scholarly journals Risk of acute exacerbation between acetaminophen and ibuprofen in children with asthma

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6760 ◽  
Author(s):  
Lin-Shien Fu ◽  
Che-Chen Lin ◽  
Chia-Yi Wei ◽  
Ching-Heng Lin ◽  
Yung-Chieh Huang
Keyword(s):  
Asthma Exacerbation ◽  
Persistent Asthma ◽  
Research Database ◽  
Pediatric Practice ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
Taiwan National Health Insurance ◽  
Inflammatory Drugs ◽  
The Impact ◽  
Ibuprofen Group

Background Antipyretics are widely prescribed in pediatric practice. Some reports have mentioned that acetaminophen and non-steroid anti-inflammatory drugs may negatively affect asthma control by causing asthma exacerbation (AE). However, many confounding factors can also influence the risks. We assessed the impact of using acetaminophen or ibuprofen on AE in asthmatic children, especially those with strong risk factors. Methods We used the 2010 Taiwan National Health Insurance Research Database and identified 983 children with persistent asthma aged 1–5 years old; among them, 591 used acetaminophen alone and 392 used ibuprofen alone in 2010. Then, we analyzed the risk of AE over 52 weeks in the patients with and without severe AE in the previous year. Results The ibuprofen group had a higher risk of an emergency room (ER) visit or hospitalization for AE (odds ratio (OR) = 2.10, 95% confidence interval (CI) [1.17–3.76], P = 0.01). Among asthmatic children who had severe AE in the previous year, the risk of AE was higher in the ibuprofen group than in the acetaminophen group (OR = 3.28, 95% CI [1.30–8.29], P = 0.01), where as among those who did not, the risks of AE were similar between the acetaminophen and ibuprofen groups (OR = 1.52, 95% CI [0.71–3.25], P = 0.28). Conclusions Among young asthmatic children, use of ibuprofen was associated with a higher risk of AE than acetaminophen, if they had severe AE with ER visit or hospitalization in the previous year. Pediatricians should use antipyretics among children with asthma after a full evaluation of the risk.

Temperature variation and the incidence of cluster headache periods: A nationwide population study

Cephalalgia ◽  
2014 ◽  
Vol 34 (9) ◽  
pp. 656-663 ◽  
Author(s):  
Y-Jung Lee ◽  
Yung-Tai Chen ◽  
Shuo-Ming Ou ◽  
Szu-Yuan Li ◽  
Albert C Yang ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Seasonal Changes ◽  
Meteorological Factors ◽  
Nationwide Survey ◽  
Research Database ◽  
Case Crossover ◽  
Mean Temperature ◽  
Taiwan National Health Insurance ◽  
Central Weather Bureau ◽  
The Impact

Background Cluster headache (CH) is well known to show a seasonal predilection; however, the impact of temperature and other meteorological factors on cluster periods (or bouts) has not been established. Methods This nationwide survey included 758 patients with episodic CH retrieved from the Taiwan National Health Insurance Research Database from 2005 to 2009. Corresponding meteorological recordings were obtained from the Central Weather Bureau. A case-crossover study design was used to investigate the association between cluster periods and meteorological factors. Results A total of 2452 episodes of cluster periods were recorded. The cluster periods were most frequent in the autumn and least frequent in the winter. Seasonal changes from winter to spring and from autumn to winter also increased the frequency of cluster periods. The risk of cluster periods increased when there was a higher mean temperature on event days (odds ratio (OR), 1.014, 95% confidence interval (CI), 1.005–1.023, p = 0.003) or within seven to 56 days. Either an increase or a decrease in temperature (0.05℃/day) following a warm period (mean temperature ≥26℃) was associated with the onset of cluster periods. In contrast, a greater increase in temperature (0.15℃/day) following a cold period (mean temperature < 21℃) was needed to evoke cluster periods. No such associations were found following moderate periods (21℃ ≤mean temperature <26℃). Discussion Our study shows that temperature is associated with precipitating or priming cluster periods. The influence depends on the temperature of the preceding periods.

