Pediatric Asthma

Cleaner Air Could Reduce Asthma, IBS, Diabetes Rates

2011-04-26T10:49:00.000-07:00

If you have asthma, know the symptoms of heart disease and other inflammatory diseases so you can treat them early.

The Environmental Protection Agency announced new rules that will require coal-burning power plants to limit emissions of toxic air pollutants that are known to exacerbate asthma. That's great news for the 8 percent of Americans who suffer from the breathing disorder. And according to a new study being presented at this week's annual meeting of the American Academy of Allergy, Asthma and Immunology, it could lead to fewer rates of other inflammatory diseases. The authors of the study found that people with asthma are more likely to suffer from cardiovascular disease, diabetes, irritable bowel disease (IBS), and rheumatoid arthritis than people with healthy lungs.

THE DETAILS: The authors used data from 2,392 people enrolled in an asthma study in Rochester, Minnesota, half of whom had asthma and the other half did not. They compared the incidence of irritable bowel disease, rheumatoid arthritis, diabetes, and coronary artery disease among those with asthma and those without, and found that with each disease, people with asthma had higher rates. The relationship was strongest with coronary artery disease, in which people with asthma had a 59 percent higher incidence, and with diabetes, in which people with diabetes had a 68 percent higher incidence. Rates of irritable bowel disease and rheumatoid arthritis also increased in asthma patients, but, says lead author Young J. Juhn, MD, pediatrician at the Mayo Clinic in Rochester, the associations weren't as strong.

WHAT IT MEANS: Though it may seem logical to think that an inflammatory condition like asthma would be accompanied by other inflammatory conditions, such as diabetes and cardiovascular disease, Dr. Juhn says his results came as somewhat of a surprise, based on the way our immune systems work. "Our immune systems have something called T-helper cells. T-helper 1 cells determine pro-inflammatory conditions, such as coronary artery disease, irritable bowel disease, rheumatoid arthritis, and diabetes, while T-helper 2 cells are considered to play a very important role in determining allergic disorders, such as asthma," he says. Because our immune systems work to maintain a balance between the two types, he adds, it would stand to reason that people with asthma would actually have lower rates of those diseases. But that's not what his study found. "At this point, we think there may be some common immune mechanisms underlying this association," he says, most likely something genetic or environmental.

Dr. Juhn's study is one of very few analyzing the relationship between asthma and other inflammatory diseases, so he says that doctors are still in the early stages of understanding what all this means, especially when it comes to solving the problem. "If we find that the association isn't genetic, then, potentially, controlling your asthma may be helpful in reducing your risk of these other pro-inflammatory conditions," Dr. Juhn says. "But if it the underlying mechanism is genetic, the association may be independent from asthma control."

The most important thing to remember, Dr. Juhn says, is that if you do have asthma, pay attention to any out-of-the-ordinary symptoms you may experience. "This study could be very important for early detection," he says. "If patients experience nonspecific chest pain, their doctors may think it's just their asthma, but it could be the beginning of heart disease."

To help you out, here's a list of some common symptoms associated with each condition.

• Coronary artery disease: Chest pain and shortness of breath are the two primary signs of coronary artery disease, which, unfortunately, makes it easy to confuse with asthma. However, pay attention to where you feel pain. Coronary heart pain may be felt under your breastbone, or in your neck, arms, stomach, or upper back. The condition is also accompanied by weakness and fatigue. The most serious symptom is, of course, having a heart attack. And check out these other six unusual signs of heart disease, such as excessive snoring and sexual dysfunction.

• Diabetes: People with type 2 (adult-onset) diabetes typically exhibit very few symptoms, but those who do may notice things like unusual thirst or hunger, blurred vision, frequent infections, and tingling or numbness in your hands or feet. A blood-glucose test will tell your doctor whether you have diabetes, and recently, doctors developed an easy online test that will allow you to assess your diabetes risk based on things like family history and weight. It doesn't include asthma as a potential risk factor, but the test should help you figure out if you're already at an increased risk.

• Rheumatoid arthritis: This is a disease that's stumped a lot of doctors, as the causes of RA remain unknown and symptoms can be vague and sporadic. But you might have rheumatoid arthritis if your joints ache or swell or are tender to the touch (it usually begins in the smaller joints, such as those in your hands and feet), you feel firm bumps of tissue under the skin on your arms, or have morning stiffness that lasts longer than the morning.

