conditional logistic regression analysis was used to calculate adjusted ORs (aORs) with their corresponding 95% CIs, adjusting for concomitant medications. RESULTS: A total of 161 386 paediatric patients was identified. An increased risk of NPAEs associated with montelukast was found in all time window periods, including 3-day (aOR 1.28, 95% CI 1.24 to 1.32), 7-day (aOR 1.29, 95% CI 1.26 to 1.33), 14-day (aOR 1.34, 95% CI 1.31 to 1.37), 28-day (aOR 1.38, 95% CI 1.36 to 1.41) and 56-day (aOR 1.21, 95% CI 1.19 to 1.22) preceding hazard periods compared with use in the four control periods. CONCLUSION: Children and adolescents with allergic rhinitis and/or asthma should be prescribed montelukast with caution considering clinical benefits.
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Acetatos , Antiasmáticos , Asma , Estudios Cruzados , Ciclopropanos , Quinolinas , Sulfuros , Humanos , Niño , Adolescente , Masculino , Femenino , Preescolar , Acetatos/efectos adversos , Acetatos/uso terapéutico , Quinolinas/efectos adversos , Quinolinas/uso terapéutico , Sulfuros/efectos adversos , Asma/tratamiento farmacológico , Asma/epidemiología , Lactante , Antiasmáticos/efectos adversos , Antiasmáticos/administración & dosificación , Antiasmáticos/uso terapéutico , Rinitis Alérgica/epidemiología , Recién Nacido , Adulto JovenRESUMEN
BACKGROUND: Consumption of ultra-processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated. METHODS: We performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines. RESULTS: Dietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar-sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end-products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies. CONCLUSION: More preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma.
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Hipersensibilidad a los Alimentos , Humanos , Hipersensibilidad a los Alimentos/epidemiología , Hipersensibilidad a los Alimentos/etiología , Niño , Comida Rápida/efectos adversos , Microbioma Gastrointestinal/inmunología , Asma/epidemiología , Asma/etiología , Asma/inmunología , Manipulación de Alimentos , Rinitis Alérgica/epidemiología , Rinitis Alérgica/etiología , Preescolar , Comités Consultivos , Alimentos ProcesadosAsunto(s)
Asma , Sobrepeso , Humanos , Asma/epidemiología , Asma/complicaciones , Niño , Masculino , Femenino , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Adolescente , Índice de Masa CorporalRESUMEN
Viral lower respiratory tract infections (LRTIs), including rhinovirus and respiratory syncytial virus during early childhood, have been linked to subsequent asthma. However, the impact of other respiratory viruses remains unclear. We analyzed nationwide Korean data from January 1, 2008, to December 31, 2018, utilizing the national health insurance database. Our study focused on 19 169 meticulously selected children exposed to severe respiratory infections requiring hospitalization with documented viral pathogens, matched with 191 690 unexposed children at a ratio of 1:10 using incidence density sampling. Our findings demonstrate that asthma exacerbation rates were higher among the exposed cohort than the unexposed cohort over a mean follow-up of 7.8 years. We observed elevated risks of asthma exacerbation and newly developed asthma compared to the unexposed cohort. Hospitalization due to rhinovirus, respiratory syncytial virus, influenza, metapneumovirus, and adenovirus was related to increased asthma exacerbations. Notably, we found a stronger association in cases of multiple LRTI hospitalizations. In conclusion, our study shows that early childhood respiratory viral infections are related to subsequent asthma exacerbations and new asthma diagnoses.
