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Lisik D, Ermis SSÖ, Ioannidou A, Milani GP, Nyassi S, Spolidoro GCI, Kankaanranta H, Goksör E, Wennergren G, Nwaru BI. Is sibship composition a risk factor for childhood asthma? Systematic review and meta-analysis. World J Pediatr 2023; 19:1127-1138. [PMID: 36997765 PMCID: PMC10590346 DOI: 10.1007/s12519-023-00706-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/12/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Following the "hygiene hypothesis", the role of sibship composition in asthma and wheezing has been extensively studied, but the findings are inconsistent. For the first time, this systematic review and meta-analysis synthesized evidences from studies investigating the association of sibship size and birth order with risk of asthma and wheezing. METHODS Fifteen databases were searched to identify eligible studies. Study selection and data extraction were performed independently by pairs of reviewers. Meta-analysis with robust variance estimation (RVE) was used to produce pooled risk ratio (RR) effect estimates from comparable numerical data. RESULTS From 17,466 identified records, 158 reports of 134 studies (> 3 million subjects) were included. Any wheezing in the last ≤ 1.5 years occurred more frequently in infants with ≥ 1 sibling [pooled RR 1.10, 95% confidence interval (CI) 1.02-1.19] and ≥ 1 older sibling (pooled RR 1.16, 95% CI 1.04-1.29). The pooled effect sizes for asthma were overall statistically nonsignificant, although having ≥ 1 older sibling was marginally protective for subjects aged ≥ 6 years (pooled RR 0.93, 95% CI 0.88-0.99). The effect estimates weakened in studies published after 2000 compared with earlier studies. CONCLUSIONS Being second-born or later and having at least one sibling is associated with a slightly increased risk of temporary wheezing in infancy. In contrast, being second-born or later is associated with marginal protection against asthma. These associations appear to have weakened since the turn of the millennium, possibly due to lifestyle changes and socioeconomic development. Video Abstract.
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Affiliation(s)
- Daniil Lisik
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Medicinaregatan 1F, 413 90, Göteborg, Sweden.
| | - Saliha Selin Özuygur Ermis
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Medicinaregatan 1F, 413 90, Göteborg, Sweden
- Department of Respiratory Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Athina Ioannidou
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Medicinaregatan 1F, 413 90, Göteborg, Sweden
| | - Gregorio Paolo Milani
- Department of Clinical Science and Community Health, University of Milan, 20122, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy
| | - Sungkutu Nyassi
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Medicinaregatan 1F, 413 90, Göteborg, Sweden
| | | | - Hannu Kankaanranta
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Medicinaregatan 1F, 413 90, Göteborg, Sweden
- Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Emma Goksör
- Department of Pediatrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Göran Wennergren
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Medicinaregatan 1F, 413 90, Göteborg, Sweden
- Department of Pediatrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Bright Ibeabughichi Nwaru
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Medicinaregatan 1F, 413 90, Göteborg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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Vasavada H, Patel S, Vora H, Agrawal R, Gamit K, Pagi R, Desai N, Rakholiya R, Modi K. Children at the Risk of Recurrent Wheezing: A Matched Case-Control Study in a Tertiary Care Center. Cureus 2023; 15:e35387. [PMID: 36987478 PMCID: PMC10039970 DOI: 10.7759/cureus.35387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/30/2023] Open
Abstract
Introduction Wheezing is a common symptom in early childhood. Recurrent wheezing is defined as more than three episodes of wheezing in the past year. Many studies have been conducted to delineate the risk factors for recurrent wheezing and to predict which of these children will progress to asthma. Most studies about risk factors and the clinicodemographic profile of children with recurrent wheeze have been carried out in developed nations. Data in developing countries may differ. This study was carried out to identify risk factors associated with recurrent wheezing in children in a tertiary care center. Materials and methods It was a retrospective, matched case-control study conducted over a period of two years (July 2019 to July 2021). Records of children aged one month to 12 years who came to pediatric OPD or were admitted to a pediatric ward with a history of recurrent wheezing were included in the study. Cases with uncontrolled recurrent wheezing diagnosed by examination with an unreliable