Inhaled Budesonide vis-à-vis Inhaled Mometasone in Chinese Children with Mild Persistent Asthma: A Single-Center, Retrospective Study

Pharmacology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Pei Gao ◽  
Ying Ding ◽  
Bingru Yin ◽  
Haoxiang Gu
Keyword(s):  
Retrospective Study ◽  
Asthma Exacerbation ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Forced Expiratory Volume ◽  
Single Center ◽  
Level Of Evidence ◽  
Asthmatic Children ◽  
Technical Efficacy ◽  
Mild Persistent Asthma

<b><i>Introduction:</i></b> A very limited option of inhaled corticosteroids (ICSs) is approved for pediatric use in China because in children the use of ICSs for long periods is associated with dose-dependent growth reduction. Due to the lack of consensus on which is the best ICS-based treatment option to manage mild persistent asthma in children, the present study was performed to evaluate the efficacy and safety of budesonide (BUD)-based therapy vis-à-vis mometasone-based therapy in children with mild persistent asthma. <b><i>Methods:</i></b> A single-center, retrospective study was conducted in asthmatic children aged between 6 and 11 years. BUD and mometasone furoate (MF) were administered as per the approved dosing regimen using pressurized metered-dose inhalers via oral inhalation route for a period of 12 weeks. The study outcome was assessed in terms of the forced expiratory volume in 1 s (FEV<sub>1</sub>), symptom scores, and nonoccurrence of side effects. <b><i>Results:</i></b> Among the 77 asthmatic children, 71 completed the study treatment and were used in carrying out the analysis. The improvement of spirometric parameters like FEV<sub>1</sub>, Tiffeneau-Pinelli index (FEV1/forced vital capacity [FVC]), and peak expiratory flow (PEF) values observed in the MF cohort was significantly greater than those of the BUD cohort (<i>p</i> &#x3c; 0.05 for all). An increase of approximately 12%/child was observed for FEV<sub>1</sub>/FVC ratios for the BUD cohort and MF cohorts. After the 12-week study, the PEF<sub>m</sub> and PEF<sub>e</sub> values increased to about 50 L/min/child for the BUD cohort and about 98 L/min/child for the MF cohort. During the study, no asthma exacerbation event was observed in the MF cohort, whereas 1 child in the BUD cohort had asthma exacerbation in week 4. The use of rescue medication during the study was required for 16.2 and 6% of children, respectively, for BUD and MF cohorts. Owing to low dosing frequency, MF could provide a better treatment approach than BUD due to improved patient compliance. <b><i>Conclusions:</i></b> Although both drugs showed improvement in the quality of life of asthmatic children with manageable treatment-emergent adverse effects, the improvement was augmented in MF-treated children. <b><i>Level of Evidence:</i></b> The level of evidence was III. <b><i>Technical Efficacy Stage:</i></b> The technical efficacy stage was 4.

scholarly journals Identifying Core Herbal Treatments for Children with Asthma: Implication from a Chinese Herbal Medicine Database in Taiwan

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Hsing-Yu Chen ◽  
Yi-Hsuan Lin ◽  
Peck-Foong Thien ◽  
Shih-Chieh Chang ◽  
Yu-Chun Chen ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Association Rule ◽  
Research Database ◽  
Clinical Database ◽  
Rule Mining ◽  
Asthmatic Children ◽  
Chinese Herbal ◽  
Children With Asthma ◽  
Great Burden

Asthma is one of the most common allergic respiratory diseases around the world and places great burden on medical payment. Chinese herbal medicine (CHM) is commonly used for Taiwanese children to control diseases. The aim of this study is to analyze the CHM prescriptions for asthmatic children by using a nationwide clinical database. The National Health Insurance Research Database (NHIRD) was used to perform this study. Medical records from 1997 to 2009 with diagnosis with asthma made for children aged 6 to 18 were included into the analysis. Association rule mining and social network analysis were used to analyze the prevalence of single CHM and its combinations. Ma-Xing-Gan-Shi-Tang (MXGST) was the most commonly used herbal formula (HF) (20.2% of all prescriptions), followed by Xiao-Qing-Long-Tang (13.1%) and Xing-Su-San (12.8%). Zhe Bei Mu is the most frequently used single herb (SH) (14.6%), followed by Xing Ren (10.7%). MXGST was commonly used with Zhe Bei Mu (3.5%) and other single herbs capable of dispelling phlegm. Besides, MXGST was the core formula to relieve asthma. Further studies about efficacy and drug safety are needed for the CHM commonly used for asthma based on the result of this study.

scholarly journals Food Allergy in Children with Asthma: Prevalence and Correlation with Clinical Severity of Respiratory Disease

2008 ◽  
Vol 1 (1) ◽  
pp. 5-11 ◽  
Author(s):  
E. Calamelli ◽  
G. Ricci ◽  
V. Dell’Omo ◽  
B. Bendandi ◽  
M. Masi
Keyword(s):  
Food Allergy ◽  
Persistent Asthma ◽  
Asthma Severity ◽  
Specific Ige ◽  
Clinical Severity ◽  
Asthma Prevalence ◽  
Epidemiological Evidence ◽  
Prick Test ◽  
Asthmatic Children ◽  
Children With Asthma

