Higher mortality of adults with asthma: a 15 year follow-up of apopulation-based cohort.
Allergy. 2018 Feb 20;:
Authors: Lemmetyinen RE, Karjalainen JV, But A, Renkonen RLO, Pekkanen JR, Toppila-Salmi SK, Haukka JK
BACKGROUND: Higher all-cause mortality in asthmatics has been shown previously. Polysensitization is associated with higher morbidity among asthmatic children, and allergic rhinitis and/or allergic conjunctivitis (AR/AC) is associated with higher morbidity in adult asthmatics. Little is known about the effect of AR/AC and other factors on mortality among adult asthmatics. The aim was to study mortality and its risk factors in adults with and without asthma.
METHODS: We randomly selected 1648 asthmatics with age over 30 years from national registers and matched the asthma sample with one or two controls. Baseline information was obtained by a questionnaire in 1997, and the study population was linked with the death certificate information of Statistics Finland from 1997 to 2013. Overall and cause-specific survival between the groups was compared in several adjusted models.
RESULTS: During a mean follow-up period of 15.6 years, 221 deaths among 1052 asthma patients and 335 deaths among 1889 non-asthmatics were observed. Cardiovascular diseases were the main cause of death in both groups. Asthma was associated with increased all-cause mortality (adjusted HR 1.25; 95% CI 1.05-1.49, P=0.011); as well as mortality from chronic obstructive pulmonary disease (HR 12.0, 4.18-34.2, P<0.001) and malignant neoplasms of respiratory organs (HR 2.33, 1.25-4.42, P=0.008). Among asthmatics, smoking was associated with increased all-cause mortality and self-reported AR/AC was associated with decreased mortality. Among non-asthmatics, smoking and obesity were associated with increased all-cause mortality, whereas female gender showed an association with a decreased risk.
CONCLUSIONS: Increased mortality among adult asthmatics was largely explained by the development of COPD, malignant respiratory tract neoplasms and cardiovascular diseases. Smoking cessation is important for reduction of total mortality in both asthmatic and non-asthmatic adults. AR/AC was associated with decreased mortality only in asthmatics. Thus, studies in other populations of larger size are needed to explore further the nature of this association. This article is protected by copyright. All rights reserved.
PMID: 29461632 [PubMed - as supplied by publisher]
Hyperglycemia in Children Hospitalized with Acute Asthma.
Adv Exp Med Biol. 2018 Feb 20;:
Authors: Mobaireek KF, Alshehri A, Alsadoun A, Alasmari A, Alashhab A, Alrumaih M, Alothman M, Alangari AA
Hyperglycemia is frequently observed in adults with acute asthma. We aimed to assess the frequency of hyperglycemia and its relation to outcomes in children admitted with acute asthma. In this retrospective study, we reviewed medical records of non-diabetic 166 children (66 girls) with the mean age of 5.4 ± 2.6 years (range of 2-12 years), who were hospitalized with acute asthma between January 2012 through December 2014. Data pertaining to demographics, vital signs, oxygen saturation, serum blood glucose level, electrolytes, blood gases, and admission were collected. Children with other chronic conditions were excluded. The findings were that hyperglycemia (blood glucose ≥ 11.1 mmol/l) was observed in 38.6% of children. The median baseline blood glucose (IQR) was 9.8 mmol/l (7.2-13.3 mmol/l). Blood glucose level was associated with the length of hospitalization, with a median extension of 1.8 days, but was inversely associated with the serum potassium and bicarbonate levels. There were no associations between baseline blood glucose and age, gender, baseline respiratory rate, oxygen saturation, or intensive care admission. Hyperglycemia resolved spontaneously in all affected children. We conclude that hyperglycemia is common in children hospitalized with acute asthma. Hyperglycemia could be considered as a marker of a longer hospital stay.
PMID: 29460272 [PubMed - as supplied by publisher]
Interaction between Hypertension and Asthma in Adult.