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Asma , Hospitalización , Infecciones del Sistema Respiratorio , Humanos , Asma/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Hospitalización/estadística & datos numéricos , Masculino , Preescolar , Femenino , Lactante , República de Corea/epidemiología , Niño , Virosis/epidemiología , Incidencia , Factores de Riesgo , Infecciones por Virus Sincitial Respiratorio/epidemiología , Rhinovirus/aislamiento & purificaciónRESUMEN
BACKGROUND: Asthma is a leading cause of emergency hospital visits and a significant factor in lost productive hours. The lack of a synthesized body of knowledge on bronchial asthma has notable public health implications. OBJECTIVE: This systematic review and meta-analysis aim to investigate the prevalence of asthma and its predictors among patients presenting in Ethiopian public hospitals. DESIGN: Duplicate studies were removed using EndNote version X9. The Newcastle-Ottawa Scale guided the quality assessment, and data extraction followed the Joanna Briggs Institute format. DATA SOURCE AND METHODS: The authors used advanced search methods, including databases such as PubMed, Scopus, Embase, Africa Index Medicus, Science Direct, HINARI, Google Scholar, and manual searches. Data presentation adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Publication bias was assessed using Egger's regression test and a funnel plot. Sensitivity analysis was also conducted. RESULTS: The search yielded 352 original articles, with 22 meeting the criteria for inclusion. Using the random-effects DerSimonian-Laird model, the prevalence of bronchial asthma was found to be 9.02% (95% CI: 7.50, 10.53). Several factors were associated with the prevalence of bronchial asthma, including the spring season (AOR 3.7; 95% CI: 2.11, 6.49), childhood age (AOR 4.2; 95% CI: 1.84, 9.55), and urban residence (AOR 1.7; 95% CI: 1.29, 2.31). Other significant factors include family history of asthma (AOR 2.89; 95% CI: 2.22, 3.75), insecticide exposure (AOR 3.3; 95% CI: 2.23, 4.91), and the presence of household insects like cockroaches (AOR 3.33; 95% CI: 2.15, 5.15). Smoking (AOR 3.64; 95% CI: 2.66, 4.98), obstructive sleep apnea (AOR 4.29; 95% CI: 2.37, 7.76), and recurrent upper respiratory tract infections (AOR 4.31; 95% CI: 2.24, 8.32) were also significant. CONCLUSION: The pooled prevalence of bronchial asthma is notably high in Ethiopia. Key predictors include childhood age, spring season, urban living, family history of asthma, exposure to insecticides, presence of cockroaches, smoking, obstructive sleep apnea, and recurrent upper respiratory infections. Targeted interventions are crucial and should focus on lifestyle improvements, allergen identification, cockroach control, smoking cessation, reducing insecticide exposure, and promoting a safe environment. TRIAL REGISTRATION: This review's protocol was pre-registered with the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42023491222).
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Asma , Hospitales Públicos , Asma/epidemiología , Asma/diagnóstico , Asma/fisiopatología , Prevalencia , Humanos , Etiopía/epidemiología , Factores de Riesgo , Adulto , Masculino , Femenino , Niño , Adolescente , Persona de Mediana Edad , Adulto Joven , Estaciones del Año , Medición de Riesgo , Preescolar , AncianoRESUMEN
BACKGROUND: Association of early pregnancy body mass index (BMI) and maternal gestational weight gain (GWG), and asthma and allergic disease in children is unclear. METHODS: We analyzed data from 3176 mother-child pairs in a prospective birth cohort study. Maternal anthropometric measurements in the first and last antenatal clinic visits were obtained through post-delivery questionnaires to calculate early pregnancy BMI and maternal GWG. Asthma and allergic diseases in children by the age of 5 years was assessed using a validated questionnaire. Furthermore, serum samples were analyzed for IgE antibodies to eight allergens. We applied Cox proportional hazards and logistic regression analyses to estimate the association of early pregnancy BMI and maternal GWG (as continuous variables and categorized into quarters), and asthma, atopic eczema, atopic sensitization, and allergic rhinitis in children. RESULTS: Neither early pregnancy BMI nor maternal GWG was associated with asthma and allergic disease in children when analyzed as continuous variables. However, compared to the first quarter of GWG (a rate <0.32 kg/week), mothers in the third quarter (rate 0.42-0.52 kg/week) had children with significantly higher odds of developing atopic eczema (adjusted OR 1.49, 95% CI [1.13-1.96]) by 5 years of age. CONCLUSION: Association of early pregnancy BMI and maternal GWG, and asthma and allergic disease in children, is inconsistent. High maternal GWG may be associated with increased odds of atopic eczema.