history and those with a global developmental delay were excluded from the study. The study involved the hospital records of 60 children. Of these, 30 were recurrent wheezers, and 30 were non-wheezers (controls). Data were collected with detailed proformas from case histories and examination sheets. The proforma had several known and suspected risk factors associated with wheezes. Each risk factor was studied and compared with the control group. The risk factors included in this study were male gender, not exclusively breastfed, history of bottle feeding, exposure to vehicles; exposure to pollen; exposure to animals; using an agarbatti or dhoop, passive smoking, or playing with a soft toy. Data were entered in an Excel sheet, and appropriate statistical analyses were done. Results The male-to-female ratio was 2:1. Out of the number of cases, 73.33% were younger than six years; 56.66% of cases were not exclusively breastfed, and 43.33% were exclusively breastfed for six months; 20% of the cases were bottle-fed, and 40% of the controls were bottle-fed. The percentage of cases exposed to vehicle smoke was 26.66%, while 20% of cases had exposure to pollen and 16% of controls were exposed to pollen. 30% of cases were exposed to animals, and 23% of controls were exposed to animals. With regard to passive smoking, 16.66% of cases were exposed to passive smoking, and 20% of controls were not exposed to passive smoking. Out of the study group, 26.66% of the children played with soft toys. Of all these risk factors, a significant difference between cases and controls was found in only one factor: not being exclusively breastfed for six months. All other risk factors showed no significant difference between cases and controls. Conclusion The present study concluded that the significant risk factor that was associated with recurrent wheezing was "not exclusively breastfeeding." The other factors studied that were suspected to be associated with recurrent wheezing cannot be ruled out entirely due to the relatively small size of the sample and the need to be studied further in detail.
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Affiliation(s)
- Halak Vasavada
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Snehal Patel
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Hetal Vora
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Riya Agrawal
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Krutik Gamit
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Ruchi Pagi
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Nirali Desai
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Ravina Rakholiya
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Krupa Modi
- Department of Paediatrics, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
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Efficacy of three different budesonide treatments in Chinese preschool children with recurrent wheezing. Sci Rep 2022; 12:17043. [PMID: 36220847 PMCID: PMC9553874 DOI: 10.1038/s41598-022-21505-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/28/2022] [Indexed: 12/29/2022] Open
Abstract
To explore and compare the clinical control of three atomized inhalation budesonide (BUD) regimens for Chinese preschool children with recurrent wheezing using Test for Respiratory and Asthma Control (TRACK) scores. A total of 474 preschool children with positive Modified Asthma Predictive Index (mAPI) were randomly assigned to a daily group (initially given inhaled BUD 1 mg once a day and assessed every 4 weeks; if symptom were well controlled for 12 weeks, the dose was reduced to 25-50% of the previous dose until afinal dose of 0.25 mg once a day, maintained until 52 weeks), an intermittent high-dose group (1 mg twice daily for 7 days starting early during a predefined respiratory tract illness) and an intermittent medium-dose group (0.5 mg twice daily as soon as they contacted allergens or experienced nasal congestion, a runny nose, cough or other suspicious respiratory symptoms and continuing until symptoms were reduced or risk factors were absent for 3 days) for 52 weeks of treatment. The TRACK questionnaire was administered every 4 weeks. When TRACK scores were ≥ 80, symptoms were considered to be controlled. The average TRACK scores of the three groups after treatment were significantly higher than those before treatment (P < 0.001). There were no significant differences in the average TRACK scores and control rate after treatment at every 4 weeks in the three groups (P > 0.05). Te number of systemic glucocorticoid courses, urgent care visits for wheezing, and wheezing episodes before and after treatment were significantly different within each of the three groups (P < 0.001), but not among the three groups (P > 0.05). In clinical treatment of children, one of the three treatment options can be selected according to the specific situation case of mAPI- positive recurrent wheezing children.