• Irritable bowel disease: If you experience a lot of abdominal discomfort, cramping, or bloating, you could be suffering from irritable bowel disease or the less-severe irritable bowel syndrome, or IBS. As with rheumatoid arthritis, there isn't a known cause, but it is an autoimmune condition that seems to be exacerbated by environmental causes, including stressful jobs.

Reduce your risk from heart disease and asthma. Eat lots of Vitamin C and Vitamin D rich foods and fruits.

Dry Powder Inhaler for Deep, Consistent Drug Administration

2010-12-03T20:40:00.000-08:00

New inhaler delivers significantly more drug to the deep lung, regardless of strength of breath Dry Powder Inhaler

Cambridge Consultants and Sun Pharma Advanced Research Company Ltd develop a high performance, easy to use dry powder inhaler

Cambridge Consultants, a leading technology product design and development firm, has developed a new high efficiency, easy to use dry powder inhaler in collaboration with Sun Pharma Advanced Research Company Ltd ("SPARC"), one of India's leading pharmaceutical research companies. The inhaler has a uniform delivery profile that ensures the full intended metered dose of the drug is administered to the deep lung, regardless of the strength of the patient's intake of breath.

The device employs a novel de-agglomeration engine to separate the drug from the lactose 'carrier' particles. Based on a highly efficient airway design, the patented drug separation mechanism has successfully completed clinical trials and demonstrated that it is capable of delivering significantly more of the drug to the deep lung than traditional inhalers. In practice, this will minimise side effects from drug build-up in the back of the throat, reduce non-systemic load and wastage, and means almost 50% less active drug needs pre-loading into the device in comparison to a standard inhaler.

This step change in inhaler technology is a reliable and easy to use device, particularly for patients with impaired lung function or those using the inhaler during an asthma attack – overcoming any patient concerns about the ability to use the device effectively.

In addition to its novel drug delivery mechanism, the device integrates a number of user-friendly design features. These include a numerical dose counter to indicate at a glance how many more doses are left in the inhaler before it runs out, a luminous feature to enable users to find the device in the dark and a small pop-out 'braille' button which activates when there are only a few doses remaining. The device gives audible and tactile feedback to indicate the delivery and completion of user steps. The device also features a unique palm-held form, designed to discreetly house the complex dose carriage and delivery system yet remain comfortable to hold and use.

Mr Dilip S. Shanghvi, Chairman and Managing Director of SPARC, commented, "Our search for the right design expertise for this project was global, but Cambridge Consultants stood out to us because of its excellent track record in medical device development. The partnership has worked incredibly well and has enabled us to take the product from initial requirement to market in half the time that such projects usually demand."

Phil Lever, Commercial Director at Cambridge Consultants, added, "We're delighted that SPARC chose to work with us on the technically challenging project as we feel this is a strong endorsement of the world-class development skills we offer, and we are very proud of the inhaler that has been developed as a result of this collaborative partnership." Cambridge Consultants and SPARC are now working together to ready the device for manufacture and the commercial launch is expected in 2011.

Cambridge Consultants will also be demonstrating the device at the Drug Delivery to the Lungs (DDL) 21 conference, Edinburgh International Conference Centre, 8th-10th December 2010.

Notes for editors:

Cambridge Consultants develops breakthrough products, creates and licenses intellectual property, and provides business consultancy in technology critical issues for clients worldwide. For 50 years, the company has been helping its clients turn business opportunities into commercial successes, whether they are launching first-to-market products, entering new markets or expanding existing markets through the introduction of new technologies. With a team of over 300 engineers, designers, scientists and consultants, in offices in Cambridge (UK) and Boston (USA), Cambridge Consultants offers solutions across a diverse range of industries including medical technology, industrial and consumer products, transport, energy, cleantech and wireless communications.