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Asma , Índice de Masa Corporal , Ganancia de Peso Gestacional , Hipersensibilidad , Humanos , Embarazo , Femenino , Asma/epidemiología , Asma/inmunología , Preescolar , Masculino , Estudios Prospectivos , Hipersensibilidad/epidemiología , Hipersensibilidad/inmunología , Adulto , Inmunoglobulina E/sangre , Lactante , Dermatitis Atópica/epidemiología , Dermatitis Atópica/inmunología , Efectos Tardíos de la Exposición Prenatal/epidemiología , Efectos Tardíos de la Exposición Prenatal/inmunología , Encuestas y Cuestionarios , Estudios de Cohortes , Cohorte de Nacimiento , Recién NacidoRESUMEN
Objective: To ascertain the prevalence of asthma attacks among archivists and identify the associated occupational factors in this understudied professional population. Methods: We conducted a cross-sectional, questionnaire-based study among 1,002 archival workers. A multiple logistic regression was conducted to identify the association between asthma attacks and occupational exposures. The Strobe Protocol was applied. Results: 999 workers were included in the final analysis with the asthma prevalence of 33.3%. Main factors associated with asthma attacks (OR [95% CI]) were the presence of chemically irritating odors (2.152 [1.532-3.024]), mold odors (1.747 [1.148-2.658]), and insects (1.409[1.041-1.907]). A significant synergistic effect was observed between chemical irritants and mold, the odds ratio was 7.098 (95% CI, 4.752-10.603). Conclusion: There was a high prevalence of asthma attacks among archival workers, an under-studied population. Chemical irritants, molds and insects were associated with their asthma attacks. Notably, this study's data analysis has revealed a strong synergy (OR = 7.098) between chemical odors and molds in the workplace. While the existing international literature on this specific interaction remains somewhat limited, previous studies have already demonstrated the potential for chemical irritants, such as sulfur dioxide and ozone, to synergistically interact with inhalable allergens, including fungi, molds and dust mites. Consequently, this interaction seems to exacerbate asthma symptoms and perpetuate untreated exposure. Furthermore, in damp and damaged buildings, the presence of microbial components, such as cellular debris or spores released during fungal growth can trigger an inflammatory response, potentially served as a shared pathway for the development of asthma among individuals exposed to these hazardous factors.
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Asma , Hongos , Exposición Profesional , Humanos , Estudios Transversales , Masculino , Adulto , Femenino , Asma/epidemiología , Asma/etiología , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Prevalencia , Encuestas y Cuestionarios , Persona de Mediana Edad , Hongos/aislamiento & purificación , Factores de Riesgo , Salud Pública , Odorantes , Irritantes/efectos adversosRESUMEN
COPD is the second leading cause of death in India. The guidelines for early detection of COPD were released by the Government of India in 2019. However, due to the COVID-19 pandemic, its implementation could not be optimal. Diagnosis of COPD is based on the presence of respiratory symptoms, the presence of exposure to risk factors, and the presence of poorly reversible airflow obstruction as assessed using a spirometer. Spirometers are currently available only at a few district hospitals. The existing guidelines expect the patient to visit the Rural hospital/ Community Health Centre, which does not have a spirometer or a pulmonary medicine specialist. Also, it is not feasible or accessible for patients to visit the district hospital to get diagnosed. The current study will be implemented to determine the prevalence, annual incidence of COPD and asthma, quality of life, and nutritional status of COPD and asthma patients. The novelty of this implementation research, which will be conducted in collaboration with Zilla Parishad (i.e., Government), Pune district, is the empowerment of an Accredited Social Health Activist (ASHA), a peripheral health worker to screen all individuals using a peak flow meter and confirmation of the diagnosis at health and wellness center (HWC). An accredited Social Health Activist (ASHA) will take relevant history to suspect COPD and asthma in 30+-year-old adults, and she will refer the suspected cases to the Community Health Officer (CHO) at the Health and Wellness Center. The CHO/ Medical officer of PHC will initiate the appropriate treatment after confirming the diagnosis using a portable spirometer. The difficult-to-diagnose patients with comorbidity and acute exacerbations will be referred to the nearest higher center, i.e., Primary Health Centre (PHC) or Community Health Centre (CHC), where a primary care physician is available. The ASHA workers will provide two follow-ups to these patients in a year, depending on the severity, to ensure compliance with the treatment. Thus, early diagnosis and appropriate treatment of COPD and asthma at the community level may help to reduce the episodes of acute exacerbations.