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Huang JQ, Zhang J, Hao CL, Chen ZR. Association of children wheezing diseases with meteorological and environmental factors in Suzhou, China. Sci Rep 2022; 12:5018. [PMID: 35322129 PMCID: PMC8943037 DOI: 10.1038/s41598-022-08985-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 03/16/2022] [Indexed: 11/09/2022] Open
Abstract
Wheezing diseases are one of the major chronic respiratory diseases in children. To explore the effects of meteorological and environmental factors on the prevalence of children wheezing diseases, clinical data of children hospitalized with wheezing diseases in Suzhou, China from 2013 to 2017 were collected. Meteorological and environmental factors from 2013 to 2017 were obtained from the local Meteorological Bureau and Environmental Protection Bureau. Relationships between wheezing diseases and meteorological and environmental factors were evaluated using Pearson's correlation and multivariate regression analysis. An autoregressive integrated moving average (ARIMA) model was used to estimate the effects of meteorological and environmental variables on children wheezing diseases. Children wheezing diseases were frequently presented in infants less than 12 months old (1897/2655, 58.28%), and the hospitalization rate was highest in winter (1024/3255, 31.46%). In pathogen-positive specimens, the top three pathogens were respiratory syncytial virus (21.35%), human rhinovirus (16.28%) and mycoplasma pneumoniae (10.47%). The seasonality of wheezing children number showed a distinctive winter peak. Children wheezing diseases were negatively correlated with average temperature (P < 0.001, r = - 0.598). The ARIMA (1,0,0)(0,0,0)12 model could be used to predict temperature changes associated wheezing diseases. Meteorological and environmental factors were associated with the number of hospitalized children with wheezing diseases and can be used as early warning indicators for the occurrence of wheezing diseases and prevalence of virus.
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Affiliation(s)
- Jia-Qi Huang
- Department of Respiratory Disease, Children's Hospital of Soochow University, Jingde Road NO. 303, Suzhou, 215003, Jiangsu, China
| | - Jin Zhang
- Department of Respiratory Disease, Children's Hospital of Soochow University, Jingde Road NO. 303, Suzhou, 215003, Jiangsu, China
| | - Chuang-Li Hao
- Department of Respiratory Disease, Children's Hospital of Soochow University, Jingde Road NO. 303, Suzhou, 215003, Jiangsu, China.
| | - Zheng-Rong Chen
- Department of Respiratory Disease, Children's Hospital of Soochow University, Jingde Road NO. 303, Suzhou, 215003, Jiangsu, China.
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5
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Bogdan RD, Rusu L, Toma AI, Nastase L. Significant Clinical Associations Between Exposure Type Factors and Recurrent Wheezing and Asthma in Children. J Med Life 2021; 13:600-611. [PMID: 33456612 PMCID: PMC7803326 DOI: 10.25122/jml-2020-0143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The study aimed to identify certain factors related to family history, pathological conditions, or exposure-type that are significantly correlated with recurrent wheezing and/or asthma in children. One hundred nine children with recurrent wheezing and 44 children with asthma were studied in order to identify the degree of correlation of these conditions with familial history of asthma or atopy, child’s age group, gender, premature birth, perinatal asphyxia, neonatal infection, and antibiotic treatment during the neonatal period, history of atopy and obesity and histamine intolerance, nasopharyngeal bacterial colonization, pneumonia with bronchospasm. The clinical picture of these two diseases was also compared regarding the severity of exacerbations and their response to controller therapy. The medium age of children diagnosed with recurrent wheezing was significantly lower than those diagnosed with asthma (5.64 vs. 9.01 years; p<0.001). Inside the recurrent wheezing group, age distribution differed significantly from the asthma group (p-value <0.001). Atopy was the only pathological condition significantly associated with asthma (56.0%) when compared with the recurrent wheezing group (30.2%) with a relative risk value of 1.34 (p<0.004). For patients colonized with Staphylococcus aureus, the medium number of wheezing exacerbations was significantly higher (p<0.049). Approximately 91% of patients in the recurrent wheezing group and 71% from the asthma group responded to appropriate controller treatment. Our study showed a significant association between asthma and atopy, justifying the need to monitor asthma risk in a child with wheezing and atopy. Nasal carriage of Staphylococcus aureus proved to be significantly associated with the recurrence of wheezing in children.