Throughout 2010, Cambridge Consultants celebrates its 50th year in business. Created by three Cambridge graduates in 1960, the company has grown into a leading technology business, renowned worldwide for its ability to solve technical problems and provide innovative, practical solutions to commercial issues. In 2009, the company was awarded the prestigious Queen’s Award for Enterprise in International Trade. For more information visit: www.CambridgeConsultants.com

Cambridge Consultants is part of Altran, the European leader in innovation and high technology consulting. The Group’s 17,500 consultants, operating worldwide, cover the entire range of engineering specialities, including electronics, information technology, quality and organisation. Altran offers its clients ongoing support throughout the innovation cycle, from technology watch, applied basic research and management consulting to industrial systems engineering and information systems. The Group provides services to most industries, including the automotive, aeronautics, space, life sciences and telecommunications sectors. Founded in 1982, Altran operates in 20 priority countries. In 2008, it generated a turnover of €1,650 million. For more information visit: www.altran.com

About SPARC

Sun Pharma Advanced Research Company Ltd (NSE: SPARC, BSE: 532872) is an international pharmaceutical company engaged in research and development of drugs and delivery systems. More information about the company can be found at www.sunpharma.in.

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Launch of Symbicort Turbuhalerfor the Treatment of Adult Bronchial Asthma in Japan

2010-01-16T09:41:00.000-08:00

Astellas Pharma Inc. (“Astellas”; headquarters: Tokyo; President and CEO: Masafumi Nogimori) and AstraZeneca K.K. (headquarters: Tokyo; President and CEO: Masuhiro Kato) announced thatSymbicort® Turbuhaler® 30 doses and Symbicort® Turbuhaler® 60 doses (generic name: Budesonide/Formoterol fumarate dihydrate) for the treatment of adult bronchial asthma will be launched on January13, 2010 in Japan.

Symbicort® Turbuhaler® is a twice-daily treatment for adult bronchial asthma combining budesonide, an inhaled corticosteroid (one dose containing 160μg) and formoterol fumarate dihydrate, a rapid and long acting β2 agonist (one dose containing 4.5μg), and the product is administered by an inhaler (Turbuhaler).

Characteristics of Symbicort® Turbuhaler® are as follows:
-The Product alone shows good efficacy in countering both of the causes of bronchial asthma, airway inflammation and airway narrowing
- By administering two medications in one product, in addition to the convenience for controlling bronchial asthma, due to the fast onset of bronchial dilation effect of formoterol, patients can easily feel the effect of the treatment. As a result, improvement in adherence (continuation of treatment) can be expected.

Symbicort® Turbuhaler® was listed as a new option for long-term maintenance treatment on “Asthma Prevention and Management Guideline 2009, Japan” which was revised in October 2009.
The guideline recommends that Symbicort® Turbuhaler® can be used for the treatment from step 2 to step 4 as the combination therapy combining an inhaled corticosteroid and a rapid and long-acting β2 agonist.

Symbicort® Turbuhaler® was first approved in Europe in 2000, and is now approved in more than 100 countries and regions. The product will be manufactured and developed by AstraZeneca K.K. and distributed and sold by Astellas Pharma Inc., while promotion will be jointly carried out by both companies (co-promotion).

P.S. Prevent asthma attacks by eating Vitamin C and Vitamin D rich foods and fruits.

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Forest Pays Almirall $75M Up Front as Part of Second Respiratory Therapies Agreement

2009-12-25T08:33:00.000-08:00

Forest Laboratories is paying Almirall $75 million up front as part of a U.S. development, marketing, and distribution agreement for the latter’s once-daily, long-acting beta2 agonist, LAS10097. The deal covers development of LAS100977 in combination with an undisclosed corticosteroid for the treatment of both asthma and chronic obstructive pulmonary disease (COPD), using Almirall’s Genuair® inhaler. LAS10097 has already completed Phase IIa trials in asthma patients.

Under terms of the deal, Forest will be responsible for U.S. regulatory approval and commercialization of the LAS100977-based therapy. Almirall will receive milestone payments and sales-based royalties on top of the up-front fee.

The deal represents the second major respiratory therapies collaboration between the companies. In April 2006 Almirall and Forest signed a $60 million up front deal to develop, market, and distribute Almirall’s inhaled, long-acting muscarinic antagonist, aclidinium bromide, in the U.S. The drug is an anticholinergic bronchodilator, selective M3 muscarinic antagonist for the treatment of COPD.

The companies had originally anticipated filing an NDA in the fourth quarter of 2009 or the first quarter of 2010. However, in March 2009 the companies announced that after consultation with FDA, additional clinical studies with aclidinium bromide will need to be conducted to provide further support for the selected regimens, including higher and/or more frequent doses. EU filing of aclidinium bromide by Almirall is currently projected for 2011.