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Asma , Tamizaje Masivo , Enfermedad Pulmonar Obstructiva Crónica , Espirometría , Humanos , India/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Asma/diagnóstico , Asma/epidemiología , Tamizaje Masivo/métodos , COVID-19/epidemiología , COVID-19/diagnóstico , Personal de Salud , Femenino , Empoderamiento , Calidad de Vida , Masculino , Guías de Práctica Clínica como AsuntoRESUMEN
BACKGROUND: The study assessed the association between COVID-19 and new-onset obstructive airway diseases, including asthma, chronic obstructive pulmonary disease, and bronchiectasis among vaccinated individuals recovering from COVID-19 during the Omicron wave. METHODS: This multicenter retrospective cohort study comprised 549,606 individuals from the U.S. Collaborative Network of TriNetX database, from January 8, 2022, to January 17, 2024. The hazard of new-onset obstructive airway diseases between COVID-19 and no-COVID-19 groups were compared following propensity score matching using the Kaplan-Meier method and Cox proportional hazards model. RESULTS: After propensity score matching, each group contained 274,803 participants. Patients with COVID-19 exhibited a higher risk of developing new-onset asthma than that of individuals without COVID-19 (adjusted hazard ratio (aHR), 1.27; 95% CI, 1.22-1.33; p < 0.001). Stratified analyses by age, SARS-CoV-2 variant, vaccination status, and infection status consistently supported this association. Non-hospitalized individuals with COVID-19 demonstrated a higher risk of new-onset asthma (aHR, 1.27; 95% CI, 1.22-1.33; p < 0.001); however, no significant differences were observed in hospitalized and critically ill groups. The study also identified an increased risk of subsequent bronchiectasis following COVID-19 (aHR, 1.30; 95% CI, 1.13-1.50; p < 0.001). In contrast, there was no significant difference in the hazard of chronic obstructive pulmonary disease between the groups (aHR, 1.00; 95% CI, 0.95-1.06; p = 0.994). CONCLUSION: This study offers convincing evidence of the association between COVID-19 and the subsequent onset of asthma and bronchiectasis. It underscores the need for a multidisciplinary approach to post-COVID-19 care, with a particular focus on respiratory health.
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Asma , COVID-19 , Enfermedad Pulmonar Obstructiva Crónica , Humanos , COVID-19/epidemiología , COVID-19/complicaciones , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Asma/epidemiología , Asma/complicaciones , Adulto , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , SARS-CoV-2 , Bronquiectasia/epidemiología , Puntaje de Propensión , Estados Unidos/epidemiología , Factores de Riesgo , Adulto JovenRESUMEN
Asthma is a respiratory disorder caused by airway inflammation which may worsen after allergen exposure. Recent cohort studies demonstrate a positive association between skin cancer and asthma or hay fever (allergy to outdoor allergens such as pollen). Nationally-representative data for adults in the United States remains limited. We aimed to characterize skin cancer prevalence among individuals in the United States who have asthma or hay fever. To achieve this aim, we extracted nationwide cross-sectional data from 16,277 adult participants (total survey-weighted sample = 174,765,931) of the Third National Health and Nutrition Examination Survey from 1988 to 1994. This study uses survey-weighted regression to compare the nationwide prevalence of skin cancer among participants with or without a history of asthma or hay fever. Sensitivity analysis examined the influence of sex, 25-hydroxyvitamin D, chronic bronchitis or emphysema, geographical region, urban proximity, and oral glucocorticoid use. Of the included participants, the age-adjusted prevalence of skin cancer was 7.2%, similar to national estimates. Skin cancer prevalence was higher among participants who had asthma with hay fever (adjusted prevalence ratio, 1.79; 95% confidence interval, 1.16, 2.76), but not among participants with asthma only or hay fever only. Similarly, skin cancer prevalence was higher for those with asthma and positive pollen allergen skin prick testing (SPT), but not for those with hay fever and positive pollen SPT. No association was noted between skin cancer and wheezing triggered by pollen. Hay fever or immunoglobulin-E sensitization to pollen may increase skin cancer prevalence among individuals with a history of asthma.
