Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air pa...Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,展开更多
The potential use of sound and vibration for diagnostic and therapeutic purposes remains largely under-explored and under-estimated.Sound and vibrational energy has great positive impact on the mind and body.It could ...The potential use of sound and vibration for diagnostic and therapeutic purposes remains largely under-explored and under-estimated.Sound and vibrational energy has great positive impact on the mind and body.It could be particularly useful for psychosomatic diseases as a complementary therapy.Singing bowls,the spiritual ancient therapy has been claimed to aid in mind relaxation and painful and inflammatory conditions.Childhood asthma is an inflammatory airway disease and a psychosomatic disorder.The psychological management in it is often neglected leading to under-treatment or a relapse.Hence,we hypothesized that sound therapy with singing bowls might be useful as complementary therapy in management of childhood asthma.We aimed to study the effect of singing bowl session on child’s asthma severity and control and on the psychological well-being.Children<18 years of age and suffering from childhood asthma were recruited after informed written consent of parents.At the baseline,demographic and clinical details were noted.Anthropometric parameters,PEFR readings,asthma severity,parental and child’s subjective feeling of well-being,asthma control score,and pediatric symptom checklist score(based on age)were determined.The child was given 15 min of singing bowl session as per the set protocol.The subjective and objective evaluation of asthma control and psychological assessment was repeated at 1 month and 3 months follow-up and compared with the baseline results for clinical significance.Eighteen children formed the study group with a mean age of 9.13±2.15 years(range 2–15.25 years).4 children had psychological issues on initial screening.There was a significant improvement in asthma severity,subjective feeling of well-being and asthma control score at 3 months(p<0.05).Singing bowl therapy could be a useful,low-cost complementary therapy in childhood asthmatics.展开更多
Background: Asthma exits with comorbidities which can affect the quality of life of children with asthma. Objective: To identify the common comorbidities with asthma, identify factors associated with the presence of s...Background: Asthma exits with comorbidities which can affect the quality of life of children with asthma. Objective: To identify the common comorbidities with asthma, identify factors associated with the presence of specific comorbidities and evaluate their impact on asthma severity and control among children attending the respiratory clinic in the Rivers State University Teaching Hospital. Materials & Methods: All asthma cases seen in the paediatric respiratory clinic, from 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> November 2014 to 30</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> October 2019 were consecutively recruited. Results: Of 264 children with asthma, 190 (72.0%) had other comorbidities with a F:M ratio of 1.56:1. Difficulty in breathing, chest pain, and the degree of asthma control w</span></span><span style="font-family:Verdana;">ere </span><span style="font-family:""><span style="font-family:Verdana;">significantly associated with having other comorbidities while SPO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> at 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> consult was significantly lower in children with comorbidities, P value</span></span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.05. Allergic rhinitis 116 (43.9%), adenotonsillar hypertrophy 99 (37.5%), atopic dermatitis 54 (20.5%), allergic conjunctivitis 37 (14%), food allergy 27 (10.2) and Gastroesophageal reflux14 (5.3%) were the commonest comorbidities identified. Majority </span><span style="font-family:Verdana;">(</span><span style="font-family:Verdana;">24</span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">88.9%) had allergy to one type of food. Children < 3</span><span style="font-family:""> </span><span style="font-family:Verdana;">years and those whose age at diagnosis was <2</span><span style="font-family:""> </span><span style="font-family:Verdana;">years were significantly at lower risk of having atopic dermatitis. Gastroesophageal reflux disease was significantly more likely to be seen in children aged > 11</span><span style="font-family:""> </span><span style="font-family:Verdana;">years, overweight children, and those presenting with chest pain or chest tightness. Presence of various comorbidities increased the odds of having a more severe asthma, and likelihood of which increased with increasing number of coexisting comorbidities. Conclusion: The prevalence of allergic comorbidity is high among asthmatic children with allergic rhinitis being the commonest cause. Most children with asthma have more than one allergic comorbidity. A comprehensive evaluation of these comorbidities is thus essential in the management of asthmatic children for improved outcomes and quality of life.展开更多
Asthma is the most common noncommunicable disease among children. It leads to substantial problems both in health and economic terms to individuals and families. This paper introduces a technological solution, Easy Br...Asthma is the most common noncommunicable disease among children. It leads to substantial problems both in health and economic terms to individuals and families. This paper introduces a technological solution, Easy Breathing, that supports the man-agement of childhood asthma, providing tools for both doctors and patients. Through the establishment of an asthma chronic care model, it combines doctors’ professional guidance and a gamification system to improve the compliance of patients with their treatments and to provide them with tools for the self-management of their disease. The system is in the testing phase, the first mockup has been developed and validated with 270 medical experts and patients, and it will be tested with 540 end-users over the next months.展开更多
