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De-Miguel-Diez J, Llamas-Saez C, Vaquero TS, Jiménez-García R, López-de-Andrés A, Carabantes-Alarcón D, Carricondo F, Romero-Gómez B, Pérez-Farinos N. Association between Asthma and Lower Levels of Physical Activity: Results of a Population-Based Case-Control Study in Spain. J Clin Med 2024; 13:591. [PMID: 38276097 PMCID: PMC10816609 DOI: 10.3390/jcm13020591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: Our aim was to determine changes in the prevalence of physical activity (PA) in adults with asthma between 2014 and 2020 in Spain, investigate sex differences and the effect of other variables on adherence to PA, and compare the prevalence of PA between individuals with and without asthma. (2) Methods: This study was a cross-sectional, population-based, matched, case-control study using European Health Interview Surveys for Spain (EHISS) for 2014 and 2020. (3) Results: We identified 1262 and 1103 patients with asthma in the 2014 and 2020 EHISS, respectively. The prevalence of PA remained stable (57.2% vs. 55.7%, respectively), while the percentage of persons who reported walking continuously for at least 2 days a week increased from 73.9% to 82.2% (p < 0.001). Male sex, younger age, better self-rated health, and lower body mass index (BMI) were significantly associated with greater PA. From 2014 to 2020, the number of walking days ≥2 increased by 64% (OR1.64 95%CI 1.34-2.00). Asthma was associated with less PA (OR0.87 95%CI 0.47-0.72) and a lower number of walking days ≥2 (OR0.84 95%0.72-0.97). (4) Conclusions: Walking frequency improved over time among people with asthma. Differences in PA were detected by age, sex, self-rated health status, and BMI. Asthma was associated with less LTPA and a lower number of walking days ≥2.
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Affiliation(s)
- Javier De-Miguel-Diez
- Respiratory Care Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | - Carlos Llamas-Saez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | | | - Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - Francisco Carricondo
- Department of Immunology, Laboratory of Neurobiology of Hearing (UCM 910915), Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (F.C.); (B.R.-G.)
| | - Barbara Romero-Gómez
- Department of Immunology, Laboratory of Neurobiology of Hearing (UCM 910915), Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (F.C.); (B.R.-G.)
| | - Napoleón Pérez-Farinos
- Epi-PHAAN Research Group, School of Medicine, Universidad de Malaga, 29071 Malaga, Spain;
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2
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Alwadeai KS. Sociodemographic factors, health behavior, parental or workplace smoking, and adult asthma risk in the United States. Work 2024; 77:1115-1124. [PMID: 38306078 DOI: 10.3233/wor-230026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Although several studies have found a link between parental or workplace smoking and asthma risk, particularly in children and adolescents, only a few studies have found this link in adults. OBJECTIVE This study aimed to investigate the associations of sociodemographic factors, health behavior, and parental or workplace smoking with adult asthma risk in the United States (US). METHODS A secondary data analysis on 874 participants aged 25-45 was performed using data from the 2011-2014 National Survey of Midlife Development in the United States Refresher. Participants were divided into smokers and nonsmokers. Participants were further divided into groups A (a father or mother with a smoking history) and B (others in the house or colleagues in the workplace who had a smoking history). RESULTS Findings from the FREQ procedure revealed that sociodemographic (female, black, school or college education, unmarried/divorced, and employed) and lifestyle (no alcohol intake, physically inactive, and obese) and clinical (diabetes and joint disease) factors were significantly associated with one- or more-fold odds of asthma among adult smokers than nonsmokers. Adult smokers in group A, particularly females, those with a high school or college education, physically inactive, and overweight or obese, had a higher risk of asthma than those in group B. CONCLUSION Adult smokers' risk of developing asthma is increased in the US by having smoked with their parents, being a woman, being black, having a school or college education, being single or divorced, working, not drinking alcohol, being physically inactive, being obese, having diabetes, and having a joint disease.
