New Study on Fixed Airways Obstruction Among Patients With Severe Asthma … – Lung Disease News


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New Study on Fixed Airways Obstruction Among Patients With Severe Asthma
Lung Disease News
Asthma is a chronic inflammatory disease of the airways and is characterized by reversible airflow obstruction in response to bronchodilators or inhaled corticosteroids. The most severe cases, accounting for 5% of all asthma cases, are associated with

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Association Between Asthma and Obesity Among Immigrant Asian Americans, California Health Interview Survey, 2001-2011.

Association Between Asthma and Obesity Among Immigrant Asian Americans, California Health Interview Survey, 2001-2011.

Prev Chronic Dis. 2014;11:E209

Authors: Becerra BJ, Scroggins CM, Becerra MB

Abstract
Our objective was to study the comorbidity of asthma and obesity among foreign-born Asian Americans, by subgroups. Public data from the California Health Interview Survey, 2001-2011, were analyzed by using independent logistic regressions, yielding the association between asthma and obesity (Asian and standard cutoffs for body mass index [BMIs]) of 19,841 Asian American immigrant respondents. Chinese, Filipino, South Asian, and Japanese immigrants had a positive association between lifetime asthma and obesity, whereas among Korean immigrants, a positive association was found between lifetime asthma and overweight status (standard BMI cutoffs). Routine screening for this comorbidity is warranted among immigrant Asian Americans.

PMID: 25427317 [PubMed – as supplied by publisher]

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Poor Quality Housing Tied to Higher Asthma Rates Among Kids – U.S. News & World Report

Poor Quality Housing Tied to Higher Asthma Rates Among Kids
U.S. News & World Report
That means that, "local agencies that enforce housing policies can partner with health care systems to target pediatric asthma care," Beck said in a hospital news release. "These agencies retain data that can be used to pinpoint potential clusters of

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Improved Management of Acute Asthma among Pregnant Women Presenting to the Emergency Department.

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Improved Management of Acute Asthma among Pregnant Women Presenting to the Emergency Department.

Chest. 2014 Oct 30;

Authors: Hasegawa K, Cydulka RK, Sullivan AF, Langdorf MI, Nonas SA, Nowak RM, Wang NE, Camargo CA

Abstract
Abstract: Background:A multicenter study in the late 1990s demonstrated suboptimal emergency asthma care for pregnant women in US emergency departments (EDs). After a decade, follow-up data are lacking. We aimed to examine changes in emergency asthma care of pregnant women since the 1990s. Methods:We combined data from four multicenter observational studies of ED patients with acute asthma performed in 1996-2001 (three studies), and 2011-2012 (one study). We restricted the data so that comparisons were based on the same 48 EDs in both time periods. We identified all pregnant patients aged 18 to 44 years with acute asthma. Primary outcomes were treatment with systemic corticosteroids in the ED, and, among those sent home, at ED discharge. Results:Of 4895 ED patients with acute asthma, the analytic cohort comprised 125 pregnant women. Over the two time periods, there were no significant changes in patient demographics, chronic asthma severity, or initial peak expiratory flow. In contrast, ED systemic corticosteroids treatment increased significantly from 51% to 78% across the time periods (OR 3.11; 95%CI 1.27-7.60; P=0.01); systemic corticosteroids at discharge increased from 42% to 63% (OR 2.49; 95%CI 0.97-6.37; P=0.054). In the adjusted analyses, pregnant women in recent years were more likely to receive systemic corticosteroids, both in ED (OR 4.76; 95%CI 1.63-13.9; P=0.004) and at discharge (OR 3.18; 95%CI 1.05-9.61; P=0.04). Conclusions:Over the two time periods, emergency asthma care in pregnant women has significantly improved. However, with one in three pregnant women being discharged home without systemic corticosteroids, further improvement is warranted.
Background: A multicenter study in the late 1990s demonstrated suboptimal emergency asthma care for pregnant women in US emergency departments (EDs). After a decade, follow-up data are lacking. We aimed to examine changes in emergency asthma care of pregnant women since the 1990s.
Methods: We combined data from four multicenter observational studies of ED patients with acute asthma performed in 1996-2001 (three studies), and 2011-2012 (one study). We restricted the data so that comparisons were based on the same 48 EDs in both time periods. We identified all pregnant patients aged 18 to 44 years with acute asthma. Primary outcomes were treatment with systemic corticosteroids in the ED, and, among those sent home, at ED discharge.
Results: Of 4895 ED patients with acute asthma, the analytic cohort comprised 125 pregnant women. Over the two time periods, there were no significant changes in patient demographics, chronic asthma severity, or initial peak expiratory flow. In contrast, ED systemic corticosteroids treatment increased significantly from 51% to 78% across the time periods (OR 3.11; 95%CI 1.27-7.60; P=0.01); systemic corticosteroids at discharge increased from 42% to 63% (OR 2.49; 95%CI 0.97-6.37; P=0.054). In the adjusted analyses, pregnant women in recent years were more likely to receive systemic corticosteroids, both in ED (OR 4.76; 95%CI 1.63-13.9; P=0.004) and at discharge (OR 3.18; 95%CI 1.05-9.61; P=0.04).
Conclusions: Over the two time periods, emergency asthma care in pregnant women has significantly improved. However, with one in three pregnant women being discharged home without systemic corticosteroids, further improvement is warranted.