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Asma , Encuestas Nutricionales , Rinitis Alérgica Estacional , Neoplasias Cutáneas , Humanos , Estudios Transversales , Masculino , Rinitis Alérgica Estacional/epidemiología , Rinitis Alérgica Estacional/inmunología , Rinitis Alérgica Estacional/diagnóstico , Femenino , Adulto , Persona de Mediana Edad , Estados Unidos/epidemiología , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/diagnóstico , Prevalencia , Asma/epidemiología , Asma/inmunología , Asma/diagnóstico , Alérgenos/inmunología , Alérgenos/efectos adversos , Pruebas Cutáneas , Anciano , Adulto Joven , Polen/inmunología , Polen/efectos adversos , Factores de RiesgoRESUMEN
OBJECTIVES: This 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 (VGDF), mould, damages from moisture and cold, and new-onset asthma. We also aimed to assess the corresponding population attributable fraction (PAF) for ever exposure to VGDF. DESIGN: Longitudinal population-based respiratory health study. SETTING: Responders from the baseline Telemark Study in south-eastern Norway were followed up from 2013 to 2018. PARTICIPANTS: 7120 participants, aged 16-55, were followed during a 5-year period. MAIN OUTCOME MEASURES: New-onset asthma and its association with self-reported occupational exposure to VGDF, data from the N-JEM and self-reported workplace conditions were assessed using logistic regression adjusted for gender, age, smoking and body mass index. The PAF was calculated using the PUNAF command in STATA. RESULTS: There were 266 (3.7%) cases of new-onset asthma and an incidence density of 7.5 cases per 1000 person-years. A statistically significant association was found for ever exposed to VGDF with an OR of 1.49 (95% CI 1.15 to 1.94), weekly OR 2.00 (95% CI 1.29 to 3.11) and daily OR 2.46 (95% CI 1.39 to 4.35) exposure to VGDF. The corresponding PAF for ever exposed to VGDF was 17% (95% CI 5.4% to 27.8%) and the risk of asthma onset increased with frequent VGDF exposure, indicating a possible exposure-response relationship (p=0.002 for trend). The N-JEM exposure group, accidental peak exposure to irritants had an increased risk of new-onset asthma, OR 2.43 (95% CI 1.21 to 4.90). A significant association was also found for self-reported exposure to visible damages due to moisture 1.51 (95% CI 1.08 to 2.11), visible and smell of mould 1.88 (95% CI 1.32 to 2.68), 1.55 (95% CI 1.12 to 2.16) and cold environment 1.41 (95% CI 1.07 to 1.86). CONCLUSION: Participants had elevated ORs for asthma associated with self-reported and N-JEM-assigned exposures. A PAF of 17% indicates that work-related asthma is still common. The possible exposure-response relationship suggests that reducing occupational VGDF exposure frequency could prevent the onset of asthma.
