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Objective:To observe any effect of combining the anti-asthmatic drug montelukast with exercise therapy on the pulmonary function, clinical symptoms, functional exercise capacity and quality of life of children with asthma.Methods:Seventy children (between 7 and 14 years old) with mild asthma were randomly divided into an observation group ( n=35) and a control group ( n=35). Both groups were given the anti-asthmatic drug montelukast, while the observation group was additionally provided with breathing training and aerobic pedaling training. Before and after the intervention, both groups′ forced expiratory volume in 1 second, forced vital capacity and 6min walking test (6MWT) distance were tested. Their asthma symptoms were scored using the pediatric asthma quality of life questionnaire (PAQLQ). Any adverse events during the study were recorded. Results:After 8 weeks the observation group′s average 6MWT distance, total PAQLQ score, as well as the scores on each domain of the PAQLQ (symptoms, activity restriction, emotions) had improved significantly. The observation group′s average heart rate and perceived exertion rating after the 6MWT had also improved significantly, as had their average daytime and nighttime asthma symptom scores. The control group also demonstrated significant improvement in their PAQLQ symptom scores and their daytime and nighttime asthma symptom scores after the intervention. There was no significant difference in the incidence of adverse reactions between the two groups.Conclusions:Supplementing montelukast with exercise is effective and feasible in the treatment of children with mild asthma, with good safety and tolerance. Such combined therapy is worthy of further research and promotion.
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Background:There are few biomarkers that can be easily accessed in clinical settings and may reflect refractory Th2-eosinophlic inflammation and remodeling of the asthmatic airways. Serum periostin may be one such biomarker to aid our understanding of the patho-bio-physiology of asthma and exercise induced asthma. The aim of the study is to explore the relationship between serum periostin level and exercise induced bronchoconstriction in asthmatic children.Materials and Methods: This cross-sectional study was carried out on (90) children both sexes aged from 6 to 15 years including, (60) children with bronchial asthma and (30) children were enrolled as control group in the period from January 2018 to January 2019. Patients were randomly classified into two groups: I) Patient group: divided into 2 groups according to standardized treadmill exercise challenge test: Group A: (30) asthmatic children with positive test. Group B: (30) asthmatic children with negative test. II-Control group: (30) children apparently healthy with no personal or family history of asthma. All children were subjected to the following Investigations: Chest x-ray, pulmonary functions tests (FEV1& PEFR) except controls, Laboratory investigations as CBC and Serum periostin level Results:The mean values of both the percentage of PEFR and FEV1 after exercise in group A were significantly lower than those in group B and the percentage of PEFR and FEV1after exercise in each group were significantly lower than the percentage before exercise in the same group. The mean value of eosinophilic count in group A was significantly higher than (group B and control group) and the mean value of eosinophilic countin group B was significantly higher than control group. The mean value of serum level of periostin in group A was significantly higher than (group B and control group), however, there was no significant difference between group B and control group as regard to serum level of periostin.Chest tightness, cough and wheezes after exercise and eosinophilic count in patients with high serum periostin level were significantly higher than patients with low serum periostin level, and both PEFR and FEV1after exercise in patients with high serum periostin level were significantly lower than patients with low serum periostin level. Also the normal serum periostin levels vary among different age groups.Conclusion:Serum periostin level can be considered as a useful biomarker for diagnosis of Exercise induced bronchospasm (EIB) in asthmatic children especially when lung function test cannot be done However, cautious is required in evaluating serum periostin levels in children because it varies with age.