PMID: 25358070 [PubMed – as supplied by publisher]

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Surveillance for Certain Health Behaviors Among States and Selected Local Areas – Behavioral Risk Factor Surveillance System, United States, 2011.

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Surveillance for Certain Health Behaviors Among States and Selected Local Areas – Behavioral Risk Factor Surveillance System, United States, 2011.

MMWR Surveill Summ. 2014 Oct 24;63(SS-09):1-149

Authors: Xu F, Mawokomatanda T, Flegel D, Pierannunzi C, Garvin W, Chowdhury P, Salandy S, Crawford C, Town M

Abstract
Problem: Chronic conditions (e.g., heart diseases, cerebrovascular diseases, malignant neoplasms, and diabetes), infectious diseases (e.g., influenza and pneumonia), and unintentional injuries are the leading causes of morbidity and mortality in the United States. Adopting positive health behaviors (e.g., staying physically active, quitting tobacco use, always wearing seatbelts in automobiles) and accessing preventive health-care services (e.g., getting routine physical checkups, receiving recommended vaccinations on appropriate schedules, checking blood pressure and cholesterol and maintaining them at healthy levels) can reduce morbidity and mortality from chronic and infectious diseases. Monitoring the health-risk behaviors of a community’s residents as well as their participation in and access to health-care services provides information critical to the development and maintenance of intervention programs as well as the implementation of strategies and health policies that address public health problems at the levels of state and territory, metropolitan and micropolitan statistical area (MMSA), and county. Reporting Period: January-December 2011. Description of the System: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed telephone survey of noninstitutionalized adults aged ?18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services and practices related to the leading causes of death and disabilities in the United States. In 2011, BRFSS adopted a new weighting methodology (iterative proportional fitting, or raking) and for the first time included data from respondents who solely use cellular telephones (i.e., do not use landlines). This report presents results for the year 2011 for all 50 states, the District of Columbia, and participating U.S. territories including the Commonwealth of Puerto Rico and Guam, 198 MMSAs, and 224 counties. Results: In 2011, the estimated prevalence of health-risk behaviors, chronic conditions, access to health care, and use of preventive health services substantially varied by state and territory, MMSA, and county. The following portion of this abstract summarizes selected results by some BRFSS measures. Each set of proportions refers to the range of estimated prevalence of the behaviors, diseases, or use of preventive health-care services as reported by survey respondents. Adults with good or better health: 65.5%-88.0% for states and territories, 72.0%-92.4% for MMSAs, and 74.3%-94.2% for counties. Adults aged <65 years with health-care coverage: 65.4%-92.3% for states and territories, 66.8%-94.7% for MMSAs, and 61.3%-95.6% for counties. Influenza vaccination received during the preceding 12 months among adults aged ?65 years: 28.6%-70.2% for states and territories, 42.0% -80.0% for MMSAs, and 41.1%-78.2% for counties. Adults meeting the federal physical activity recommendations for both aerobic physical activity and muscle-strengthening activity: 8.5%-27.3% for states and territories, 7.3%-32.0% for MMSAs, and 11.0%-32.0% for counties. Current cigarette smokers: 11.8%-30.5% for states and territories, 8.4%-30.6% for MMSAs, and 8.1%-35.2% for counties. Binge drinking during the last month: 10.0%-25.0% for states and territories, 7.0%-32.5% for MMSAs, and 7.0%-32.5% for counties. Adults always wearing seatbelts while driving or riding in a car: 63.9%-94.1% for states and territories, 51.8%-96.9% for MMSAs, and 51.8%-97.0% for counties. Adults aged ?18 who were obese: 20.7%-34.9% for states and territories, 15.1%-37.2% for MMSAs, and 15.1%-41.0% for counties. Adults with diagnosed diabetes: 6.7%-13.5% for states and territories, 3.9%-15.9% for MMSAs, and 3.5%-18.3% for counties. Adults with current asthma: 4.3%-12.1% for states and territories, 2.9%-14.1% for MMSAs, and 2.9%-15.6% for counties. Adults aged ?45 years who have had coronary heart disease: 7.1%-16.2% for states and territories, 5.0%-19.4% for MMSAs, and 3.9%-18.5% for counties. Adults using special equipment because of any health problem: 5.1%-11.3% for states and territories, 3.9%-13.2% for MMSAs, and 2.4%-14.7% for counties. Interpretation: Because of the recent change in the BRFSS methodology, the results should not be compared with those from previous years. The findings in this report indicate that substantial variations exist in the reported health-risk behaviors, chronic diseases, disabilities, access to health-care services, and the use of preventive health services among U.S. adults at state and territory, MMSA, and county levels. The findings underscore the continued need for surveillance of health-risk behaviors, chronic conditions, and use of preventive health-care services as well as surveillance-informed programs designed to help improve health-related risk behaviors, levels of chronic disease and disability, and the access to and use of preventive services and health-care resources. Public Health Action: State and local health departments and agencies can continue to use BRFSS data to identify populations at high risk for certain unhealthy behaviors and chronic conditions. Additionally, they can use the data to inform the design, implementation, direction, monitoring, and evaluation of public health programs, policies, and use of preventive services that can lead to a reduction in morbidity and mortality among U.S. residents.