Commenting on the deal, Howard Solomon, chairman and CEO at Forest, said, “with the addition of LAS100977, Forest rounds out a broad COPD pipeline that was recently augmented with Daxas® (roflumilast) and will also gain access to the larger asthma market with a once-daily inhaled corticosteroid/LABA combination.”

P.S. Boost your natural immunity against Asthma by eating Vitamin C and Vitamin D rich foods and fruits.

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Treatment of childhood asthma

2009-12-23T08:27:00.000-08:00

MBBS(Ceylon), DCH(Ceylon), DCH(England), MD(Paediatrics), FRCP(Edinburgh), FRCP(London), FRCPCH(United Kingdom), FSLCPaed, FCCP, FCGP(Sri Lanka) Consultant Paediatrician

Asthma is an inflammatory disorder of the airways characterised by narrowing of the air tubes brought on by swelling of the lining of the airway, contraction of the muscles of the airways and increased secretion of mucus or "phlegm". In the case of children, asthma is such a variable disorder that there are many considerations that need to be gauged when one looks at the treatment options that could be used. There is a very wide spectrum of clinical presentation of asthma ranging from mild infrequent attacks through moderately severe and frequent episodes to acute severe life-threatening events. Careful assessment is essential before tangible decisions are made regarding further management and the use of certain medications.

One component of treatment is the management of an acute attack. There are several drugs which are so very useful in controlling an acute episode but judicious decisions have to be made regarding their use. Initial assessment of the severity of the attack is the determining factor for the selection of drugs. This initial evaluation is used to classify the episode as a mild attack, a moderately severe attack or an acute severe attack. The last could be so severe that the presence of certain features would further categorise it as a life-threatening attack. This is a harbinger of death and urgent intensive treatment is absolutely essential to save life. All these assessments need to be done by an experienced doctor using features of the history of the illness, its progression, past history and the findings on clinical examination.

The first requirement for a moderately severe or an acute severe attack is the provision of added oxygen through either a mask or through nasal prongs. The airway narrowing leads to marked interference with ventilation of the lungs that the necessary amounts of life-giving oxygen are not allowed to be provided to the blood and thereby to the tissues of the body. The only initial solution to this problem, at least till one could take steps to correct the narrowing of the airways is to provide an additional increased amount of oxygen into the lungs. Parents often get frightened by medical staff starting a child on oxygen but it is more or less a precautionary measure. Most people believe that added oxygen is given only to a dying patient. This is not true and there are several other instances where added oxygen may be used. Steps must be taken to explain this to the parents or care-givers, allay their anxiety and provide reassurance.

Then there are the drugs that are so useful to treat the acute episode and relieve the airway narrowing. Their action is centred around dilatation of the narrowed airways. These drugs are therefore known by the collective term "relievers". There are several different groups of medications that fall into this category. Some of them need to be given by inhalation, either by using a nebuliser or via a spacer device attached to a metered dose inhaler which is commonly known by the name of "puffer". The advantage of these methods is that only tiny doses need to be used as the drug is directly provided to the lung where its primary effect is required. Some of these drugs could also be given by mouth but then much larger doses need to be used. The oral use is generally employed only for very mild attacks. Many people also believe that these children who are once nebulised will always need nebulisation. This too is not true and there is no scientific basis for this belief. Nebulisation and other forms of inhalation therapy is used for the moderately severe and severe attacks as it is so very effective and the observable clinical effect comes on within minutes. The other advantage is that inhalation therapy could be repeated at very frequent intervals as and when necessary. The general side effects that are seen when the same drug is given by mouth are generally not seen as frequently with inhalation therapy. Inhaled therapy is quite safe in the acute phase of the attack and this is so even when the procedure has to be repeated at frequent intervals. It certainly has no adverse effects on the heart.

There are other reliever drugs that are used through the intravenous route. These are generally used when inhaled therapy fails to control the acute attack. Some of these drugs, just like those used for inhalation therapy, act quite quickly but prolonged treatment in the form of intravenous infusions may be necessary to maintain the achieved dilatation of the airways. There are several drugs that fall into this category and some newer drugs are being increasingly used. All these drugs work by different mechanisms of action, the effects are generally complementary when more than one drug needs to be used and the end results are quite good. It is however imperative that proper doses are used to obtain the best effect.