Epidemiological evidence suggests that there is a link between asthma and food allergy. The aim of this study was to estimate the prevalence of food allergy in asthmatic children and to evaluate a possible impact of food allergy on asthma severity. The study enrolled 103 asthmatic children (mean age: 11 years). Skin prick-test, dosage of specific IgE to a standardized panel of inhalant and food allergens and spirometric evaluation was made for each patient. Twenty-four (23%) patients presented food allergy, 75 (77%) were sensitized to at least one food. A lower rate of children with controlled symptoms was found in children with food allergy and a higher rate of persistent asthma was found in children sensitized to at least 4 foods. In conclusion, food allergy/sensitization should always be investigated in asthmatic children for its association with increasing severity (only in food sensitized patients) and reduced control of asthmatic symptoms.

scholarly journals A Multifactorial Evaluation of the Effects of Air Pollution and Meteorological Factors on Asthma Exacerbation

2020 ◽  
Vol 17 (11) ◽  
pp. 4010 ◽  
Author(s):  
Hong-Ren Yu ◽  
Chun-Hung Richard Lin ◽  
Jui-Hsiu Tsai ◽  
Yun-Ting Hsieh ◽  
Ti-An Tsai ◽  
...  
Keyword(s):  
Air Pollution ◽  
Environmental Protection Agency ◽  
Air Pollutants ◽  
Protective Factor ◽  
Meteorological Factors ◽  
Research Database ◽  
Asthmatic Children ◽  
Crossover Analysis ◽  
Taiwan National Health Insurance ◽  
Comprehensive Study

In the real world, dynamic changes in air pollutants and meteorological factors coexist simultaneously. Studies identifying the effects of individual pollutants on acute exacerbation (AE) of asthma may overlook the health effects of the overall combination. A comprehensive study examining the influence of air pollution and meteorological factors is required. Asthma AE data from emergency room visits were collected from the Taiwan National Health Insurance Research Database. Complete monitoring data for air pollutants (SO2; NO2; O3; CO; PM2.5; PM10) and meteorological factors were collected from the Environmental Protection Agency monitoring stations. A bi-directional case-crossover analysis was used to investigate the effects of air pollution and meteorological factors on asthma AE. Among age group divisions, a 1 °C temperature increase was a protective factor for asthma ER visits with OR = 0.981 (95% CI, 0.971–0.991) and 0.985 (95% CI, 0.975–0.994) for pediatric and adult patients, respectively. Children, especially younger females, are more susceptible to asthma AE due to the effects of outdoor air pollution than adults. Meteorological factors are important modulators for asthma AE in both asthmatic children and adults. When studying the effects of air pollution on asthma AE, meteorological factors should be considered.

scholarly journals MP9: SINO-NASAL 5 QUESTIONNAIRE PREDICTS POOR ASTHMA CONTROL IN CHILDREN WITH PERSISTENT ASTHMA

2016 ◽  
Vol 64 (3) ◽  
pp. 808.1-808
Author(s):  
G Phull ◽  
D Prue ◽  
C Martinez ◽  
K Scheffey ◽  
D Pillai
Keyword(s):  
Asthma Control ◽  
Persistent Asthma ◽  
Upper Airway ◽  
Asthma Severity ◽  
Life Questionnaire ◽  
Night Time ◽  
Time Activity ◽  
Asthmatic Children ◽  
Airway Symptoms ◽  
The Impact

Purpose of StudyUp to 80% of asthmatic children may experience upper airway symptoms, including rhinitis, often perceived as coming from lower airways. Asthma diagnosis, classification and assessment of control are defined by the National Asthma Education Prevention Program (NAEPP) 2007 guidelines, but may understate the impact of the upper airway. We explored associations between Sino-Nasal 5 (SN-5) quality of life questionnaire, validated in radiographic confirmed sinus disease, and NAEPP asthma impairment in children. We hypothesize that children with NAEPP defined uncontrolled asthma will have abnormal SN-5 scores.Methods UsedWe performed a retrospective chart review of children (1–21 yr) referred to a pediatric pulmonary clinic for persistent asthma. Data collected include age, gender, BMI%, NAEPP asthma severity, SN-5, asthma control (TRACK children <5 y, ACT children ≥5 y) and pulmonary function testing (PFT). The primary analysis was to identify associations between SN-5 scores and levels of NAEPP guideline impairment: daytime symptoms, night time awakenings, activity interference and PFTs. Significant SN-5 scoring was defined as ≥3.5 based on prior studies. PFT was performed in children ≥5 y. Statistical analysis with SPSS 22.Summary of Results76 children were evaluated; 38% female, mean age 6.9 y and mean BMI% 69%. Significant SN-5 score (≥3.5 vs. <3.5) was associated with decreased control of daytime symptoms (OR 0.16 [95% CI:0.06–0.44]), night time awakenings (OR 0.09 [0.03–0.29]), activity interference (OR 0.2 [0.06–0.68]) and asthma control (OR 0.32 [0.12–0.85]). Those with SN-5 ≥3.5 had poor asthma control based on TRACK (p<0.002) and ACT (p<0.001). Age, gender, BMI%, asthma severity and PFTs were not associated with SN-5.ConclusionsIn persistent asthmatic children, NAEPP defined daytime, night time, activity related impairment and poor asthma control were associated with a significant SN-5 score; PFTs and NAEPP asthma severity were not. This suggests that upper airways may play a larger role in lower airway associated symptoms, and that SN-5 may be beneficial in assessing asthma symptoms. Recognizing and treating upper airway symptoms, an understated area in asthma guidelines, might improve overall asthma control. A prospective analysis in a larger cohort is recommended to evaluate these findings.