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Asma , Exposición Profesional , Humanos , Masculino , Adulto , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Femenino , Noruega/epidemiología , Persona de Mediana Edad , Asma/epidemiología , Asma/etiología , Adolescente , Estudios de Seguimiento , Incidencia , Adulto Joven , Estudios Longitudinales , Autoinforme , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Factores de Riesgo , Modelos Logísticos , PolvoRESUMEN
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and asthma can be treated with inhaled corticosteroids (ICS) delivered by low climate impact inhalers (dry powder inhalers) or high climate impact inhalers (pressurized metered-dose inhalers containing potent greenhouse gasses). ICS delivered with greenhouse gasses is prescribed ubiquitously and frequent despite limited evidence of superior effect. Our aim was to examine the beneficial and harmful events of ICS delivered by low and high climate impact inhalers in patients with asthma and COPD. METHODS: Nationwide retrospective cohort study of Danish outpatients with asthma and COPD treated with ICS delivered by low and high climate impact inhalers. Patients were propensity score matched by the following variables; age, gender, tobacco exposure, exacerbations, dyspnoea, body mass index, pulmonary function, ICS dose and entry year. The primary outcome was a composite of hospitalisation with exacerbations and all-cause mortality analysed by Cox proportional hazards regression. RESULTS: Of the 10,947 patients with asthma and COPD who collected ICS by low or high climate impact inhalers, 2,535 + 2,535 patients were propensity score matched to form the population for the primary analysis. We found no association between high climate impact inhalers and risk of exacerbations requiring hospitalization and all-cause mortality (HR 1.02, CI 0.92-1.12, p = 0.77), nor on pneumonia, exacerbations requiring hospitalization, all-cause mortality, or all-cause admissions. Delivery with high climate impact inhalers was associated with a slightly increased risk of exacerbations not requiring hospitalization (HR 1.10, CI 1.01-1.21, p = 0.03). Even with low lung function there was no sign of a superior effect of high climate impact inhalers. CONCLUSION: Low climate impact inhalers were not inferior to high climate impact inhalers for any risk analysed in patients with asthma and COPD.
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Asma , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Asma/tratamiento farmacológico , Asma/epidemiología , Asma/diagnóstico , Anciano , Estudios Retrospectivos , Dinamarca/epidemiología , Estudios de Cohortes , Administración por Inhalación , Adulto , Inhaladores de Polvo Seco , Clima , Inhaladores de Dosis Medida , Corticoesteroides/administración & dosificación , Corticoesteroides/efectos adversos , Resultado del TratamientoRESUMEN
Asthma is a prevalent chronic disease characterized by airflow obstruction, causing breathing difficulties and wheezing. This study investigates the association between the C-reactive protein to albumin ratio (CAR) and asthma prevalence, as well as all-cause and respiratory mortality among asthma patients, using data from the 2001-2018 National Health and Nutrition Examination Survey. We included participants aged 20 years and older with complete CAR data, excluding those who were pregnant or lost to follow-up. The analysis employed weighted logistic regression and Cox proportional hazards models with stepwise adjustment, restricted cubic spline analysis for nonlinear relationships, and time-dependent ROC curves for predictive accuracy. Results showed that the highest CAR quartile significantly increased the risk of asthma (OR 1.56, 95% CI 1.38-1.78), all-cause mortality (HR 2.20, 95% CI 1.67-2.89), and respiratory mortality (HR 2.56, 95% CI 1.30-5.38). The impact of CAR on all-cause mortality was particularly significant in hypertensive patients. These findings highlight CAR's potential as a valuable biomarker for predicting asthma prevalence and mortality, underscoring its role in asthma management and prognostication.