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Affiliation(s)
- Khalid S Alwadeai
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia. E-mail:
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3
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Clemente-Suárez VJ, Mielgo-Ayuso J, Ramos-Campo DJ, Beltran-Velasco AI, Martínez-Guardado I, Navarro Jimenez E, Redondo-Flórez L, Yáñez-Sepúlveda R, Tornero-Aguilera JF. Basis of preventive and non-pharmacological interventions in asthma. Front Public Health 2023; 11:1172391. [PMID: 37920579 PMCID: PMC10619920 DOI: 10.3389/fpubh.2023.1172391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
Asthma is one of the most common atopic disorders in all stages of life. Its etiology is likely due to a complex interaction between genetic, environmental, and lifestyle factors. Due to this, different non-pharmacological interventions can be implemented to reduce or alleviate the symptoms caused by this disease. Thus, the present narrative review aimed to analyze the preventive and non-pharmacological interventions such as physical exercise, physiotherapy, nutritional, ergonutritional, and psychological strategies in asthma treatment. To reach these aims, an extensive narrative review was conducted. The databases used were MedLine (PubMed), Cochrane (Wiley), Embase, PsychINFO, and CinAhl. Asthma is an immune-mediated inflammatory condition characterized by increased responsiveness to bronchoconstrictor stimuli. Different factors have been shown to play an important role in the pathogenesis of asthma, however, the treatments used to reduce its incidence are more controversial. Physical activity is focused on the benefits that aerobic training can provide, while physiotherapy interventions recommend breathing exercises to improve the quality of life of patients. Nutritional interventions are targeted on implement diets that prioritize the consumption of fruits and vegetables and supplementation with antioxidants. Psychological interventions have been proposed as an essential non-pharmacological tool to reduce the emotional problems associated with asthma.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, Burgos, Spain
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Ismael Martínez-Guardado
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, Universidad Camilo José Cela, Madrid, Spain
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
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4
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Denche-Zamorano Á, Urbano-Mairena J, Pastor-Cisneros R, Muñoz-Bermejo L, Barrios-Fernandez S, Garcia-Gordillo MÁ, Colmenarez-Mendoza A, Guerra-Bustamante J, Mendoza-Muñoz M. A Cross-Sectional Study on Physical Activity and Psychological Distress in Adults with Asthma. Healthcare (Basel) 2022; 10:healthcare10122469. [PMID: 36553992 PMCID: PMC9778577 DOI: 10.3390/healthcare10122469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Physical Activity (PA) could contribute to decreasing psychological distress and improving Self-Perceived Health (SPH) in adults with Asthma. The main objective of this study was to analyse the associations between the Physical Activity Level (PAL) Perceived Social Support (PSS) and Mental Health, using the Goldberg General Health Questionnaire (GHQ-12), and SPH in the adult population with Asthma. This descriptive cross-sectional study is based on data from the 2017 Spanish National Health Survey, including 1040 participants with Asthma in the study. The Kruskal-Wallis test was performed to study the hypothetical differences between the PAL and the different variables derived from the GHQ-12. In addition, correlations between the variables generated and the items of the GHQ-12, together with the PAL and the Duke-UNC-11, were analysed using Spearman's rho correlation coefficients. Inverse correlations were found between Mental Health and PSS (rho: -0.351) and between Mental Health and PAL (rho: -0.209), as well as in the rest of the GHQ-12 items: successful coping (rho: -0.197), self-esteem (rho: -0.193) and stress (rho: -0.145). The more active subjects had better SPH. Therefore, the research showed how higher PAL and positive SPH are related to lower psychological distress in adults with Asthma.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Javier Urbano-Mairena
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Raquel Pastor-Cisneros
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain
- Correspondence:
| | - Laura Muñoz-Bermejo
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain
| | | | | | - Joan Guerra-Bustamante
- Area of Personality, Evaluation and Psychological Treatment, Department of Psychology and Anthropology, Faculty of Nursing and Occupational Therapy, University of Extremadura, 10003 Caceres, Spain
| | - María Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
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5
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Jenkins CR, Boulet LP, Lavoie KL, Raherison-Semjen C, Singh D. Personalized Treatment of Asthma: The Importance of Sex and Gender Differences. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:963-971.e3. [PMID: 35150902 DOI: 10.1016/j.jaip.2022.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/18/2022] [Accepted: 02/03/2022] [Indexed: 12/19/2022]
Abstract
An individual's sex (nominally male or female, based on biological attributes) and gender (a complex term referring to socially constructed roles, behaviors, and expressions of identity) influence the clinical course of asthma in several ways. The physiologic development of the lungs and effects of sex hormones may explain why more boys than girls have asthma, and after puberty, more women than men have asthma. Female sex hormones have an impact throughout the life span and are associated with poor asthma control. Gender may influence exposure to asthma triggers, and sex and gender can influence the prevalence of comorbidities and interactions with health care professionals. Despite widely reported sex- and gender-based differences in asthma and asthma management, these issues frequently are not considered by health care professionals. There is also inconsistency regarding the use of "sex" and "gender" in scientific discourse; research is needed to define sex- and gender-based differences better and how they might interact to influence asthma outcomes. This review outlines the impact an individual's sex and gender can have on the pathogenesis, clinical course, diagnosis, treatment, and management of asthma.