Objective To investigate the association of polymorphisms of STAT6 gene and air pollutants of PM10, NO2, and SO2, with asthma in Chinese children. Methods 418 subjects aged 14 years and under were recruited in a case-...Objective To investigate the association of polymorphisms of STAT6 gene and air pollutants of PM10, NO2, and SO2, with asthma in Chinese children. Methods 418 subjects aged 14 years and under were recruited in a case-control study. The association between STAT6 polymorphisms and childhood asthma were tested by allele frequency, genotype analysis, and MDR analysis. Exposure to outdoor air pollutants was estimated by a 5-day moving average level. Statistical analyses were performed with SAS 9.1 software. Results Only 3 alleles of GT repeats at exon 1 of STAT6 were found in Chinese children. C258T and T710C were 2 new SNPs of STAT6 at 3＇-UTR. Children who carried T allele of C258T were more common in asthma children than in control subjects （P〈0.05）. The MDR analysis showed that GT repeats, C258T and T710C of STAT6 polymorphisms interacted together in leading to susceptibility to childhood asthma among Chinese people. After confounding factors were controlled, such as SNP C258T, family history of asthma, frequency of influenza within a year, the 5-day average of SO2 was tested to be a key risk factor of asthma in Chinese children （P〈0.05）. Conclusion Chinese children differed in polymorphisms of STAT6 and in its relation with childhood asthma.展开更多
Lipid metabolism play an essential role in occurrence and development of asthma,and it can be disturbed by phthalate esters(PAEs)and organophosphate fame retardants(OPFRs).As a chronic infammatory respiratory disease,...Lipid metabolism play an essential role in occurrence and development of asthma,and it can be disturbed by phthalate esters(PAEs)and organophosphate fame retardants(OPFRs).As a chronic infammatory respiratory disease,the occurrence risk of childhood asthma is increased by PAEs and OPFRs exposure,but it remains not entirely clear how PAEs and OPFRs contribute the onset and progress of the disease.We have profiled the serum levels of PAEs and OPFRs congeners by liquid chromatography coupled with mass spectrometry,and its relationships with the dysregulation of lipid metabolism in asthmatic,bronchitic(acute infammation)and healthy(non-infammation)children.Eight PAEs and nine OPFRs congeners were found in the serum of children(1–5 years old)from Shenzhen,and their total median levels were 615.16 ng/m L and 17.06 ng/m L,respectively.Moreover,the serum levels of mono-methyl phthalate(MMP),tri-propyl phosphate(TPP)and tri-n-butyl phosphate(TNBP)were significant higher in asthmatic children than in healthy and bronchitic children as control.Thirty-one characteristic lipids and fatty acids of asthma were screened by machine-learning random forest model based on serum lipidome data,and the alterations of infammatory characteristic lipids and fatty acids including palmitic acids,12,13-Di HODE,14,21-Di HDHA,prostaglandin D2 and Lyso PA(18:2)showed significant correlated with high serum levels of MMP,TPP and TNBP.These results imply PAEs and OPFRs promote the occurrence of childhood asthma via disrupting infammatory lipid and fatty acid metabolism,and provide a novel sight for better understanding the effects of plastic additives on childhood asthma.展开更多
BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills ...BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.展开更多
Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment ...Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled;patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.展开更多
基金supported by the Development Foundation of Shanghai Meteorological and Health Key Laboratory [QXJK201606]the Investigation of Science&Technology Basic Resources Program of China [2017FY101206]the General Program Foundation of Hebei Meteorological Bureau [17KY10]
文摘Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,
文摘The potential use of sound and vibration for diagnostic and therapeutic purposes remains largely under-explored and under-estimated.Sound and vibrational energy has great positive impact on the mind and body.It could be particularly useful for psychosomatic diseases as a complementary therapy.Singing bowls,the spiritual ancient therapy has been claimed to aid in mind relaxation and painful and inflammatory conditions.Childhood asthma is an inflammatory airway disease and a psychosomatic disorder.The psychological management in it is often neglected leading to under-treatment or a relapse.Hence,we hypothesized that sound therapy with singing bowls might be useful as complementary therapy in management of childhood asthma.We aimed to study the effect of singing bowl session on child’s asthma severity and control and on the psychological well-being.Children<18 years of age and suffering from childhood asthma were recruited after informed written consent of parents.At the baseline,demographic and clinical details were noted.Anthropometric parameters,PEFR readings,asthma severity,parental and child’s subjective feeling of well-being,asthma control score,and pediatric symptom checklist score(based on age)were determined.The child was given 15 min of singing bowl session as per the set protocol.The subjective and objective evaluation of asthma control and psychological assessment was repeated at 1 month and 3 months follow-up and compared with the baseline results for clinical significance.Eighteen children formed the study group with a mean age of 9.13±2.15 years(range 2–15.25 years).4 children had psychological issues on initial screening.There was a significant improvement in asthma severity,subjective feeling of well-being and asthma control score at 3 months(p<0.05).Singing bowl therapy could be a useful,low-cost complementary therapy in childhood asthmatics.