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Asma , Biomarcadores , Proteína C-Reactiva , Humanos , Asma/mortalidad , Asma/sangre , Asma/epidemiología , Femenino , Masculino , Proteína C-Reactiva/metabolismo , Proteína C-Reactiva/análisis , Adulto , Persona de Mediana Edad , Biomarcadores/sangre , Encuestas Nutricionales , Prevalencia , Anciano , Modelos de Riesgos Proporcionales , Albúmina Sérica/análisis , Adulto Joven , Factores de RiesgoRESUMEN
BACKGROUND: With the backdrop of global climate change, the impact of climate change on respiratory diseases like asthma is receiving increasing attention. However, the effects of temperature and diurnal temperature range (DTR) on asthma are complex, and understanding these effects across different seasons, age groups, and sex is of utmost importance. METHODS: This study utilized asthma hospitalization data from Lanzhou, China, and implemented a distributed lag nonlinear model (DLNM) to investigate the relationship between temperature and DTR and asthma hospitalizations. It considered differences in the effects across various seasons and population subgroups. RESULTS: The study revealed that low temperatures immediately increase the risk of asthma hospitalization (RR = 1.2010, 95% CI: 1.1464, 1.2580), and this risk persists for a period of time. Meanwhile, both high and low DTR were associated with an increased risk of asthma hospitalization. Lower temperatures (RR = 2.9798, 95% CI: 1.1154, 7.9606) were associated with higher asthma risk in the warm season, while in the cold season, the risk significantly rose for the general population (RR = 3.6867, 95% CI: 1.7494, 7.7696), females (RR = 7.2417, 95% CI: 2.7171, 19.3003), and older individuals (RR = 18.5425, 95% CI: 5.1436, 66.8458). In the warm season, low DTR conditions exhibited a significant association with asthma hospitalization risk in males (RR = 7.2547, 95% CI: 1.2612, 41.7295) and adults aged 15-64 (RR = 9.9494, 95% CI: 2.2723, 43.5643). Children also exhibited noticeable risk within specific DTR ranges. In the cold season, lower DTR increases the risk of asthma hospitalization for the general population (RR = 3.1257, 95% CI: 1.4004, 6.9767). High DTR significantly increases the risk of asthma hospitalization in adults (RR = 5.2563, 95% CI: 2.4131, 11.4498). CONCLUSION: This study provides crucial insights into the complex relationship between temperature, DTR, and asthma hospitalization, highlighting the variations in asthma risk across different seasons and population subgroups.
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Asma , Hospitalización , Estaciones del Año , Temperatura , Humanos , Asma/epidemiología , Masculino , Femenino , China/epidemiología , Adulto , Persona de Mediana Edad , Adolescente , Hospitalización/estadística & datos numéricos , Niño , Adulto Joven , Preescolar , Anciano , Lactante , Cambio Climático , Factores de Riesgo , Recién NacidoRESUMEN
BACKGROUND: Asthma is a chronic inflammatory condition, and choline may alleviate airway inflammation and oxidative stress but studies on the association between dietary choline and asthma remain limited. The purpose of this study is to investigate the associations between dietary choline intake and asthma, as well as pulmonary inflammation and lung function in children and adults. METHODS: In our research, we employed the data of the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018, including 7,104 children and 16,580 adults. We used fractional exhaled nitric oxide (FENO) to assess pulmonary inflammation and forced expiratory volume in one second (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio, peak expiratory flow rate (PEF), predicted FEV1% and predicted FVC% to assess lung function. Binary logistic regression, linear regression, and the restricted cubic splines were used to analyze the associations between dietary choline intake and asthma and pulmonary inflammation and lung function. RESULTS: In children, we observed the positive associations between the natural logarithmic transformation of choline (ln-choline) and ln-FEV1 [ ß:0.011; 95%CI: (0.004,0.018)] and ln-FVC [ ß:0.009; 95%CI: (0.002,0.016)]. In adult males, the ln-choline was positively associated with ln-FEV1[ ß:0.018; 95%CI: (0.011,0.024)], ln-FVC [ ß:0.020; 95%CI: (0.014,0.026)], ln-PEF [ ß:0.014; 95%CI: (0.007,0.022)], ln-predicted FEV1% [ ß: 0.007; 95%CI: (0.001, 0.013)] and ln-predicted FVC%[ ß: 0.010; 95%CI: (0.005, 0.015)] and negatively associated with FENO [ ß: -0.029; 95%CI: (-0.049, -0.009)]. In unadjusted and partially adjusted models, adult females with ln-choline in the highest quartile had 25.2% (95%CI:9.4-38.3%) and 23.8% (95%CI:7.6-37.1%) decreased odds of asthma compared to those with the lowest quartile group. In the dose-response relationships of dietary choline and pulmonary inflammation and lung function indicators in adults, there existed threshold and saturation effects. CONCLUSION: The associations between dietary choline and lung function indicators such as FEV1 and FVC are positive in children and adults. The association between dietary choline and pulmonary inflammation is negative only in adults.