In markedly severe cases, drugs belonging to the corticosteroid group may need to be used. However, it must be remembered that these medicines take about 4 to 6 hours to produce optimal effect. They could be given orally or through the intravenous route. In severe cases, the latter route of administration is preferred. They act by suppressing the inflammatory response of the airways and this process necessarily takes time. Steroids may need to be continued for up to a week in certain instances. Such short courses of steroids are safe and do not have long-lasting undesirable side effects on the child.

In most acute episodes, ancillary treatment measures are also quite important. If the child is hospitalised, good nursing, attention to good quality nutrition and adequate hydration are essential. The latter is of marked significance as rapid breathing induced by the attack leads to a loss of water from the body via exhaled breath. If it is not possible for the child to drink because of the severity of the episode of asthma, replenishment of the fluid losses should be by the intravenous route. In the case of suspected bacterial infections precipitating the acute attack of asthma, it may be necessary to use antibiotics but it must be stressed that this is perhaps uncommon and the use of antibiotics is certainly not a panacea for all ills in asthma.

Once the acute episode has been brought under control, it is time to assess the need for further long-term treatment. There are several drugs available today which, when used prudently, help to prevent recurrences of asthma. These drugs are therefore known as "preventers". However, these decisions are not to be made lightly as preventive treatment is a protracted form of therapy and needs to be continued for quite some time. There are certain features that suggest that the child may benefit from these forms of treatment. Children with what is known as persistent asthma with some degree of airway narrowing virtually every day, those who get very frequent attacks that interfere with normal life, children with acquired chest deformities as a result of asthma, those with marked exercise induced asthma, those who have growth retardation as a result of asthma, those who have significant disturbance of schooling as a result of asthma, those who are prone to get acute severe episodes of asthma and those who suffer from troublesome nocturnal asthma and persistent night cough that interferes with sleep are the ones in whom preventive therapy may be considered. In addition, those who have poor access to medical care, especially at night too, may be considered for primarily social reasons. The rationale for this is that severe attacks at night may cause a lot of problems and perhaps may even cause death.

There are some oral drugs that may be used for preventive therapy but these are effective only in some cases and are not quite useful in severe forms of the disease. However, some of them may be quite useful in combinations with other forms of preventive therapy, especially in severe and difficult to control cases. In today’s context, the "gold standard" for preventive therapy is the use of inhaled corticosteroids. Only very small doses of these steroids need to be used as the drug is delivered directly to the lungs and as such general effects on the rest of the body are not of any significant consequence. In the recommended doses, even long-term treatment with inhaled corticosteroids is safe. The effectiveness of these drugs depends on their anti-inflammatory action as it counteracts the very basic disturbance in childhood asthma which is inflammation of the airways. All preventive medications have to be given even when the child is quite well as they work purely for prevention and most of them are not useful during acute attacks.

There are several different formulations of inhaled corticosteroids and different inhaler devises that could be used in children. There are some dry powder inhalers that could be usefully employed in older children. The child has to inhale the very fine powder into the lungs. However, the most useful form if inhaler in children is the metered dose inhaler or "puffer". When each dose is actuated, a jet of gas containing the effective dose of the drug is ejected. The only problem is that the speed of ejection is very high, around 70 miles per hour and most children, and for that matter, even adults, find it impossible to synchronise their intake of the breath with the actuation of the device to ensure that the drug is inhaled properly. To get over this problem a holding chamber or "spacer" needs to be used. This device is connected to the puffd the child breathes in and out normally at the other end of the spacer after the puffer is actuated and the dose of medicine is put into the spacer. One-way valve systems ensure that the breaths that are put out do not get into the spacer. In the case of children, they need to be trained under direct medical supervision on the proper technique of the use of all these devices. The parents too must observe and learn all necessary details of these forms of treatment. All inhalers have a finite number of doses and it is useful to write down the date of starting a fresh inhaler on the inhaler device label itself so that a new inhaler could be purchased when all the contained doses have been used up. Many parents wait till the inhaler device completely finishes and is no longer able to eject, before purchasing a new one. This is a mistake as, beyond the total number of doses that are specified in the device, there is only the propellant gas that is emitted. The active drug is available only for the total specified number of ejections.

