Asthma control on the basis of perceived stress, locus of control, and self-efficacy in patients with adult Asthma

Objective: This study aimed to investigate the prediction of asthma control on the basis of perceived stress, locus of control, and self-efficacy in adult patients with asthma

Methods: This was a descriptive-correlative and cross-sectional study.The solecty of this study is all asthmatic patients in Tehran. our sample consisted of 100 participants who were selected by purposeful sampling method. A total of 100 patients with asthma were selected among outpatients of Masih Daneshvari Hospital. Participants included 52 women and 48 men. Their mean [ +/- SD] age was 36.12 [ +/- 9.82] years. Sociodemographic data were collected and Perceived Stress Scale [PSS], Multidimensional Health Locus of Control [MHLC], Asthma Self-efficacy Scale [ASES], and Asthma Control Test [ACT] were applied. Data were analyzed by Pearson correlation and multiple regression analysis. Statistical analysis was performed using the SPSS ver. 16.0

Results: The results indicated that there were negative significant relationships between perceived stress, dimension of external control [chance] and asthma control, but positive significant relationships between self-efficacy and asthma control. In regression analysis, the perceived stress was the predictor of asthma control

Conclusion: In this study, our findings suggest that perceived stress has an important role in the development and maintenance of asthma symptoms. In addition, self-efficacy and a tendency to externally attribute the locus of control [chance] are significantly associated with asthma control

Skin prick test reactivity to common aero and food allergens among children with allergy

Background: The prevalence of allergic diseases has risen in the last decades. The objective of this study was to determine the common allergens in children via the skin prick test

Methods: This cross-sectional study recruited 313 allergic children [4 months to 18 years old] referred to the Asthma and Allergy Clinic of Children's Medical Center in Tehran. A questionnaire containing demographic data and patient history was completed. The Skin Prick Test [SPT] was selected according to the patients' history of food and/or aeroallergen sensitivity

Results: Patients [62.4% male, 37.6% female] with symptoms of asthma [n=141, 57.1%], allergic rhinitis [n=50, 20.4%], atopic dermatitis [n=29, 11.7%], and urticaria [n=20, 8.1%] were studied. Positive skin prick test to at least one allergen was 58.1%. The most prevalent allergens were tree mix [26%], Alternaria alternata [26%], weed mix [23.6%], Dermatophagoides farinae [22.9%], Dermatophagoides pteronyssinus [22.9%], milk [21.7%], eggs [20%], and wheat flour [18.3%]. Also, common allergens in the patients with different symptoms of allergic disorders were as follows: asthma [tree mix, weed mix, and Dermatophagoides farinae]; allergic rhinitis [Dermatophagoides farinae, tree mix, and Dermatophagoides pteronyssinus]; and atopic dermatitis [Alternaria alternata, Dermatophagoides pteronyssinus, and cockroaches]

Conclusion: Identifying allergens in each area is necessary and has an important role in the diagnosis and management of allergic disorders and possibility of performing immunotherapy. In this study, the most common aeroallergens were tree mix, Alternaria alternata, and weed mix and also the most common food allergens were milk, eggs, and wheat. Considering these data, appropriate preventive strategies can decrease the cost and morbidity of therapeutic actions

Role of the immune cells, mediators and cytokines in pathogenesis of asthma: a review article

Asthma is a chronic inflammatory disorder of the airways, associated with airway re-modeling and hyperresponsiveness. It is expressed that asthma influences about 300 million people around the world, which is estimated to increase to about 400 million by 2025. The prevalence rate is 15 to 20 percent in children and 5 to 10 percent in adults, while its trend is still increasing. Inflammation plays an important role in the patho-physiology of asthma, which involves an interaction of different types of the immune cells and mediators. It leads to a number of pathophysiology changes, including bron-chial inflammation, airway obstruction, and clinical episodes such as cough, wheeze and shortness of breath. Asthma is now greatly being introduced as a heterogeneous disorder and it is pointed out to the role of T cells, including Th1, Th2, Th17, and regu-latory T cells. Other immune cells, especially neutrophils, macrophages and dendritic cells, as well structural cells such as epithelial and airway smooth muscle cells also produce disease-associated cytokines in asthma. Increased levels of these immune cells and cytokines have been recognized in clinical samples and mouse models of asthma. Different cytokines, including pro-inflammatory cytokines [such as TNF[alpha], IL-1, and IL-6], T helper 2 cytokines [such as IL-4, IL-5, IL-9, IL-13], and growth factors [such as GM-CSF, PDGF] play a role in the pathogenesis of asthma. Indeed chemokines [such as MPC-1, RANTES, MIP-1] and the chemokine receptors [such as CCR3, CCR4, CCL11, CCL24, and CCL26] play an important role in the recruitment of circu-lating inflammatory cells into the airways in asthmatic patients and also is related with increased T helper 2 cytokines after inhaled allergens. Among new approaches, treat-ment of asthma with anti-cytokine drugs such as antibodies blocking IL-4, IL-5, IL-9 could reduce recruitment inflammatory cells into the airways and remodeling. The final perspective of asthma treatments would be to alter from the symptomatic treatments to disease modifying

Infectious and non-infectious complications among undiagnosed patients with common variable immunodeficiency

Common variable immunodeficiency [CVID] is a heterogeneous group of disorders, characterized by hypogammaglobulinemia, defective specific antibody responses to pathogens and increased susceptibility to recurrent bacterial infections. Delay in diagnosis and inadequate treatment can lead to irreversible complications and mortality. In order to determine infectious complications among undiagnosed CVID patients, 47 patients diagnosed in the Children's Medical Center Hospital during a period of 25 years [1984-2009] were enrolled in this study. Patients were divided into two groups including Group 1 [Gl] with long diagnostic delay of more than 6 years [24 patients] and Group 2 [G2] with early diagnosis [23 patients]. The clinical manifestations were recorded in a period prior to diagnosis in Gl and duration follow up in G2. The number of infections, non infectious complications, hospitalizations, and mortality rate was compared between the two groups. The patients in Gl group had 500 episodes of infections before diagnosis in 256 patient-years [0.08 per patient per year] and 203 times of hospitalization [0.03 per patient per year], which were significantly higher than in G2 patients, who had 75 episodes of infections [0.015 per patient per year] and 88 hospital admissions [0.018 per patient per year] during 207 patient follow-up years. Frequency of enteropathies and liver diseases in Gl were also significantly higher than in G2. Lack of awareness about nature of disease, especially among rural and suburban physicians, single organ involvement as a site of clinical presenting, and predomination of non infectious presentation in Gl were the major factors of delayed diagnosis. Diagnostic delay is a major concern in CVID patients, which could result in irreversible complications and mortality, while early diagnosis and proper initial treatment leads to better outcomes and quality of life