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Affiliation(s)
| | - Lidia Rusu
- Regional Center of Public Health, Iasi, Romania
| | - Adrian Ioan Toma
- Department of Neonatology, Life Memorial Hospital, Bucharest, Romania.,Department of Medico-Surgical and Prophylactic Disciplines, Faculty of Medicine, "Titu Maiorescu" University, Bucharest, Romania
| | - Leonard Nastase
- Department of Neonatology, "Alessandrescu-Rusescu" National Institute of Mother and Child Health, Bucharest, Romania.,Department of Obstetrics-Gynecology and Neonatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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6
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Fadugba OO, Haddadin Z, Muhimpundu S, Faouri S, Shehabi A, Rahman H, Williams JV, Miller EK, Khuri-Bulos N, Halasa NB. Respiratory Viruses Associated With Acute Wheezing in Hospitalized Young Children in Jordan. J Pediatric Infect Dis Soc 2020; 10:525-528. [PMID: 33340313 PMCID: PMC8087140 DOI: 10.1093/jpids/piaa143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/09/2020] [Indexed: 11/13/2022]
Abstract
A cross-sectional viral surveillance study of hospitalized children less than 2 years of old in Amman, Jordan, noted that respiratory syncytial virus and human metapneumovirus, but not human rhinovirus, were associated with higher odds of acute wheezing. Future longitudinal studies are needed to evaluate the association between early childhood viral acute respiratory infections and recurrent wheezing later in childhood.
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Affiliation(s)
- Olajumoke O Fadugba
- Department of Medicine, Division of Allergy and Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Zaid Haddadin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee USA,Corresponding Author: Zaid Haddadin, MD, Vanderbilt University Medical Center; Division of Pediatric Infectious Diseases; 1161 21st Ave South, Medical Center North D7232; Nashville, TN 37232, USA. E-mail:
| | - Sylvie Muhimpundu
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee USA
| | - Samir Faouri
- Department of Pediatrics, Al Bashir Hospital, Amman, Jordan,Department of Pathology-Microbiology, The University of Jordan, Amman, Jordan
| | - Asem Shehabi
- Department of Pathology-Microbiology, The University of Jordan, Amman, Jordan
| | - Herdi Rahman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee USA
| | - John V Williams
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - E Kathryn Miller
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee USA
| | | | - Natasha B Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee USA
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7
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Cloutier MM, Baptist AP, Blake KV, Brooks EG, Bryant-Stephens T, DiMango E, Dixon AE, Elward KS, Hartert T, Krishnan JA, Lemanske RF, Ouellette DR, Pace WD, Schatz M, Skolnik NS, Stout JW, Teach SJ, Umscheid CA, Walsh CG. 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol 2020; 146:1217-1270. [PMID: 33280709 PMCID: PMC7924476 DOI: 10.1016/j.jaci.2020.10.003] [Citation(s) in RCA: 399] [Impact Index Per Article: 99.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/22/2022]
Abstract
The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group was coordinated and supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. It is designed to improve patient care and support informed decision making about asthma management in the clinical setting. This update addresses six priority topic areas as determined by the state of the science at the time of a needs assessment, and input from multiple stakeholders:A rigorous process was undertaken to develop these evidence-based guidelines. The Agency for Healthcare Research and Quality's (AHRQ) Evidence-Based Practice Centers conducted systematic reviews on these topics, which were used by the Expert Panel Working Group as a basis for developing recommendations and guidance. The Expert Panel used GRADE (Grading of Recommendations, Assessment, Development and Evaluation), an internationally accepted framework, in consultation with an experienced methodology team for determining the certainty of evidence and the direction and strength of recommendations based on the evidence. Practical implementation guidance for each recommendation incorporates findings from NHLBI-led patient, caregiver, and clinician focus groups. To assist clincians in implementing these recommendations into patient care, the new recommendations have been integrated into the existing Expert Panel Report-3 (EPR-3) asthma management step diagram format.