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Objective To explore the association rules of behavior problems and parenting styles in asthmatic children. Methods The database was established with the data of behavior problems and paren-ting styles of 202 allergic asthma children.Based on the algorithm of Apriori,the relativity between these be-havior problems and parenting styles was mined.314 healthy children of the same age were selected as the control group. Results (1)The differences in behavior problems between asthmatic group and control group were significant,which includes attention(7.63±3.44 vs 4.03±3.01),sociality(4.10±2.14 vs 2.86± 1.67),aggression(11.74±5.10 vs 6.63±4.26)and flinch(3.03±1.58 vs 2.06±1.38)(all P<0.01),while the difference in offence between two groups was not significant(P>0.05).The differences in parenting styles be-tween asthmatic group and control group were significant,including spoiledness(15.26 ± 4.16 vs 10.88 ± 3.29),indulgence(22.47±4.68 vs 16.59±4.12),discrepancy(13.54±3.50 vs 11.92±3.35)and democracy (35.08±5.25 vs 39.76±4.80)(all P<0.01),while the difference in autocracy was not significant between two groups(P>0.05).(2)There were multi-positive associations among these behavior problems of asthmatic children as followed.There were positive associations between the cognitive impairment(such as attention) and social impairment(including flinch,aggression and sociality),(each support>10%,confidence>0.60,lift>1.20,the value of correlation coefficient between(1,+∞)).(3)There were multiple associations between behavior problems and parenting styles of asthmatic children as followed.There were negative associations be-tween democracy and behavior problems(the value of correlation coefficient between[0,1)),and there were positive associations among indulgence、spoiledness,discrepancy and these behavior problems(the value of correlation coefficient between(1,+∞)).Conclusion There are positive associations among these behavior problems of asthmatic children,and there are multi-associations between behavior problems and parenting styles.
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Objective To explore the effect of parenting style and behavior on children with allergic asthma.Methods From July to December in 2016,a total of 60 children with allergic asthma,who were from Jiangsu Province Hospital of Traditional Chinese Medicine and Jiangsu Research Institute of Traditional Chinese Medicine,were selected as the asthma group.Another 60 normal children from kindergarten and primary school were selected as the healthy group.Achenbach child behavior checklist (CBCL) and parenting style questionnaire were used to evaluate the behavior and parenting style of the two groups.The Fractional exhaled nitric oxide (FeNO) of the two groups were also collected.Results (1) The scores of dotage,autocracy,inconsistence of parenting style in asthma group ((14.95±4.95),(22.23±4.69),(13.43±3.80))were higher than those in healthy group((11.68±3.69),(16.47±4.16),(11.07±3.32))and the differences were significant (all P＜0.05).The scores of democracy,indulgence in asthma group ((38.92 ± 5.37),(18.12± 4.54)) were lower than those in healthy group((41.35±3.62),(19.88±3.41)),and the differences were statistically significant(all P＜0.05).(2) The scores of attention,socialization,aggression and withdrawal of child behavior in asthma group ((7.35±3.55),(3.85±2.17),(11.57±5.30),(3.40±2.65))were higher than those in healthy group((3.38±2.81),(2.52± 1.52),(6.98±4.77),(2.02± 1.63)),the differences were statistically significant(all P＜0.01).There was no significant difference between the two groups in the dimension of discipline(P＞0.05).(3) The FeNO index of asthma group((32.27± 14.27) × 10-9 mol/L) was higher than that of healthy group ((11.10± 1.88) × 10-9 mol/L) and the differences were statistically significant (P＜0.01).(4)Logistic regression analysis showed that the attention(B=0.38,OR=1.47,95％ CI =1.27-1.70,P＜0.01),dotage(B=0.19,OR=1.20,95％ CI =1.06-1.37,P＜0.01) and autocracy(B=0.24,OR=1.27,95％ CI =1.14-1.42,P＜0.01)had significant effects on allergic asthma.Conclusion Attention,dotage and autocracy are the risk factors to influence the control level of allergic asthma.This should arouse the attention of clinicians and parents.