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Affiliation(s)
| | | | - Kim L Lavoie
- Department of Psychology, University of Québec at Montreal and Montreal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Chantal Raherison-Semjen
- Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe, France; INSERM U1219, EpiCene Team, University of Bordeaux, Bordeaux, France
| | - Dave Singh
- University of Manchester, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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6
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Busse WW, Kraft M. Current unmet needs and potential solutions to uncontrolled asthma. Eur Respir Rev 2022; 31:31/163/210176. [PMID: 35082128 PMCID: PMC9488919 DOI: 10.1183/16000617.0176-2021] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/28/2021] [Indexed: 12/16/2022] Open
Abstract
Despite the availability of effective inhaled therapies, many patients with asthma have poor asthma control. Uncontrolled asthma presents a significant burden on the patient and society, and, for many, remains largely preventable. There are numerous reasons why a patient may remain uncontrolled despite access to therapies, including incorrect inhaler technique, poor adherence to treatment, oversight of triggers and suboptimal medical care. Shared decision-making, good patient–clinician communication, supported self-management, multidisciplinary patient education, new technology and risk stratification may all provide solutions to this major unmet need in asthma. Novel treatments such as biologics could benefit patients’ lives, while the investigations into biomarkers, non-Type 2 asthma, treatable traits and disease modification give an exciting glimpse into the future of asthma care. Despite effective therapies, many patients with asthma have poor asthma control, which is preventable. The benefits of shared decision-making, supported self-management, risk stratification and novel treatments in transforming patient care are reviewed.https://bit.ly/3A386Nm
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Affiliation(s)
- William W Busse
- Dept of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Monica Kraft
- University of Arizona College of Medicine, Tucson, AZ, USA
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7
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Adzrago D, Nyarko SH, Ananaba N, Asare M, Odame E, Jones A, Paul TK, Mamudu HM. Between and Within Sexual Identity-Group Differences in Asthma Prevalence in the United States. Respir Care 2022; 67:331-338. [PMID: 34599088 PMCID: PMC9993488 DOI: 10.4187/respcare.09258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Although prior studies have established the association of asthma with smoking and obesity, literature on difference-in-differences analyses involving sexual identity is sparse. Therefore, this study aimed to examine the between and within sexual identity-group differences in asthma prevalence among individuals who smoke and are obese. METHODS We aggregated the 2017-2019 National Survey on Drug Use and Health data on adults (N = 128,319) to perform weighted multivariable logistic regression analysis and marginal estimates and marginsplot to determine asthma prevalence by sexual identity and the status of smoking and obesity. RESULTS About 66% of the study population reported having asthma. Among the individuals with asthma, 42% were obese, 10% were daily cigarette smokers, and 6% identified as bisexual persons. Lesbian/gay daily smokers (86%) or former smokers (75%) had a higher probability of having asthma than bisexual (daily smokers = 78% vs former smokers = 72%) and heterosexual (daily smokers = 68% vs former smokers = 65%) persons. Within each sexual identity subgroup, daily smokers (68-86%) had the highest probability of asthma. Obese bisexual (73%) or lesbian/gay (72%) persons had higher probabilities of having asthma than heterosexual persons (69%). Obese (73%) or overweight (72%) bisexual (compared to normal weight = 70% or underweight = 51%) and obese (69%) or overweight (65%) heterosexual (compared to normal weight = 62% or underweight = 57%) persons had the highest probabilities of having asthma within their groups, whereas overweight persons (overweight = 81% vs underweight = 79%, normal weight = 78%, and obese = 72%) had the highest probabilities within lesbian/gay persons. CONCLUSIONS Smoking and obesity show heightened odds for asthma, with significant odds for sexual minorities in asthma diagnosis relative to heterosexuals. These findings provide formative information for future longitudinal and experimental studies to explore these mechanisms of asthma risks among sexual and gender minorities.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas.
| | - Samuel H Nyarko
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas
| | - Nnenna Ananaba
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
| | - Matt Asare
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas
| | - Emmanuel Odame
- Department of Environmental Health Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Antwan Jones
- Department of Sociology and Department of Epidemiology, The George Washington University, Washington, District of Columbia
| | - Timir K Paul
- University of Tennessee at Nashville, Nashville, Tennessee
| | - Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee
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8
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Kuder MM, Clark M, Cooley C, Prieto-Centurion V, Danley A, Riley I, Siddiqi A, Weller K, Kitsiou S, Nyenhuis SM. A Systematic Review of the Effect of Physical Activity on Asthma Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:3407-3421.e8. [PMID: 33964510 PMCID: PMC8434961 DOI: 10.1016/j.jaip.2021.04.048] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Asthma is a chronic respiratory disease that affects millions worldwide. Medication management is the current mainstay of treatment; however, there is evidence to suggest additional benefit with lifestyle changes, particularly with increased physical activity. OBJECTIVE To discover and evaluate the effects of physical activity on asthma outcomes. METHODS Systematic search of PubMed, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Rehabilitation and Sports Medicine Source, Scopus, and Web of Science identified 11,155 results. Thirty-five articles met our inclusion criteria spanning 20 studies. Data extraction was conducted by 6 independent reviewers, and final results were evaluated by a seventh reviewer and the senior author. RESULTS Wide variation among selected studies, including the heterogeneity of interventions and outcome variables, did not support a meta-analysis. Mixed results of the effects of physical activity on asthma outcomes were found. Most studies suggest that physical activity improves asthma control, quality of life, lung function parameters, and inflammatory serologies, whereas 3 found no improvements in any of these outcomes. No studies reported worsening asthma outcomes. CONCLUSIONS This review highlights the emerging and promising role of physical activity as a nonpharmacologic treatment for asthma. Additional high-quality randomized controlled trials are needed to overcome the problems of measurement heterogeneity and the dilution of outcome effect size measurement related to physical activity interventions for asthma.