PMID: 25340985 [PubMed – as supplied by publisher]

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Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco.

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Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco.

Int J Infect Dis. 2014 Oct 8;

Authors: Jroundi I, Mahraoui C, Benmessaoud R, Moraleda C, Tligui H, Seffar M, Kettani SE, Benjelloun BS, Chaacho S, Muñoz-Almagro C, Ruiz J, Alonso PL, Bassat Q

Abstract
OBJECTIVES: Data on prognostic factors among children with severe pneumonia are scarce in middle-income countries. We investigated prognostic factors for an adverse outcome among children admitted to the Hôpital d’Enfants de Rabat, Morocco with World Health Organization-defined clinically severe pneumonia (CSP).
METHODS: Children aged 2-59 months admitted to the hospital and fulfilling the CSP definition were recruited into this 13-month prospective study. A poor prognosis was defined as death, a need for intensive care, or a Respiratory Index of Severity in Children (RISC) score ?3. Multivariate logistic regression was performed to ascertain independent predictive factors for a poor prognosis.
RESULTS: Of the 689 children included in this analysis, 55 (8.0%) required intensive care and 28 died (4.0%). Five hundred and two (72.8%) children were classified as having a good prognosis and 187 (27.2%) as having a poor prognosis. A history of prematurity (odds ratio (OR) 2.50, 95% confidence interval (CI) 1.24-5.04), of fever (OR 2.25, 95% CI 1.32-3.83), living in a house with smokers (OR 1.79, 95% CI 1.18-2.72), impaired consciousness (OR 10.96, 95% CI 2.88-41.73), cyanosis (OR 2.09, 95% CI 1.05-4.15), pallor (OR 2.27, 95% CI 1.34-3.84), having rhonchi on auscultation (OR 2.45, 95% CI 1.58-3.79), and human metapneumovirus infection (OR 2.13, 95% CI 1.13-4.02) were all independent risk factors for an adverse outcome, whereas a history of asthma (OR 0.46, 95% CI 0.25-0.84) was the only independent risk factor for a positive outcome.
CONCLUSIONS: The early identification of factors associated with a poor prognosis could improve management strategies and the likelihood of survival of Moroccan children with severe pneumonia.

PMID: 25305555 [PubMed – as supplied by publisher]

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