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Introducción: el humo ambiental del tabaco es un riesgo significativo para la salud de los niños pequeños. Se pretende estudiar el papel del tabaquismo pasivo en el padecimiento de asma en niños. Objetivo: identificar la presencia de tabaquismo pasivo y su asociación con la recurrencia de crisis en niños asmáticos de edad escolar. Métodos: estudio longitudinal de casos y controles (n= 320) en el servicio de Alergología del Hospital Pediátrico Universitario "William Soler" de La Habana, en el período comprendido entre febrero 2014 y enero 2015. Se aplicó una encuesta de factores ambientales a todos los sujetos participantes. La construcción y validación de la misma se realizó por un grupo de expertos. Se utilizaron medidas de resumen para variables cualitativas (porcentajes). Para valorar la asociación entre factores de riesgo se aplicó la prueba de X2 y razón de momios (Odds Ratio, OR), como medida de la fuerza de esa relación con su estimación puntual y por intervalos de confianza de 95 por ciento. Se fijó un nivel de significación de 0,05. Resultados: la exposición al humo del tabaco estuvo presente en el 75 por ciento de los niños con recurrencia de crisis de asma, con OR de 3,6; de ellos el 72,5 por ciento tenían padres fumadores, con un OR de 4,89. Conclusiones: el tabaquismo pasivo, con especial significación la presencia de padres fumadores, fue el factor de riesgo más importante para la recurrencia de las crisis de asma en el grupo de estudio(AU)
Introduction: environmental tobacco smoke is a significant risk for the health of younger children. We intend to study the role of passive smoking to asthma suffering in children. Objective: to identify the presence of passive smoking and its association with relapsing crisis in asthmatic preschool children. Methods: longitudinal case-control study (n=320) at the Allergology service of William Soler University Pediatric Hospital of Havana, in the time from February 2014 and Janu8ary 2015. We conducted an environmental factors survey to all the participant individuals. Construction and validation of such survey was carried out by a group of experts. We used summarizing measures for qualitative variables (percentages). To assess the association among risk factors we applied the chi-square test and the odds ratio, as to measure the strength of the relation with it score estimate and by confidence intervals at 95 percent. We fixed a significance level of 0.05. Results: exposition to tobacco smoke was present in 75 percent of the children with asthmatic crisis relapsing, with OR of 3.6; out of which 72.5 percent had smoking parents, with OR of 4.89. Conclusions: passive smoking, specially the presence of smoking parents, was the most important risk factor for the relapse of asthmatic crisis in the studied group(AU)
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Humans , Child, Preschool , Child , Asthma/complications , Tobacco Smoke Pollution/prevention & controlABSTRACT
Background: Cysteinyl leukotrienes have been shown to play an important role in the pathogenesis of asthma. The effect of the leukotriene receptor antagonist, montelukast, on bronchial hyperreactivity (BHR) as measured by the methacholine challenge test in school children has not been reported. Objective: To determine the effect of montelukast (Singulairâ) on BHR measured by methacholine challenge and lung function tests in Thai asthmatic children aged 6-13 years. Materials and methods: This was a randomized, double-blind, placebo-controlled, crossover study performed in 29 mild to moderate persistent asthmatic children aged 6-13 years. Each child received crossover treatment with 6 weeks of montelukast (5 mg/day) and 6 weeks of placebo separated by a two-week washout period. Results: The improvement of FEV1 and FEV1/FVC after 6 weeks of treatment was significantly higher in montelukast group compared to those of placebo group (p<0.05). After 6 weeks of treatment, mean (+ SEM) PC was 20 in the placebo group (5.7 + 1.41 mg/ml) which was lower than in montelukast group (6.8 + 1.74 mg/ml) but there was no significant difference (p=0.79). Conclusion: Montelukast significantly improved FEV1 and FEV1/FVC but not BHR in mild to moderate persistent asthmatic children aged 6-13 years after the 6 weeks of treatment.
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The main purpose of this study was to identify the effects of group social support and individual social support on the reduction of burden and improvement in family functioning of families with asthmatic children. The design of this study was a randomized pre-posttest quasi-experimental design to compare the two experimental groups. The theoretical framework for this study was derived from the study of burden in family caregivers by Suh and Oh(1993) based on the main effect model of social support theories. The data were collected from February 12, 1998 to May 29, 1998 at the pediatric out patient department of a university hospital located in Suwon city. The sample consisted of 39 family members who were identified as families with asthmatic children, Eighteen subjects were randomly assigned to the group social support group and 21 were assigned to the individual social support group. Group and individual social support members were seen for 60 to 90 minutes, four times over one to three weeks. The instruments used in this study were the Burden Scale developed by Suh and Oh(1993), the Visual Analogue Scale, and the Family Adaptability Cohesion Evaluation Scale(FACES-III) developed by Olson, Portner, and Lavee(1985). The collected data were analyzed using Mann-Whitney test, x2-test, Wilcoxon sign rank test, t-test, ANOVA(Scheff), pearson correlation coefficient, multiple regression, and social support process and content analysis. The results are as follow ; 1. There was no significant difference before the experimental treatment among the subjects in the group social support group and individual social support group for general characteristics, burden, or family functioning. 2. Hypothesis 1 ; "There will be a greater reduction on the burden score of the group social support group compared to the individual social support group" was not statistically significant(U=174.5, p=.683). The burden scores showed a significant decrease after participation in social support as compared to before participation for both groups. However there was a tendency for more reduction in the burden scores for the group social support than for individual social support. 3. Hypothesis 2 ; "There will be a greater improvement in the family functioning scores for the group social support group compared to the individual social support group" was not statistically significant(U=153.0, p=.309). There was a tendency toward improvement in the family functioning scores of the group social support as compared to that of the individual social support. 4. According to the length of the treatment period, families with asthmatic children displayed affirmative responses, and the families set up a self-help group of mothers with asthmatic children n order to share their experiences, to get information and to solve their problems. In conclusion, it was found that group social support was the more effective nursing intervention for reducing burden and for improving family functioning of families with asthmatic children.