文摘Background: Asthma exits with comorbidities which can affect the quality of life of children with asthma. Objective: To identify the common comorbidities with asthma, identify factors associated with the presence of specific comorbidities and evaluate their impact on asthma severity and control among children attending the respiratory clinic in the Rivers State University Teaching Hospital. Materials & Methods: All asthma cases seen in the paediatric respiratory clinic, from 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> November 2014 to 30</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> October 2019 were consecutively recruited. Results: Of 264 children with asthma, 190 (72.0%) had other comorbidities with a F:M ratio of 1.56:1. Difficulty in breathing, chest pain, and the degree of asthma control w</span></span><span style="font-family:Verdana;">ere </span><span style="font-family:""><span style="font-family:Verdana;">significantly associated with having other comorbidities while SPO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> at 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> consult was significantly lower in children with comorbidities, P value</span></span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.05. Allergic rhinitis 116 (43.9%), adenotonsillar hypertrophy 99 (37.5%), atopic dermatitis 54 (20.5%), allergic conjunctivitis 37 (14%), food allergy 27 (10.2) and Gastroesophageal reflux14 (5.3%) were the commonest comorbidities identified. Majority </span><span style="font-family:Verdana;">(</span><span style="font-family:Verdana;">24</span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">88.9%) had allergy to one type of food. Children < 3</span><span style="font-family:""> </span><span style="font-family:Verdana;">years and those whose age at diagnosis was <2</span><span style="font-family:""> </span><span style="font-family:Verdana;">years were significantly at lower risk of having atopic dermatitis. Gastroesophageal reflux disease was significantly more likely to be seen in children aged > 11</span><span style="font-family:""> </span><span style="font-family:Verdana;">years, overweight children, and those presenting with chest pain or chest tightness. Presence of various comorbidities increased the odds of having a more severe asthma, and likelihood of which increased with increasing number of coexisting comorbidities. Conclusion: The prevalence of allergic comorbidity is high among asthmatic children with allergic rhinitis being the commonest cause. Most children with asthma have more than one allergic comorbidity. A comprehensive evaluation of these comorbidities is thus essential in the management of asthmatic children for improved outcomes and quality of life.
文摘Asthma is the most common noncommunicable disease among children. It leads to substantial problems both in health and economic terms to individuals and families. This paper introduces a technological solution, Easy Breathing, that supports the man-agement of childhood asthma, providing tools for both doctors and patients. Through the establishment of an asthma chronic care model, it combines doctors’ professional guidance and a gamification system to improve the compliance of patients with their treatments and to provide them with tools for the self-management of their disease. The system is in the testing phase, the first mockup has been developed and validated with 270 medical experts and patients, and it will be tested with 540 end-users over the next months.