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Affiliation(s)
- Michelle M Cloutier
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Alan P Baptist
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Kathryn V Blake
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Edward G Brooks
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Tyra Bryant-Stephens
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Emily DiMango
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Anne E Dixon
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Kurtis S Elward
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Tina Hartert
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Jerry A Krishnan
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Robert F Lemanske
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Daniel R Ouellette
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Wilson D Pace
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Michael Schatz
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Neil S Skolnik
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - James W Stout
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Stephen J Teach
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Craig A Umscheid
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
| | - Colin G Walsh
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda
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Li Y, Cao L, Yu Q, Xue H, Lu Y. Association between peripheral blood mononuclear cell ORMDL3 expression and the asthma predictive index in preschool children. J Int Med Res 2019; 47:3727-3736. [PMID: 31342811 PMCID: PMC6726768 DOI: 10.1177/0300060519862674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Yaqin Li
- 1 Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lanfang Cao
- 2 Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Yu
- 1 Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Xue
- 2 Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanming Lu
- 1 Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Al-Shamrani A, Bagais K, Alenazi A, Alqwaiee M, Al-Harbi AS. Wheezing in children: Approaches to diagnosis and management. Int J Pediatr Adolesc Med 2019; 6:68-73. [PMID: 31388550 PMCID: PMC6676316 DOI: 10.1016/j.ijpam.2019.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
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Zaffanello M, Gasperi E, Tenero L, Piazza M, Pietrobelli A, Sacchetto L, Antoniazzi F, Piacentini G. Sleep-Disordered Breathing in Children with Recurrent Wheeze/Asthma: A Single Centre Study. CHILDREN-BASEL 2017; 4:children4110097. [PMID: 29135910 PMCID: PMC5704131 DOI: 10.3390/children4110097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/05/2017] [Accepted: 11/06/2017] [Indexed: 12/22/2022]
Abstract
The relationship between asthma and sleep-disordered breathing is bidirectional due to common risk factors that promote airway inflammation. Obstructive sleep-disordered breathing and recurrent wheeze/asthma are conditions that involve the upper and the lower respiratory system, respectively. The aim of the present study was to investigate the sleep disordered breathing in children with recurrent wheeze/asthma. This was a retrospective study concerning children older than 2 years who underwent—between January 2014 and November 2016—an in-laboratory overnight polygraphic study. We match the children between those who do or do not have recurrent wheeze/asthma disease. We examined the clinical records of 137 children. We excluded eight patients because of neurological and genetic conditions. Children with recurrent wheeze/asthma (N = 28) were younger (p = 0.002) and leaner (p = 0.013) compared to non-affected children (N = 98). Children with wheeze/asthma and unaffected ones had a similar obstructive apnea-hypopnea index (p = 0.733) and oxygen desaturation index (p = 0.535). The logistic regression analysis, in which the condition of wheeze/asthma (yes/no) was a dependent variable, while demographic (age, sex, body mass index (BMI) Z-score) and polygraphic results during sleep (obstructive apnea-hypopnea index, central apnea index, peripheral oxygen saturation (SpO2), and snoring) were covariates, showed that children with wheeze/asthma had higher central apnea index (Exp(B) = 2.212; Wald 6.845; p = 0.009). In conclusion, children with recurrent wheeze/asthma showed an increased number of central sleep apneas than unaffected children. This finding may suggest a dysfunction of the breathing control in the central nervous system during sleep. Systemic or central inflammation could be the cause.
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Affiliation(s)
- Marco Zaffanello
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy.
| | - Emma Gasperi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy.
| | - Laura Tenero
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy.
| | - Michele Piazza
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy.
| | - Angelo Pietrobelli
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy.
| | - Luca Sacchetto
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Otorhinolaryngology Unit, University of Verona, 37134 Verona, Italy.
| | - Franco Antoniazzi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy.
| | - Giorgio Piacentini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy.