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Child , Humans , Caregivers , Mothers , Nursing , Self-Help GroupsABSTRACT
PURPOSE: Asthma features not only infiltration of various inflammatory cells including eosinophils into bronchus but increased bronchial hyperresponsiveness which comes from bronchial epithelial cells damaged by toxic granular protein like MBP and ECP released from the activated eosinophils. Recently, several authors have reported that nasal mucosa histologic findings are similar to an inflammatory change of lower airway in respiratory allergic diseases. Based on the latter, we performed this study to compare serum ECP with nasal wash fluid ECP by their ages and to find out contribution of eosinophils in infants and children with wheezing. METHODS: The 62 patients in age from 6 months to 14 years who were admitted due to acute asthma from June 1995 to May 1996 were divided into 3 groups by their ages as follows : group A for less than 2 years old, group B for 2-4 years old and group C for 5-14 years old. The 32 children with no previous history of wheezing or no respiratory symptoms on admission were enrolled as control subject. Serum ECP & nasal wash fluid ECP from each age group with asthma were measured and compared with control, and the relationship between serum ECP and atopic findings were studied. RESULTS: 1) The geometric mean level of serum ECP were significantly higher in wheezing children than in control in all three age group as follows : 16.5+/-7.1micorgram/l for group A, 28.9+/-18.7micorgram/l for group B, 45.9+/-34.8micorgram/l for group C. 2) The geometric mean level of nasal wash fluid ECP were significantly higher in wheezing children than in control in all age group as follows : 11.3+/-7.1micorgram/l for group A, 21.3+/-15.2micorgram/l for group B, and 30.2+/-18.2micorgram/l for group C. 3) Serum ECP had correlation with nasal wash fluid ECP & blood eosinophils in group B and C, except group A. CONCLUSION: On acute asthma attack, the mean ECP level of serum & nasal wash fluid from all children including infancy were significantly higher than control and this suggests that the role of eosinophils to airway inflammation in many wheezing infants may be the same as that in older children with asthma.