Mymensingh Med J. 2018 Jan;27(1):34-40
Authors: Nasreen S, Nessa A, Islam F, Khanam A, Sultana R, Alam K, Naznin R, Tajkia T, Rahman R, Hossain M, Sultana MA, Kamal ST
Asthma has been defined as a chronic inflammatory disorder of the airways that is associated with recruitment of inflammatory cells and the clinical development of wheezing, shortness of breath, chest tightness, and cough. The prevalence of asthma increased steadily over the latter part of the last century, first in the developed and then in the developing world. Current estimates suggest that asthma affects 300 million people worldwide, with a predicted additional 100 million people affected by 2025. This cross sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people and another same study carried out from November 2009 to April 2010 on 8088 subjects. In 1999 the prevalence of asthma was 6.9% whereas in 2010 it is 6.96%. Both asthma and hypertension are spastic disorders of smooth muscle, there is the similarities between these two diseases may predispose the individuals with one disease to the other. This descriptive type of cross-sectional study was done to find the Interaction between hypertension and asthma in adult and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and fifty (50) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. Blood pressure was estimated by auscultatory method by sphygmomanometer. For statistical analysis unpaired student's 't' test was used. Mean blood pressure were significantly increased in study group in comparison to control group and the result was statistically significant (p<0.001). The study findings showed a high prevalence of hypertension among asthmatic patients than non asthmatic healthy persons. From this study, it may be concluded that hypertension and asthma are closely connected.
PMID: 29459589 [PubMed - in process]
Changes in respiratory and non-respiratory symptoms in occupants of a large office building over a period of moisture damage remediation attempts.
PLoS One. 2018;13(1):e0191165
Authors: Park JH, Cho SJ, White SK, Cox-Ganser JM
There is limited information on the natural history of building occupants' health in relation to attempts to remediate moisture damage. We examined changes in respiratory and non-respiratory symptoms in 1,175 office building occupants over seven years with multiple remediation attempts. During each of four surveys, we categorized participants using a severity score: 0 = asymptomatic; 1 = mild, symptomatic in the last 12 months, but not frequently in the last 4 weeks; 2 = severe, symptomatic at least once weekly in the last 4 weeks. Building-related symptoms were defined as improving away from the building. We used random intercept models adjusted for demographics, smoking, building tenure, and microbial exposures to estimate temporal changes in the odds of building-related symptoms or severity scores independent of the effect of microbial exposures. Trend analyses of combined mild/severe symptoms showed no changes in the odds of respiratory symptoms but significant improvement in non-respiratory symptoms over time. Separate analyses showed increases in the odds of severe respiratory symptoms (odds ratio/year = 1.15‒1.16, p-values<0.05) and severity scores (0.02/year, p-values<0.05) for wheezing and shortness of breath on exertion, due to worsening of participants in the mild symptom group. For non-respiratory symptoms, we found no changes in the odds of severe symptoms but improvement in severity scores (-0.04‒-0.01/year, p-values<0.05) and the odds for mild fever and chills, excessive fatigue, headache, and throat symptoms (0.65-0.79/year, p-values<0.05). Our study suggests that after the onset of respiratory and severe non-respiratory symptoms associated with dampness/mold, remediation efforts might not be effective in improving occupants' health.
PMID: 29324816 [PubMed - indexed for MEDLINE]
Sudden Death in a Patient with Pulmonary Veno-occlusive Disease (PVOD) and Severe Pulmonary Hypertension.
Intern Med. 2017;56(15):2025-2031
Authors: Saito M, Ohshima N, Matsui H, Hebisawa A, Ohta K
A 58-year-old woman was referred to our hospital with a chief complaint of exertional dyspnea. Bronchoscopy failed to establish a diagnosis, and the patient subsequently died suddenly due to respiratory insufficiency because of advanced pulmonary hypertension (PH). The pathological diagnosis at autopsy was pulmonary veno-occlusive disease (PVOD). PVOD is difficult to diagnose antemortem and has a poor prognosis. Lung transplantation is the only curative treatment for PVOD.
PMID: 28768975 [PubMed - indexed for MEDLINE]