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Affiliation(s)
- Margaret M Kuder
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Maureen Clark
- Library of the Health Sciences, University of Illinois at Chicago, Chicago, Ill; Department of Medical Education, University of Illinois at Chicago, Chicago, Ill
| | - Caitlin Cooley
- Department of Medicine, University of Illinois at Chicago, Chicago, Ill
| | | | - Adam Danley
- Department of Medicine, University of Illinois at Chicago, Chicago, Ill
| | | | - Aminaa Siddiqi
- Department of Pediatrics, Stanford University, Palo Alto, Calif
| | - Katherine Weller
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, Ill
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9
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Ali Z, Ulrik CS, Egeberg A, Thyssen JP, Francis Thomsen S. Increased all-cause mortality in concomitant atopic dermatitis and asthma: A nationwide registry-based study. Clin Exp Allergy 2021; 51:1207-1217. [PMID: 34191378 DOI: 10.1111/cea.13978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Excess mortality has been reported for adults with atopic dermatitis (AD) and asthma. OBJECTIVE To assess the mortality rate in adults with concomitant AD and asthma. METHODS Adults with hospital-diagnosed AD were matched (1:4) with non-AD individuals from the background population. RESULTS The study cohort comprised 8,095 adults with AD (of which 1,201 (14.8%) had concomitant asthma) and 32,380 reference individuals without AD from the background population (of which 878 (2.7%) had asthma). A total of 1,057, 330, 55 and 99 deaths were observed among subjects with neither AD nor asthma, AD only, asthma only, and subjects with concomitant AD and asthma, respectively. The mortality rate per 1,000 person-years was 4.75 (95% CI 4.47-5.05) for subjects with neither AD nor asthma, 7.17 (95% CI 5.92-10.05) for asthma only, 7.09 (95% CI 6.37-7.90) for AD only and 10.87 (95% CI 8.92-13.23) for concomitant AD and asthma. Risk for all-cause mortality was increased in subjects with concomitant AD and asthma compared to asthma only (HR 1.52, 95% CI 1.07-2.15) and neither AD nor asthma (HR 2.27, 95% CI 1.83-2.81) but not compared to subjects with AD only (HR 1.10, 95% CI 0.87-1.39). However, compared to AD only subjects with AD and asthma had increased risk of death due to pulmonary disease (HR 1.81, 95% CI 1.04-3.15). CONCLUSION Adults with AD, asthma or both conditions have increased risk of death, and further concomitant AD and asthma have increased risk of death compared with asthma alone.
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Affiliation(s)
- Zarqa Ali
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Department of Pulmonary Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Simon Francis Thomsen
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Kuder MM, Nyenhuis SM. Optimizing lifestyle interventions in adult patients with comorbid asthma and obesity. Ther Adv Respir Dis 2021; 14:1753466620906323. [PMID: 32103702 PMCID: PMC7047422 DOI: 10.1177/1753466620906323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The prevalence of obesity and asthma are both increasing at alarming rates. The link between obesity and asthma suggests that obesity contributes to both risk of new onset asthma and increased asthma severity. The emerging evidence demonstrating the role of obesity and other lifestyle factors, such as diet and physical activity, on asthma outcomes warrants lifestyle interventions that can address these components of asthma care. This review examines the current literature on the pathophysiology of obesity’s role in asthma, as well as the role of diet and physical activity in weight loss and in asthma outcomes. We discuss recent studies that employ lifestyle interventions to target improved asthma outcomes. Finally, we discuss the future direction of research in this area. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Margaret M Kuder
- Department of Allergy and Immunology, Cleveland Clinic, Cleveland, OH, USA
| | - Sharmilee M Nyenhuis
- Division of Pulmonary, Critical Care, Sleep and Allergy, Affiliate Faculty, Center for Dissemination and Implementation Science, University of Illinois at Chicago, 840 S. Wood St. MC 719, Chicago, IL 60612, USA
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11
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Günaydın FE, Ediger D, Erbay M. Fatigue: A forgotten symptom of asthma. CLINICAL RESPIRATORY JOURNAL 2021; 15:741-752. [PMID: 33783133 DOI: 10.1111/crj.13356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Fatigue is a common symptom frequently reported in many disorders but little is known about the prevalence of fatigue in asthma. The objective of this study was to determine the prevalence of fatigue in asthmatic patients, the effect of fatigue on asthma quality of life and the relationship between fatigue and anxiety/depression MATERIALS AND METHODS: This prospective cross-sectional study was conducted in Uludağ University Faculty of Medicine, Department of Immunology and Allergic Diseases outpatient clinic from June 2019 to December 2019. Fatigue was assessed using the Checklist Individual Strength-Fatigue (CIS-Fatigue), psychological distress was assessed using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) and quality of life were assessed using the Asthma Quality of Life Questionnaire (AQLQ). RESULTS In the present study, a total of 168 patients are included with an average age of 43.8 ± 4.3 years. Nearly 64.8% of patients had controlled asthma and (35.2%) patients had uncontrolled asthma. Fatigue (CIS-Fatigue ≥ 27 points) was detected in 62.6% of patients and associated with asthma-related quality of life, asthma control, dyspnea, depression and anxiety (P < 0.05). However, the degree of lung function impairment and asthma severity were not associated with fatigue. CONCLUSIONS Fatigue as a symptom is common in asthmatic patients and correlates with asthma-related quality of life, asthma control, dyspnea, depression and anxiety. Future studies are needed to better understand the physical, psychological, behavioural and systemic factors that precipitate or perpetuate fatigue in asthma.