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Child , Child, Preschool , Humans , Infant , Asthma , Bronchi , Eosinophils , Epithelial Cells , Inflammation , Nasal Mucosa , Respiratory SoundsABSTRACT
It is widely known that the cockroach is an inhalant allergen in atopic asthma and allergic rhinitis. Even though Bla g I and Bla g II are considered as the major allergens, several relatively high-molecular weight (MW) cockroach allergens have also been recently identified by IgE-immunoblot in western countries. However, the environmental control and diagnostic tests mainly focussed on Bla g I and Bla g II. Furthermore there is no data about major IgE-binding cockroach antigens in Korea. We performed this study to identify the major German cockroach allergens in Korean atopic children. By the results of allergy skin tests, 14 children with atopic asthma (9 were cockroach-sensitive and 5 were cockroach-nonsensitive atopics) were enrolled in this study. We conducted IgE immunoblot and autoradiographic analysis using Yonsei-extract of German cockroach antigen produced in our laboratory, individual sera from 9 cockroach- sensitive children, and the pooled sera of 5 house-dust-mites-only-sensitive children. We performed an allergic skin test to cockroach mix, and a radioallergosorbent test (RAST) using German cockroach crude extract on all subjects. German cockroach-specific IgE was detected in 6 out of 9 subjects by RAST. We identified at least 15 IgE-binding protein bands, and among them, the components of MWs of 76, 64, 50, 38, and <14 kilodaltons (kDa) were the major German cockroach allergens in study subjects. Therefore, Bla g I (25-30 kDa) and Bla g II (36 kDa) could not be the absolute indicators of German cockroach sensitization and parameters of environmental control.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Adolescent , Allergens/analysis , Animals , Asthma/metabolism , Asthma/immunology , Asthma/complications , Cockroaches/immunology , Cockroaches/chemistry , Hypersensitivity/metabolism , Hypersensitivity/immunology , Hypersensitivity/complications , Immunoglobulin E/metabolism , Korea , Tissue Extracts/metabolismABSTRACT
Intradermal skin-teat reactions in 521 Thai asthmatic children (345 males and 176 females), aged between 3 and 15 years, with an average age of 6.8, were studied at the allergy clinic of Ramathibodi Hospital. Of the total, 456 (87 per cent) patients gave positive immediate skin reaction at least one “common aeroallergen”. The mist commonly seen aeroallergens were house dust (75 per cent) and house dust mite (73 per cent), followed by mold (55 per cent), grass ( per cent), weed (43 per cent), kapox (41 per cent) and cockroach (18 per cent). The finding of this study was that the most important aeroallergens were house dust and house dust mites which was similar to the results previously found in similar studies.
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Objective: To examine the emotional states of asthmatic children with different degrees of severity, as well as the effects of emotion on change of cytokines in airway. Methods: Asthmatic children were divided into two groups according to the degrees of severity: moderate and mild. Their emotional states were measured and results were compared. Correlation analysis was conducted between scores on emotional scales and sputum levels of IL-8.Results: Total scores on anxiety and depression were higher in the moderate group than in the mild group. Negative correlation was found between levels of anxiety and IL-8 during acute exacerbation of asthmatic condition. Conclusion: Emotional distress was found to be increased with severity of asthmatic condition in children. Anxiety contributed to the decreased concentration of IL-8 in asthmatic children's airway.
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The bioavailability of Elixir Theophylline (Siriraj Hospital Formula) and Table Aminophylline (The Government Pharmaceutical Association) was compared with Elixir Quibron in Thai asthmatic children. The mean rate of absorption and the extent of drug absorption were not significantly different for local made drugs, compared with that of an imported one. With regards to the mean maximum serum levels (Cmax) and time to maximum serum level (Tmax) values, there were also no significant differences between two local preparations and an innovative one. Thus, the results suggest that the local made theophylline drugs possess the same efficacy as the imported drug.
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The rhizome of “Plai” (Zingiber cassummunar Roxb.) has been used as antiasthmatic drug in Thai traditional medicine for a long time. Compound “D” in hexane fraction of “Plai” extract has been shown to inhibit smooth muscle contraction nonspecifically in guinea pig. It also antagonized the action of histamine on bronchial smooth muscle both in vivo and in vitro. Clinical trials of “Plai” have been shown to be effective in asthmatic patients. The purpose of this study is to determine whether usual dose of “Plai” has any antihistamine effect on skin testing. The study was carried out in 24 asthmatic children who had no any medication for 24 hours. There were 13 males and 11 females, age ranged between 8-16 years. Twelve subjects were tested for effect of “Plai” by using intracutaneous test with 0.02 ml of 1 : 100 histamine solution before and 1ฝ hours after taking 500 mg of “Plai” orally. Diameter of wheal reactions were measured in millimeter. Comparison of wheal size before and after “Plai” was made by statistical analysis and the patients were carefully observed for any side effect. Similar procedures were done in another 12 subjects before and at 1ฝ hours after taking chlorpheniramine (0.1 mg/kg) by month. Comparison in any change of wheal was observed and compared. The results of study revealed that 500 mg. of “Plai” had antihistamine effect. The size of wheal reactions before and after “Plai” had statistical significant difference (P < .005). The size of wheal reactions before and after chlorpheniramine also had statistical significant difference (P < .0005), and reduction of wheal size by “Plai” was lesser than by chlorpheniramine (P < .05). No any adverse reaction was observed during the study.