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11
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Cong X, Xu X, Zhang Y, Wang Q, Xu L, Huo X. Temperature drop and the risk of asthma: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:22535-22546. [PMID: 28804860 DOI: 10.1007/s11356-017-9914-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/03/2017] [Indexed: 02/05/2023]
Abstract
The relationship between asthma and temperature changes remains controversial. The aim of this study was to investigate the association between temperature changes and the risk of asthma. A total of 26 studies (combined total number of subjects N > 26 million), covering 13 countries and Costa Rica, were identified by using a series of keywords in different combinations and searching the papers in PubMed, EMBSEA, Web of Science, MEDLINE, AIM, LILACS, and WPRIM before February 2016. Most of the papers were published in English. Random-effects meta-analyses were performed to evaluate the effect of temperature drop on risk of asthma. Several secondary analyses were also calculated based on stratification for different age, season, latitude, and region on risk of asthma. The odds ratio (OR) estimate between temperature drop and asthma was 1.05 (95% CI 1.02, 1.08) in the meta-analysis. For children, the overall OR was 1.09 (95% CI 1.03, 1.15). Dose-effect analyses showed stronger associations in asthma risk for each 1°1 °C decrement in short-term temperature (OR 1.055, 95% CI 1.00, 1.11). Further stratifications showed that winter (OR 1.03, 95% CI 1.01, 105) and low latitude (OR 1.72, 95% CI 1.23, 2.41) have a statistically significant association with the increased risk of asthma. Exposure of people to short-term temperature drop (per 1 °C decrement) was significantly associated with the risk of lower respiratory tract infections (LRTI) with asthma (OR 1.02, 95% CI 1.00, 1.04). Results suggest an adverse effect of temperature drop on asthma risk, especially in children and low-latitude areas. It may be opportune to consider the preventive actions against temperature drop, including simple face masks, to decrease the risk of asthma.
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Affiliation(s)
- Xiaowei Cong
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China.
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, 515041, China.
| | - Yuling Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Qihua Wang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Long Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Xia Huo
- School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong, 510632, China.
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Lin CH, Chao YH, Wu KH, Lin WC. Primary mucoepidermoid carcinoma at the carina of trachea presenting with wheezing in an asthmatic child mimicking an attack of asthma: A case report. Medicine (Baltimore) 2016; 95:e5292. [PMID: 27858901 PMCID: PMC5591149 DOI: 10.1097/md.0000000000005292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Asthma is a very common disease, but primary tracheal tumors are extremely rare in children. Wheezing is not pathognomonic, but is the typical presentation of asthma and could also be found in patients with tracheal tumors. CLINICAL FINDINGS This report describes a 12-year-old boy with a previous history of frequent asthma attacks and experienced responses to antiasthma treatment. He was admitted to the hospital due to persistent wheezing and progressive dyspnea. Hyperinflation in the bilateral lungs was detected on chest x-ray, but without other significant findings. Chest computed tomography revealed a mass at the carina. Tracheal mucoepidermoid carcinoma was diagnosed by histopathological assessment. CONCLUSION Despite the rarity of tracheal tumors, chest computed tomography scans should be performed in the first place for children presenting persistent wheezing and having poor response to antiasthma treatment to rule out the other alternative diagnosis. Coexistence of other diseases such as tracheal tumor in asthmatic patients should be considered.
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Affiliation(s)
- Chien-Heng Lin
- Division of Pediatric Pulmonology, China Medical University Children's Hospital
- Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University
| | - Yu-Hua Chao
- Department of Pediatrics, Chung Shan Medical University Hospital
- School of Medicine, Chung Shan Medical University
| | - Kang-Hsi Wu
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University
- Division of Pediatric Hematology-Oncology, China Medical University Children's Hospital
| | - Wei-Ching Lin
- Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University
- Department of Radiology, China Medical University Hospital
- School of Medicine, China Medical University, Taichung, Taiwan
- Correspondence: Wei-Ching Lin, Department of Radiology, China Medical University Hospital, Taichung, Taiwan, Address: No 2, Yuh-Der Road, Taichung 404, Taiwan (e-mail: )
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