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Affiliation(s)
- Fatma Esra Günaydın
- Section of Immunology and Allergy Diseases, Department of Chest Diseases, Medical Faculty, Uludağ University, Bursa, Turkey
| | - Dane Ediger
- Section of Immunology and Allergy Diseases, Department of Chest Diseases, Medical Faculty, Uludağ University, Bursa, Turkey
| | - Müge Erbay
- Section of Immunology and Allergy Diseases, Department of Chest Diseases, Medical Faculty, Uludağ University, Bursa, Turkey
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12
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Manivannan S, Chandrasekaran V, Subramanian N. A comparative study of clinical profile and symptom control in overweight and normal weight school-age children with mild persistent asthma. Health Sci Rep 2021; 4:e224. [PMID: 33364442 PMCID: PMC7752164 DOI: 10.1002/hsr2.224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/10/2020] [Accepted: 11/27/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To find out the proportion of children with poor symptom control in overweight/obese and normal weight children with mild persistent asthma and to know the sociodemographic and clinical correlates of poor symptom control in them. MATERIALS AND METHODS Children aged 6 to 12 years with mild persistent asthma with BMI Z score for age and sex more than +1 Z score on WHO BMI Z score chart for age and sex formed the cases. Age- and sex-matched asthmatics with BMI Z score for age and sex between -2 Z and +1 Z score formed the controls. FEV1, FEV1/FVC were measured in both groups using Care Fusion Jaeger spirometer. Symptom control was assessed by ACT score. Statistical analysis was done using SPSS version 19 and Vassarstats. RESULTS The proportion of children with poor control was 19.1% in the overweight/obese group and 23.4% in the normal weight group. There was no significant correlation between BMI and symptom control as assessed by the ACT score. Overweight/obese children with good control showed a slightly lower FEV1/FVC ratio and higher median eosinophil count compared to children with normal weight. Gastroesophageal reflux and allergic rhinitis were more commonly seen in overweight/obese children. In the poor control group, FEV1, FEV1/FVC, and median eosinophil counts were not significantly different between overweight/obese and normal weight group but were less when compared to good control group. CONCLUSION The proportion of poor symptom control was not high in overweight/obese asthmatic children compared to normal weight asthmatic children. No significant risk factors for poor symptom control could be identified in our study for either of the groups.
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Li X, Cao X, Guo M, Xie M, Liu X. Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ 2020; 368:m234. [PMID: 32075787 PMCID: PMC7190065 DOI: 10.1136/bmj.m234] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017. DESIGN Systematic analysis. DATA SOURCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2017. METHODS Mortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data. RESULTS Between 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma. CONCLUSIONS Regions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.
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Affiliation(s)
- Xiaochen Li
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China
| | - Xiaopei Cao
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China
| | - Mingzhou Guo
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China
| | - Min Xie
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China
| | - Xiansheng Liu
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, Wuhan, China
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Van Herck M, Spruit MA, Burtin C, Djamin R, Antons J, Goërtz YMJ, Ebadi Z, Janssen DJA, Vercoulen JH, Peters JB, Thong MSY, Otker J, Coors A, Sprangers MAG, Muris JWM, Wouters EFM, van 't Hul AJ. Fatigue is Highly Prevalent in Patients with Asthma and Contributes to the Burden of Disease. J Clin Med 2018; 7:E471. [PMID: 30477110 PMCID: PMC6306949 DOI: 10.3390/jcm7120471] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 12/17/2022] Open
Abstract
The 2018 update of the Global Strategy for Asthma Management and Prevention does not mention fatigue-related symptoms. Nevertheless, patients with asthma frequently report tiredness, lack of energy, and daytime sleepiness. Quantitative research regarding the prevalence of fatigue in asthmatic patients is lacking. This retrospective cross-sectional study of outpatients with asthma upon referral to a chest physician assessed fatigue (Checklist Individual Strength-Fatigue (CIS-Fatigue)), lung function (spirometry), asthma control (Asthma Control Questionnaire (ACQ)), dyspnea (Medical Research Council (MRC) scale), exercise capacity (six-minute walk test (6MWT)), and asthma-related Quality-of-Life (QoL), Asthma Quality of Life Questionnaire (AQLQ) during a comprehensive health-status assessment. In total, 733 asthmatic patients were eligible and analyzed (47.4 ± 16.3 years, 41.1% male). Severe fatigue (CIS-Fatigue ≥ 36 points) was detected in 62.6% of patients. Fatigue was not related to airflow limitation (FEV1, ρ = -0.083); was related moderately to ACQ (ρ = 0.455), AQLQ (ρ = -0.554), and MRC (ρ = 0.435; all p-values < 0.001); and was related weakly to 6MWT (ρ = -0.243, p < 0.001). In stepwise multiple regression analysis, 28.9% of variance in fatigue was explained by ACQ (21.0%), MRC (6.5%), and age (1.4%). As for AQLQ, 42.2% of variance was explained by fatigue (29.8%), MRC (8.6%), exacerbation rate (2.6%), and age (1.2%). Severe fatigue is highly prevalent in asthmatic patients; it is an important determinant of disease-specific QoL and a crucial yet ignored patient-related outcome in patients with asthma.