Whatever the device, it is best to rinse the mouth with water and throw out this water each time inhaled steroids are used. This is to ensure that some of the drug that is deposited in the mouth is not swallowed. All spacer devices need cleaning from time to time and there are special ways in which these need to be cleaned. Vigorous rubbing of the inside of the spacers should be avoided as this interferes with the normal working of the device. Proper advice regarding the use of all inhaler devices should be given by the prescribing doctor and time taken to explain the different aspects of inhalation therapy is time well spent to guarantee proper utilisation of the drug and ensuring optimal effectiveness of these forms of treatment.

Preventive therapy has to be carried out under medical supervision. These children need regular assessment by the prescribing doctors from time to time. The dosage may be reduced by the doctor once control of the disease has been obtained and the child remains well for a reasonable period of time. The dosages may also need to be increased to deal with special situations and when the disease appears to be getting out of control. These are not drugs that could be continued by the parents without regular medical direction. Haphazard changes in dosage, keeping off doses from time to time and abrupt stoppage of treatment should be scrupulously avoided. It must be remembered that the disease is being kept under control by these drugs and the child may develop an unprotected acute severe attack if the drugs are suddenly withdrawn. There is no truth whatsoever in the commonly held belief that patients tend to get addicted to these inhalers. These drugs are used simply because the asthmatic state is of considerable concern which requires their use and there is no risk of addiction to them.

P.S. Boost your immunity against asthma by eating Vitamin C and Vitamin D rich foods and fruits.

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Smoke a testing time for asthmatics

2009-12-20T08:22:00.000-08:00

THE National Asthma Council Australia is urging people with asthma in bush fire zones, or those planning summer holidays in the country, to ensure they have considered their asthma as part of their total summer survival plan.

“People with asthma are at particular risk from bush fire smoke, especially the very young and older people,” National Asthma Council Australia Director,Associate Professor Peter Wark.

“The best protection, where possible, is avoiding exposure to high levels of smoke and ensuring your asthma is well controlled from day-to-day.

“This means seeing your doctor to make sure you have an appropriate written asthma action plan to help you manage your asthma over summer as well as making sure you regularly take your preventer puffer,” Professor Wark said.

“If you live in a high risk fire zone, you should also ask for a prescription for a second emergency inhaler, which you should have ready to take with you if you evacuate.

“Keep your back-up medication with your most precious papers or photographs to ensure it goes with you if you decide to leave.”

The National Asthma Council Australia also stressed the need to follow the manufacturer’s storage recommendations for medications during the hotter summer months.

“Keeping a back up inhaler in your glove box may seem like a good idea, but the extreme heat may render your medication ineffective, or worse still, some medication canisters could explode under the intense heat conditions that will occur in cars this summer.”

People who live in built up areas also need to plan for days of smoke haze as winds can move bush fire smoke and harmful airborne particles over great distances.

Bushfire smoke contains particles of different sizes, water vapour and gases, including carbon monoxide, carbon dioxide and nitrogen oxides, which can trigger asthma symptoms, such as wheezing, coughing or chest tightness

Larger sized air-borne particles, containing burning debris, contribute to the visible haze when a fire is burning.

They are generally too large to be breathed into the lungs, but they can cause irritation to the lungs, throat and nose.

Finer particles and gases, however, are small enough to be breathed into the lungs.

“This is why we are cautioning people with asthma across Australia to be vigilant about their health as the 2009/10 bushfire season unfolds and Australia heats up.”

P.S. Boost your immunity against asthma by eating Vitamin C and Vitamin D rich foods and fruits.

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Just breathe - Buteyko Method

2009-12-17T08:13:00.000-08:00

"When a person gets short of breath, intuitively the right thing to do seems to be to inhale deeply," says Margalit Noam. "But amazingly, if asthma patients are asked whether a deep breath helped them during an attack, the answer is unequivocally no. This is because people with breathing problems do not suffer from a lack of air, but from too much ventilation. They inhale too much air and the body has a hard time coping with that."

To anyone who's ever witnessed an asthmatic struggling to get air into his lung, this approach sounds contrary to logic. However Noam, a therapist who treats asthma using the Buteyko method, explains, "When you inhale too much, the concentration of carbon dioxide in the body dwindles and not enough oxygen reaches the tissues. Inhaling more air in order to provide more oxygen to the tissues not only does not help, it actually worsens the situation."