scholarly journals A Single-Institution Experience in the Use of Chest Radiographs for Hospitalized Children Labelled as Asthma Exacerbation

2021 ◽  
Author(s):  
Ela Beyyumi ◽  
Mohamed Tawil ◽  
Huda AlDhanhani ◽  
Sara Jameel ◽  
Manal Mouhssine ◽  
...  
Keyword(s):  
Asthma Exacerbation ◽  
Asthma Management ◽  
Antibiotic Use ◽  
Chest Radiographs ◽  
Eligibility Criteria ◽  
Tertiary Center ◽  
Lower Oxygen ◽  
Children With Asthma ◽  
Model Coefficient ◽  
The Impact

Background: Risks of cancer have become more notable lately, especially for young children with a chronic condition such as atopy. This study reports on cumulative radiation from chest radiographs in children with asthma. Its main aims were to consider our current practice, and suggest minimizing chest radiograph use in this vulnerable people. Methods: The study was retrospective and conducted at tertiary center. Eligibility criteria included children 2-15 y who were admitted between January-2017 and December-2018 for asthma management. Results: Of 643 children who were admitted as ‘asthma exacerbation’, 243 (40% females; age [mean±SD] 5.4±3.3 y) met the study criteria for inclusion. Ninety-two (38%) children had temperature 38.8±0.7oC on the day of admission. Antibiotics were prescribed for 148 (61%) children, mainly for presumed pneumonia. Chest radiographs were requested for 214 (88%) children, mainly on the day of admission. Only 38 (18%) chest radiographs showed focal/multifocal pneumonia justifying antibiotic use. Significant predictors for requesting chest radiographs were antibiotic use for presumed pneumonia, lower oxygen saturation at presentation, and requesting blood culture. Rate of chest radiographs per year was negatively related to child’s age; the younger the child the higher the rate (model coefficient -0.259, P<0.001). For children <5 y, rate of chest radiographs was 1.39±1.21/y and radiation dose 0.028±0.025 mSV/y. The corresponding rates for children ≥5 y were 0.78±0.72/y and 0.008±0.007 mSV/y, respectively (P<0.001). Conclusion: Chest radiographs were commonly requested for children with asthma, especially the young ones. Prospective studies are necessary to measure the impact of this practice on their health.

scholarly journals Study of Clinical Characteristics and Cytokine Profiles of Asthmatic Children with Rhinovirus Infection during Acute Asthma Exacerbation at National Hospital of Pediatrics

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Thuy Nguyen-Thi-Dieu ◽  
Huong Le-Thi-Thu ◽  
Huong Le-Thi-Minh ◽  
An Pham-Nhat ◽  
Sy Duong-Quy
Keyword(s):  
Asthma Exacerbation ◽  
Acute Asthma ◽  
Cytokine Profile ◽  
Severe Exacerbation ◽  
Polymorphonuclear Leucocytes ◽  
Healthy Children ◽  
Asthmatic Children ◽  
Significant Difference ◽  
Children With Asthma ◽  
Acute Asthma Exacerbation