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Affiliation(s)
- Maarten Van Herck
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
- Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands.
| | - Martijn A Spruit
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
- Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands.
- Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands.
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6229 ER Maastricht, The Netherlands.
| | - Chris Burtin
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
| | - Remco Djamin
- Department of Respiratory Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands.
| | - Jeanine Antons
- Department of Pulmonary Medicine, Radboud University Medical Center (Radboudumc), 6525 GA Nijmegen, The Netherlands.
| | - Yvonne M J Goërtz
- Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands.
| | - Zjala Ebadi
- Department of Medical Psychology, Radboudumc, 6525 GA Nijmegen, The Netherlands.
| | - Daisy J A Janssen
- Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands.
- Centre of expertise for palliative care, MUMC+, 6229 HX Maastricht, The Netherlands.
| | - Jan H Vercoulen
- Department of Medical Psychology, Radboudumc, 6525 GA Nijmegen, The Netherlands.
| | - Jeannette B Peters
- Department of Medical Psychology, Radboudumc, 6525 GA Nijmegen, The Netherlands.
| | - Melissa S Y Thong
- Department of Medical Psychology, Amsterdam University Medical Centers, location AMC, 1105 AZ Amsterdam, The Netherlands.
| | - Jacqueline Otker
- Member of Lung Foundation Netherlands, 3818 LE Amersfoort, The Netherlands.
| | - Arnold Coors
- Member of Patient Advisory Board, Radboudumc, 6525 GA Nijmegen, The Netherlands.
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, location AMC, 1105 AZ Amsterdam, The Netherlands.
| | - Jean W M Muris
- Department of General Practice, MUMC+, 6229 HX Maastricht, The Netherlands.
| | - Emiel F M Wouters
- Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands.
- Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands.
| | - Alex J van 't Hul
- Department of Pulmonary Medicine, Radboud University Medical Center (Radboudumc), 6525 GA Nijmegen, The Netherlands.
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Serum Total Magnesium Level and its Correlation with Symptom Control in Children with Mild Persistent Asthma. Indian J Pediatr 2018; 85:420-425. [PMID: 29349628 DOI: 10.1007/s12098-017-2599-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 12/20/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine the prevalence of hypomagnesemia in children with mild persistent asthma and to correlate the serum magnesium levels with symptom control in the above children. METHODS It was a cross sectional study carried out from 1st April 2015 to 31st July 2016 at the department of Pediatrics, JIPMER Hospital. Participants included six to 12-y-old children with mild persistent asthma registered at childhood asthma clinic. Pulmonary function tests were done in all children using Care fusion Jaeger spirometer. Symptom control was assessed by childhood asthma control test questionnaire and the asthma control test questionnaire (ACT) score. Serum magnesium was measured using photometric method. Proportion of children with well controlled, partially controlled and poorly controlled asthma, serum magnesium levels across the three levels of control and correlation of serum magnesium level with ACT score and pulmonary function tests were studied. RESULTS The prevalence of hypomagnesemia in children with mild persistent asthma was 5.6%. The median serum magnesium level was 2.0 mg/dl (IQR 1.9-2.1 mg/dL). As assessed by the ACT score, 66% had well controlled, 23% had partially controlled and 11% had poorly controlled asthma. There was no significant difference in the serum magnesium levels in the above three groups. There was no significant correlation between serum magnesium levels and ACT score as well as pulmonary function tests. CONCLUSIONS The prevalence of hypomagnesemia in the index study is much lower than earlier studies and there seems to be no significant association between serum magnesium levels and asthma symptom control.
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Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM. A Systematic Review of Associations of Physical Activity and Sedentary Time with Asthma Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1968-1981.e2. [PMID: 29510231 DOI: 10.1016/j.jaip.2018.02.027] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/05/2018] [Accepted: 02/22/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Physical inactivity and high sedentary time are associated with adverse health outcomes in several diseases. However, their impact in asthma is less clear. OBJECTIVE We aimed to synthesize the literature characterizing physical activity and sedentary time in adults with asthma, to estimate activity levels using meta-analysis, and to evaluate associations between physical activity and sedentary time and the clinical and physiological characteristics of asthma. METHODS Articles written in English and addressing the measurement of physical activity or sedentary time in adults ≥18 years old with asthma were identified using 4 electronic databases. Meta-analysis was used to estimate steps/day in applicable studies. RESULTS There were 42 studies that met the inclusion criteria. Physical activity in asthma was lower compared with controls. The pooled mean (95% confidence interval) steps/day for people with asthma was 8390 (7361, 9419). Physical activity tended to be lower in females compared with males, and in older people with asthma compared with their younger counterparts. Higher levels of physical activity were associated with better measures of lung function, disease control, health status, and health care use. Measures of sedentary time were scarce, and indicated a similar engagement in this behavior between participants with asthma and controls. High sedentary time was associated with higher health care use, and poorer lung function, asthma control, and exercise capacity. CONCLUSIONS People with asthma engage in lower levels of physical activity compared with controls. Higher levels of physical activity may positively impact on asthma clinical outcomes. Sedentary time should be more widely assessed.