Professor Konstantin Buteyko, a Ukrainian doctor, derived this understanding from the findings of the physiologist Christian Bohr in the early 20th century. Bohr found that a decline in carbon dioxide levels in the body reduces the blood's ability to release oxygen to tissues and vice versa. Based on this phenomenon, known as the Bohr effect, Buteyko concluded that while in a state of shortness of breath, the body will benefit more from a reduction in the volume of air that enters the body. In the mid-20th century, Buteyko developed a unique method for treating patients suffering from asthma and other breathing passage problems, and patients of this method learn to slow the pace of their breathing.

Restoring balance

A shortage of oxygen is not the only problem related to over-breathing. "When there is too much air, the acidity level of the body drops [the PH level increases] and the body is not balanced," adds Noam. "In order to restore its acidity level, the body begins to secrete more lactic acid. This does not improve the situation and only causes fatigue. The breathing system enables the balancing of the acidity level in the body much more quickly than the body's other systems."

"For the sake of comparison," he continues, "the metabolism, the digestive system and kidney tract require several hours and sometimes even several days to restore the body's acidity levels to normal levels, whereas the breathing system can do so in minutes. Slowing the pace of breathing and sometimes even a brief halt in breathing reverses the process, and with a normal breathing pace the body returns to its desired acidity levels."

The treatment is sought primarily by asthmatics, but also helps people with allergies, anoxia, snoring, chronic runny noses, stuffed noses and sinusitis. The treatment is also sought by those with a tendency to suffer from anxiety and unease, high blood pressure and migraines. The direct connection between breathing and the improved conditions is explained by the following: after the breathing is relaxed, oxygen is released to the tissues, the blood vessels expand, pressure from them decreases and pain is reduced.

Learning to relax

Noam's patients attend six two-hour sessions, during which they improve their awareness of breathing difficulties, learn to identify situations where they over-breathe and learn how to relax the pace of breathing.

The Buteyko method is one of the most effective ways of treating asthma patients. In studies conducted in Canada and Australia, patients report a substantial reduction in the use of extenders, inhalers and inhalation machines (up to 96 percent after just 12 weeks) and in asthma prevention medications (49 percent). The reduction in the use of inhalers and medications is of greater significance for asthmatics who have become used to living alongside the inhaler and in many cases become anxious if they can't remember where they put it. Noam also reports improvements for those suffering from sleep disturbances such as apnea or snoring.

In Russia, the method is widespread and has been studied for over 50 years. In the West it is also starting to gain institutional recognition. In Australia, medical insurance covers some of the expenses of attending a Buteyko workshop, given the knowledge that it will save on other insurance costs. In England, a family doctor is authorized to recommend the method for treating breathing problems.

Dr. Avner Goren, a pediatrician and allergy, clinical immunology and asthma expert, as well as the director of the Maccabi health maintenance organization branch in Ramat Hasharon, says he frequently recommends the treatment, based on "the research results that indicate a substantial reduction in the use of medications and also because of the fact that I know for certain that they do not interfere in any stage of the patient's drug treatment."

P.S. Boost your asthma immunity by eating Vitamin C and Vitamin D foods and fruits.

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Smart Inhalers Help Fight Asthma

2009-12-08T20:08:00.000-08:00

Developing and deploying smarter wireless medical devices to manage chronic conditions is a high growth area, and with good reason.

According to the CDC, 70 percent of deaths among Americans are due to a chronic illness. One of the keys to controlling chronic disease is adhering to proper medication dosage and schedules. Yet many patients seem to have difficulty following their doctor’s recommendations. We recently came across a couple of smart, connected medical devices designed to help asthma patients be more compliant and achieve better control over their disease – which may in turn help them lead longer lives.

Asthma is a widespread chronic disease that often strikes in childhood, making it a prime area for smarter treatment solutions that help patients to manage their symptoms. One avenue for such devices is to deliver medication through inhalers. Computer controlled inhalers with embedded intelligence can precisely measure the amount of the drug that gets to the patient. Increasingly, doctors are moving from pills to inhalers as a way to administer drugs, but it can be difficult determining how much actually was inhaled into the lungs. This is the challenge that smart inhalers help to solve.