Asunto(s)
Asma , Colina , Encuestas Nutricionales , Neumonía , Humanos , Colina/administración & dosificación , Asma/epidemiología , Masculino , Femenino , Adulto , Niño , Neumonía/epidemiología , Persona de Mediana Edad , Dieta , Adolescente , Pruebas de Función Respiratoria , Pulmón/fisiopatología , Volumen Espiratorio Forzado , Adulto Joven , Capacidad Vital , Óxido Nítrico/análisisRESUMEN
Missing regulatory effects of asthma genetic risks might be hidden within specific cell states. In this issue of Cell Genomics, Djeddi et al.1 uncover how airway epithelial cells, when activated by rhinovirus, influence genetic susceptibility to childhood-onset asthma, and this preview emphasizes the need to address these missing regulatory effects across diverse cell states.
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Asma , Rhinovirus , Humanos , Asma/virología , Asma/genética , Asma/epidemiología , Asma/etiología , Rhinovirus/genética , Niño , Predisposición Genética a la Enfermedad , Células Epiteliales/virología , Células Epiteliales/patología , Edad de InicioRESUMEN
This study outlines asthma burden trends across age, sex, regions and risk factors in 'Belt and Road' (B&R) countries from 1990 to 2019 using the Global Burden of Disease Study 2019 data. Incidence, mortality, prevalence, years lived with disability (YLDs), disability-adjusted life years (DALYs) and risk factors for asthma were measured. India, China and Indonesia bore the heaviest burden in 2019. Despite the significant decline in the average annual percent change for age-standardized mortality and years of life lost from 1990 to 2019, increases were observed in several East Asian, Central Asian, North African and Middle Eastern countries between 2010 and 2019. For both sexes, YLDs decreased in most B&R countries but increased in Montenegro, Saudi Arabia, Armenia, Vietnam and Oman. YLDs in Georgia, the United Arab Emirates and Albania increased in males but decreased in females. YLDs increased for those aged <15 years in Central Asia and Europe, while China's 50-74-year age group showed the lowest YLD change. High body mass index (BMI) led to increased YLDs in East, Central and Southeast Asia; North Africa; and the Middle East. Conclusively, asthma burden varies significantly by country. Tailoring control efforts to specific regions, sex and high BMI could enhance asthma management.
Asunto(s)
Asma , Años de Vida Ajustados por Discapacidad , Carga Global de Enfermedades , Humanos , Asma/epidemiología , Masculino , Femenino , Carga Global de Enfermedades/tendencias , Persona de Mediana Edad , Factores de Riesgo , Adulto , Adolescente , Anciano , Niño , Preescolar , Adulto Joven , Años de Vida Ajustados por Discapacidad/tendencias , Prevalencia , Lactante , Incidencia , Costo de Enfermedad , Salud Global/estadística & datos numéricos , Años de Vida Ajustados por Calidad de Vida , Recién NacidoRESUMEN
OBJECTIVE: To determine the role of comorbid diseases in patients with coronavirus disease-2019. Methods: The quantitative, retrospective study was conducted in July 2022 at Arifin Achmad Hospital, Riau, Indonesia, and comprised patients who died due to coronavirus disease-2019 between January and March 2021. Data was retrieved from the institutional medical records using a checklist that contained items related to demographic and comorbid data. Data was analysed using SPSS 27. RESULTS: Of the 48 patients, 27(56.3%) were males, 21(43.7%) were females, and 20(41.7%) were aged 45-60 years. There were 16(33.3%) patients having hypertension, 11(22.9%) had diabetes mellitus, 5(10.4%) had both hypertension and diabetes mellitus, 5(10.4%) had asthma, and there was no co-morbidity in 11(22.9%) patients. Conclusion: Hypertension was the most common comorbid disease among coronavirus disease-2019 who died.