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Affiliation(s)
- Laura Cordova-Rivera
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Peter G Gibson
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Paul A Gardiner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, Queensland, Australia; Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
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Yawn BP, Wollan PC, Rank MA, Bertram SL, Juhn Y, Pace W. Use of Asthma APGAR Tools in Primary Care Practices: A Cluster-Randomized Controlled Trial. Ann Fam Med 2018; 16. [PMID: 29531100 PMCID: PMC5847347 DOI: 10.1370/afm.2179] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care. Patient outcomes included asthma control, quality of life, and emergency department (ED), urgent care, and inpatient hospital visits. The practice outcome was adherence to asthma guidelines. RESULTS We enrolled 1,066 patients: 245 children, 174 adolescents, and 647 adults. Sixty-five percent (692 patients) completed both baseline and 12-month questionnaires, allowing analysis for patient-reported outcomes. Electronic health record data were available for 1,063 patients (99.7%) for practice outcomes. The proportion of patients reporting an asthma-related ED, urgent care, or hospital visit in the final 6 months of the study was lower in the APGAR practices vs usual care practices (10.6% vs 20.9%, P = .004). The percentage of patients with "in control" asthma increased more between baseline and 1 year in the APGAR group vs usual care group (13.5% vs 3.4%, P =.0001 vs P =.86) with a trend toward better control scores and asthma-related quality of life in the former at 1 year (P ≤.06 and P = .06, respectively). APGAR practices improved their adherence to 3 or more guideline elements compared with usual care practices (20.7% increase vs 1.9% decrease, P = .001). CONCLUSIONS Introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines.
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Affiliation(s)
- Barbara P Yawn
- Department of Research, Olmsted Medical Center, Rochester, Minnesota
| | - Peter C Wollan
- Department of Research, Olmsted Medical Center, Rochester, Minnesota
| | - Matthew A Rank
- Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic, Scottsdale, Arizona
| | - Susan L Bertram
- Department of Research, Olmsted Medical Center, Rochester, Minnesota
| | - Young Juhn
- Department of Pediatrics and Adolescent Medicine, Asthma Epidemiology Research Unit, Mayo Clinic, Rochester, Minnesota
| | - Wilson Pace
- National Research Network, American Academy of Family Physicians, Leawood, Kansas
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Thomson NC. Asthma and smoking-induced airway disease without spirometric COPD. Eur Respir J 2017; 49:49/5/1602061. [PMID: 28461294 DOI: 10.1183/13993003.02061-2016] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/01/2017] [Indexed: 12/15/2022]
Abstract
Due to the high prevalence rates of cigarette smoking and asthma, current and ex-smokers frequently develop chronic airway disease without spirometric evidence of chronic obstructive pulmonary disease (COPD), either alone or associated with asthma. This review considers the classification, clinical outcomes, inflammatory and imaging variables, phenotypes, and management of current and ex-smokers with airway disease without COPD, focusing on overlaps in those with and without asthma. These individuals have more respiratory symptoms, worse quality of life, increased exacerbation rates, reduced lung function and more comorbidities than never-smokers with asthma or healthy never-smokers. As well as clinical features, airway inflammatory and structural changes in smoking-induced airway disease without COPD overlap with those found in smokers with asthma. Cigarette smoking is associated with worse clinical outcomes in some phenotypes of asthma. Management involves public health measures to control exposure to tobacco smoke, personal advice on smoking cessation and the use of appropriate targeted therapies, although evidence is limited on their effectiveness. Understanding the mechanisms, natural history and management of current and ex-smokers with asthma and smoking-induced airway disease without COPD is a priority for future research.
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Affiliation(s)
- Neil C Thomson
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
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19
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Jansson SA, Axelsson M, Hedman L, Leander M, Stridsman C, Rönmark E. Subjects with well-controlled asthma have similar health-related quality of life as subjects without asthma. Respir Med 2016; 120:64-69. [PMID: 27817817 DOI: 10.1016/j.rmed.2016.09.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/25/2016] [Accepted: 09/29/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND The burden of asthma and rhinitis on health-related quality of life (HRQL) among adults has been assessed mainly in studies of patients seeking health-care, while population-based studies are relatively scarce. The objective of this study was to investigate HRQL among subjects with asthma and rhinitis derived from a random population sample and to identify factors related to impairment of HRQL. METHODS A randomly selected cohort was invited to participate in a postal questionnaire survey. Of those who responded, a stratified sample of 1016 subjects was invited to clinical examinations and interviews, and 737 subjects in ages 21-86 years participated. Of these, 646 completed HRQL questions. HRQL was assessed with the generic SF-36 Health Survey. RESULTS The physical score was lower among subjects with asthma vs. subjects without asthma (p < 0.001). No significant difference was found in the mental score. Subjects with well-controlled asthma had higher physical score compared to subjects with partly and un-controlled asthma (p = 0.002). Actually, subjects with well-controlled asthma had similar physical HRQL as subjects without asthma. Asthmatics who were current smokers had lower physical score compared to those who were non-smokers (p = 0.021). No significant differences in physical or mental scores were found between subjects with and without rhinitis. Subjects with both asthma and rhinitis had lower physical score compared to subjects without these conditions (p < 0.001), but subjects with asthma alone had even worse physical score. CONCLUSIONS The physical score was significantly lower in asthmatics compared to subjects without asthma. Importantly, non-smoking and well-controlled asthmatics have similar HRQL compared to subjects without asthma. Thus, subjects with asthma should be supported to achieve and maintain good asthma control and if they smoke, be offered smoking cessation as means to improve their HRQL.