基金supported by the 11th five-year plan program of the Ministry of Science and Technology of PR China(MOST)(No.2006BAI19B05)
文摘Objective To investigate the association of polymorphisms of STAT6 gene and air pollutants of PM10, NO2, and SO2, with asthma in Chinese children. Methods 418 subjects aged 14 years and under were recruited in a case-control study. The association between STAT6 polymorphisms and childhood asthma were tested by allele frequency, genotype analysis, and MDR analysis. Exposure to outdoor air pollutants was estimated by a 5-day moving average level. Statistical analyses were performed with SAS 9.1 software. Results Only 3 alleles of GT repeats at exon 1 of STAT6 were found in Chinese children. C258T and T710C were 2 new SNPs of STAT6 at 3＇-UTR. Children who carried T allele of C258T were more common in asthma children than in control subjects （P〈0.05）. The MDR analysis showed that GT repeats, C258T and T710C of STAT6 polymorphisms interacted together in leading to susceptibility to childhood asthma among Chinese people. After confounding factors were controlled, such as SNP C258T, family history of asthma, frequency of influenza within a year, the 5-day average of SO2 was tested to be a key risk factor of asthma in Chinese children （P〈0.05）. Conclusion Chinese children differed in polymorphisms of STAT6 and in its relation with childhood asthma.
基金supported by the National Natural Science Foundation of China (Nos.22076197,21707149 and 82127801)the Scientific Instrument Developing Project of the Chinese Academy of Sciences (No.YJKYYQ20200034)+1 种基金Shenzhen Science and Technology Research Funding (Nos.JCYJ20210324115811031 and JCYJ20200109115405930)Guangdong Basic and Applied Basic Research Foundation (No.2020B1515120080)。
文摘Lipid metabolism play an essential role in occurrence and development of asthma,and it can be disturbed by phthalate esters(PAEs)and organophosphate fame retardants(OPFRs).As a chronic infammatory respiratory disease,the occurrence risk of childhood asthma is increased by PAEs and OPFRs exposure,but it remains not entirely clear how PAEs and OPFRs contribute the onset and progress of the disease.We have profiled the serum levels of PAEs and OPFRs congeners by liquid chromatography coupled with mass spectrometry,and its relationships with the dysregulation of lipid metabolism in asthmatic,bronchitic(acute infammation)and healthy(non-infammation)children.Eight PAEs and nine OPFRs congeners were found in the serum of children(1–5 years old)from Shenzhen,and their total median levels were 615.16 ng/m L and 17.06 ng/m L,respectively.Moreover,the serum levels of mono-methyl phthalate(MMP),tri-propyl phosphate(TPP)and tri-n-butyl phosphate(TNBP)were significant higher in asthmatic children than in healthy and bronchitic children as control.Thirty-one characteristic lipids and fatty acids of asthma were screened by machine-learning random forest model based on serum lipidome data,and the alterations of infammatory characteristic lipids and fatty acids including palmitic acids,12,13-Di HODE,14,21-Di HDHA,prostaglandin D2 and Lyso PA(18:2)showed significant correlated with high serum levels of MMP,TPP and TNBP.These results imply PAEs and OPFRs promote the occurrence of childhood asthma via disrupting infammatory lipid and fatty acid metabolism,and provide a novel sight for better understanding the effects of plastic additives on childhood asthma.
基金Supported by Science and Technology Research Project of Songjiang District,No.2020SJ340.
文摘BACKGROUND Childhood asthma is a common respiratory ailment that significantly affects preschool children.Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver.With the rise of digital healthcare and the need for innovative interventions,Internet-based models can potentially offer relatively more efficient and patient-tailored care,especially in children.AIM To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test(TRACK)on asthma management in preschool children.METHODS The study group comprised preschoolers,aged 5 years or younger,that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022.Total of 200 children were evenly and randomly divided into the observation and control groups.The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma.In addition to above treatment,the observation group was introduced to an intelligent internet nursing model,emphasizing the TRACK scale.Key measures monitored over a six-month period included the frequency of asthma attack,emergency visits,pulmonary function parameters(FEV1,FEV1/FVC,and PEF),monthly TRACK scores,and the SF-12 quality of life assessment.Post-intervention asthma control rates were assessed at six-month follow-up.RESULTS The observation group had fewer asthma attacks and emergency room visits than the control group(P<0.05).After six months of treatment,the children in both groups had higher FEV1,FEV1/FVC,and PEF(P<0.05).Statistically significant differences were observed between the two groups(P<0.05).For six months,children in the observation group had a higher monthly TRACK score than those in the control group(P<0.05).The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period(P<0.05).Furthermore,the groups showed statistically significant differences(P<0.05).The asthma control rate was higher in the observation group than in the control group(P<0.05).CONCLUSION TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children,improve lung function,quality of life,and the TRACK score and asthma control rate.The effect of nursing was significant,allowing for development of an asthma management model.
文摘Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled;patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.
