[News in childhood asthma therapy].

Research in the field of paediatric pulmonology, especially asthmology, has been intensified for the last couple of years. A large number of studies describe early wheezing episodes, risk factors, natural course of early childhood asthma. Besides this, literature shows a growing interest in epidemiology, genetics and virusology as predictive factors for development and clinical course of childhood asthma. In this paper, the authors are providing a review of recently published articles on asthma therapy based on phenotypes in terms of better understanding of asthma and asthma-like syndromes. Paediatric respiratory experts worldwide are equally positive in the following statements: real diagnosis leads to real therapy as soon as possible; inhaled corticosteroids are not recommended in very young infants especially if a positive effect is missing; long-term therapy with inhaled corticosteroids has to be scrutinized.

[Influence of environmental tobacco smoke on characteristics of childhood asthma].

INTRODUCTION: We compared characteristics of asthma in children from smoking and non-smoking families. OBJECTIVE: To examine if there was any difference in asthma in children exposed and not exposed to environmental tobacco smoke (ETS). METHODS: We examined 231 asthmatic children and their parents. According to the questionnaire and carbon monoxide (CO) values in exhaled air measured by Smokerlyzer, we divided the children in two groups: children from smoking and children from non-smoking families. We compared birth weight, birth length, the occurrence of the first broncho-obstruction, the number of respiratory infections and exacerbations per year, asthma severity, the number of hospitalizations, total IgE, Skin prick test and allergic manifestations. We examined the influence of parental educational level on smoking behaviour and how much money a smoking family spent on cigarettes. RESULTS: The children's average age was 10.6 years, there were 49% of boys and 51% of girls. We had 77% of smoking families, 45.9% of active smoking mothers and 51% of active smoking fathers. Smoking was more common among lower educated parents. A smoking family spent 7.3% of the family budget on cigarettes. The children from smoking families had more allergic manifestations. The children of smoking mothers had more respiratory infections (without a statistic difference in the second and third year) and more asthmatic exacerbations with a statistic difference after the third year. With parents who smoked, children had more severe asthma. There was no statistical difference in the following: birth weight, birth length, Skin prick test, total IgE, the first wheezing episode and the number of hospitalizations. However, in the group of 26 children with exhaled CO values higher than 6 ppm, birth weight was lower (3250 g vs. 3550 g), the first wheezing episode occurred earlier (2 years vs. 3.7 years) and total IgE was higher (702 IU/ml vs. 563 IU/ml) by more than two normal ranges (60 IU/ml). CONCLUSION: It is necessary to protect children with asthma from ETS because it has a negative impact on their illness.