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Affiliation(s)
- Sven-Arne Jansson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
| | - Malin Axelsson
- Department of Care Sciences, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden; Department of Health Science, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Mai Leander
- Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
| | - Caroline Stridsman
- Department of Health Science, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden
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Mafort TT, Rufino R, Costa CH, Lopes AJ. Obesity: systemic and pulmonary complications, biochemical abnormalities, and impairment of lung function. Multidiscip Respir Med 2016; 11:28. [PMID: 27408717 PMCID: PMC4940831 DOI: 10.1186/s40248-016-0066-z] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 05/10/2016] [Indexed: 12/11/2022] Open
Abstract
Obesity is currently one of the major epidemics of this millennium and affects individuals throughout the world. It causes multiple systemic complications, some of which result in severe impairment of organs and tissues. These complications involve mechanical changes caused by the accumulation of adipose tissue and the numerous cytokines produced by adipocytes. Obesity also significantly interferes with respiratory function by decreasing lung volume, particularly the expiratory reserve volume and functional residual capacity. Because of the ineffectiveness of the respiratory muscles, strength and resistance may be reduced. All these factors lead to inspiratory overload, which increases respiratory effort, oxygen consumption, and respiratory energy expenditure. It is noteworthy that patterns of body fat distribution significantly influence the function of the respiratory system, likely via the direct mechanical effect of fat accumulation in the chest and abdominal regions. Weight loss caused by various types of treatment, including low-calorie diet, intragastric balloon, and bariatric surgery, significantly improves lung function and metabolic syndrome and reduces body mass index. Despite advances in the knowledge of pulmonary and systemic complications associated with obesity, longitudinal randomized studies are needed to assess the impact of weight loss on metabolic syndrome and lung function.
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Affiliation(s)
- Thiago Thomaz Mafort
- Laboratory of Respiration Physiology, Pulmonary Medicine Department, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, Vila Isabel, 20551-030 Rio de Janeiro Brazil
| | - Rogério Rufino
- Laboratory of Respiration Physiology, Pulmonary Medicine Department, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, Vila Isabel, 20551-030 Rio de Janeiro Brazil ; Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manoel de Abreu, 444, Vila Isabel, 20550-170 Rio de Janeiro Brazil
| | - Cláudia Henrique Costa
- Laboratory of Respiration Physiology, Pulmonary Medicine Department, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, Vila Isabel, 20551-030 Rio de Janeiro Brazil ; Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manoel de Abreu, 444, Vila Isabel, 20550-170 Rio de Janeiro Brazil
| | - Agnaldo José Lopes
- Laboratory of Respiration Physiology, Pulmonary Medicine Department, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, Vila Isabel, 20551-030 Rio de Janeiro Brazil ; Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manoel de Abreu, 444, Vila Isabel, 20550-170 Rio de Janeiro Brazil
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Good J, Jagroop D, Dogra S. Sociodemographic, health-related and lifestyle correlates of physical activity in adults with current asthma. J Asthma 2016; 54:69-76. [PMID: 27285062 DOI: 10.1080/02770903.2016.1194432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Regular physical activity is associated with better asthma control; however, little is known of the determinants of physical activity in a population of adults with asthma. Thus, the purpose of this study was to identify important sociodemographic, health and lifestyle correlates of physical activity among adults with asthma. METHODS Data from adults with asthma aged 18-44 years (n = 2740) from the Canadian Community Health Survey (CCHS), 2011-2012 annual component were used for analysis. The main outcome was Daily Energy Expenditure (DEE). This variable was based on frequency and duration of leisure activities in the past 3 months. Self-reported sociodemographic (age, sex, total household income, highest education level, and ethnicity), health-related (body mass index (BMI), self-perceived health, mood disorder, anxiety disorder, and asthma symptoms/attacks, past year) and lifestyle (type of smoker, sedentary time, fruit and vegetable consumption) variables were assessed as correlates for DEE. Data were analysed using linear regressions. RESULTS In the final model, sociodemographic correlates accounted for 4.2% of the variation in DEE. Adding health correlates increased the R2 to 12.1%. Finally, adding lifestyle correlates increased the R2 to 17.6%. CONCLUSIONS In adults with current asthma, the main correlates of physical activity are age, total household income, BMI, self-perceived health, anxiety disorder, sedentary time, and fruit and vegetable consumption. These data are important for informing education and exercise interventions for adults with asthma. Future research is needed to determine asthma-specific correlates of physical activity.
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Affiliation(s)
- Joshua Good
- a Faculty of Health Sciences, University of Ontario Institute of Technology , Oshawa , Ontario , Canada
| | - David Jagroop
- a Faculty of Health Sciences, University of Ontario Institute of Technology , Oshawa , Ontario , Canada
| | - Shilpa Dogra
- a Faculty of Health Sciences, University of Ontario Institute of Technology , Oshawa , Ontario , Canada
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