Background. In children with asthma, the viral infection of airways is usually a main cause of acute asthma exacerbation and hospitalization. However, few studies on clinical and biomolecular characteristics of asthmatic children in this field have been done, especially in emergent countries. Objective. This study described the clinical and biological characteristics of asthmatic children who had acute asthma exacerbation and rhinovirus (RV) infection. Methods. Children under 15 years of age hospitalized for acute asthma exacerbation were included. They underwent clinical examination and peripheral blood analyses for the cytokine profile. The severity of acute asthma exacerbation was evaluated by Pediatric Asthma Score (PAS). Healthy children under 15 years of age were also invited in this study. Results. One hundred fifteen asthmatic children were included in this study. There were 18.2% of mild PAS, 37.4% of moderate PAS, and 44.4% of severe PSA. Among them, 63/115 (54.8%) asthmatic children had positive RV infection (RV+). The percentages of asthmatic children with RV+ had increased polymorphonuclear leucocytes were significantly higher than asthmatic children with RV−. There were no significant differences of the concentrations of non-Th2-related cytokines in asthmatic children with RV− and RV+. The concentration of Th2-related cytokines (IL-5 and IL-13) in asthmatic children with RV+ was significantly higher than those with RV−. However, there was no significant difference for the cytokine profile between mild, moderate, and severe asthma. Conclusion. RV infection is a main cause of acute asthma exacerbation in children with asthma. The increase of Th2-related cytokines, especially IL-5 and IL-13, is a relevant biomarker for RV infection in asthmatic children with severe exacerbation.

scholarly journals COVID-19 Pandemic and Reduced Physical Activity: Is There an Impact on Healthy and Asthmatic Children?

2021 ◽  
Vol 9 ◽  
Author(s):  
Giuliana Ferrante ◽  
Desiree Mollicone ◽  
Salvatore Cazzato ◽  
Enrico Lombardi ◽  
Massimo Pifferi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Indoor Air ◽  
Urban Areas ◽  
Indoor Air Pollution ◽  
World Health ◽  
Minimal Amount ◽  
Sedentary Behaviors ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
The Impact

Physical activity (PA) has been seen to improve asthma symptoms, lung function, and quality of life, as well as to reduce airway inflammation and bronchial responsiveness. As a consequence of the COVID-19 pandemic, the minimal amount of PA recommended by the World Health Organization—i.e., about 60 min/day of moderate-to-high intensity—is difficult to achieve for many children, particularly those living in urban areas. Short-term changes in PA because of the COVID-19 pandemic may become habitual, increasing the risk of adverse asthma outcomes in children. Indeed, prolonged home confinement during the COVID-19 pandemic reduces PA levels and increases sedentary behaviors, possibly impairing immune system function and increasing susceptibility to inflammatory diseases. However, there is limited evidence regarding the effects of lockdown due to COVID-19 on PA and sedentary behaviors in asthmatic children. Given that children stay longer indoors, indoor air pollution represents a major issue to consider during home confinement. This narrative review aims to summarize the available evidence about the impact of decreased PA and increased sedentary behaviors on children with asthma during the COVID-19 pandemic. In addition, strategies for supporting PA in children with asthma during the COVID-19 pandemic are suggested, also looking at the issue of indoor air quality.

scholarly journals Telehome monitoring of symptoms and lung function in children with asthma

2021 ◽  
Author(s):  
Audrey Fossati ◽  
Caroline Challier ◽  
Aman Dalhoumi ◽  
Javier Rose ◽  
François Galodé ◽  
...  
Keyword(s):  
Statistical Tests ◽  
Asthma Management ◽  
Smartphone Application ◽  
Kappa Coefficient ◽  
Management Control ◽  
Control Treatment ◽  
Bronchial Obstruction ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
The Impact

Background: The ability to perceive bronchial obstruction is variable in asthma. This is one of the main causes of inaccurate asthma control assessment, on which therapeutic strategies are based. Objective: Primary: To evaluate the ability of a clinical and spirometric telemonitoring device to characterize symptom perception profile in asthmatic children. Secondary: To evaluate its impact on asthma management (control, treatment, respiratory function variability) and the acceptability of this telemonitoring system. Method: 26 asthmatic children aged 6-18 years equipped with a portable spirometer and a smartphone application were monitored remotely for 3 months. Clinical and spirometric data were automatically transmitted to a secure internet platform. A medical team contacted the patient to optimize management. Three physicians blindly and independently classified the patients according to their perception profile. The impact of telemonitoring on the quantitative data was assessed at the beginning (T0) and end (T3 months) of telemonitoring, using matched statistical tests. Results: Patients could initially be classified according to their perception profile, with a concordance between the 3 observers of 64% (kappa coefficient: 0.55, 95%CI [0.39; 0.71]). After further discussion, a consensus was reached and resulted in 97% concordance (kappa coefficient: 0.97, 95%CI [0.91; 1.00]). There was a trend towards improvement in the ACT score, and a significant > 40% decrease in FEV1 and PEF variability, with good acceptance of the device. Conclusion: Clinical and spirometric telehome monitoring is applicable and can help define the perception profile of bronchial obstruction in asthmatic children. The device was generally well accepted.

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