One such smart inhaler system prototype is being developed by Clement Kleinstreuer, a mechanical engineering professor at North Carolina State University in Raleigh, in collaboration with a departmental colleague, Dr. Stefan Seelecke.

According to Kleinstreuer, the inhaler system (pictured left) “modulates the patient’s inhalation waveform and then releases a controlled drug-air stream which targets specific lung sites.” This stream could also be targeted at sites like a tumor or some other predetermined lung area, giving the smart device even wider applicability. Kleinstreuer adds that this “optimal targeting methodology” has been successfully tested in both virtual reality and in the lab, and components of a smart inhaler system prototype are now being built and tested.

“Clearly,” he says, “clinical trials will be necessary to convincingly document the amazing capabilities and wide-range applicability of the invention.”

In the long run, medical devices that use embedded intelligence to deliver precise amounts of medication to patients will help not only asthma patients, but also address other chronic and acute diseases that need targeted and specific medications.

Asthma patients can look for more immediate relief from a smart inhaler that is already available in New Zealand. This device comes from Nexus6, Ltd, a New Zealand company. New Zealand has one of the highest incidences of asthma in the world so it’s not surprising that they are leading the efforts in this area. According to COO Garth Sutherland, “New Zealand has the second-highest per capital incidence of asthma in the world; over a half a million of the 4 million people have the disease. Fortunately, we have a good public health care system so there is a good chance that asthma will be diagnosed and treated.”

Sutherland started the company in order to help chronic asthma patients better manage their own care. The Nexus6 Smartinhaler device (pictured right) helpspatients adhere to the prescribed amount and frequency of medicine. It connects to the patient’s computer via a docking station and the data is uploaded and sent to their email system. The patient can then print a report to provide to their doctor and health care team. A wireless version, which has a cell phone chip imbedded in the device, is currently in clinical trials. Also in trials is a ringtone reminder that is designed with kids in mind. Preventing asthma attacks is important, and keeping to the prescribed routine is crucial in those prevention efforts. “Kids really like the ring tones and it keep them on a schedule.”

The need for smarter management of asthma treatment is certainly not unique to New Zealand. In the United States, it’s estimated that more than 34 million Americans suffer from asthma. Smart inhalers are one example of how connected health technology can help those with chronic illness get the most benefit from prescription drugs and give them tools to better manage their own care.

P.S. boost your asthma immunity by eating Vitamin C and Vitamin D rich foods and fruits.

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Beckham tips for asthma sufferers

2009-12-07T16:44:00.000-08:00

David Beckham hopes the revelation that he has suffered from asthma since he was a boy will help others with the condition.

The England midfielder said he had not tried to hide the fact he had asthma - it became apparent when he was seen using an inhaler after playing for Los Angeles Galaxy in the MLS Cup final in Seattle.

Beckham said: "It's out there now. Sometimes I have good days and bad days. I've never hidden it but it's something I've had for a good few years now."

He added: "I hope it turns into a positive because I've been able to play for many years with the condition. I know there are many other players who have overcome it such as Paul Scholes."

The 34-year-old also dismissed a report that he smokes cigars.

"I've always prided myself on the way I look after myself," he said. "On special occasions, like winning the European Cup, I might have had a puff. But I don't sneak into the garden - I think my boys would kill me if I did."

Beckham is recovering from an ankle injury and had three painkilling injections in Seattle but said it should be mended by the time he joins AC Milan after Christmas.

He added: "In the last few days it has felt a bit better. Bone bruising takes time to go away and obviously the injections I had during the game in Seattle didn't help.

"But it should be fine by the time I get to Milan. There's not much you can do with bone bruising apart from resting it and icing it. I just need a couple of weeks off, which I'm having."

P.S. boost your asthma immunity by eating Vitamin C and Vitamin D rich foods and fruits.

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What is Chronic Obstructive Pulmonary Disease

2009-12-06T10:29:00.000-08:00

COPD (Chronic Obstructive Pulmonary Disease) is a chronic disease of the lung that covers several conditions including Chronic Bronchitis or Emphysema.

Chronic Bronchitis results from an inflammation of the airways of the lung. The term chronic refers to the fact that the condition is present for a long time and bronchitis means inflammation of the bronchi or air passages of the lung. You can find the anatomy of the lung on any well-researched website, but I will give a brief summary here.

The air passages begin with the trachea in the neck which branches into the left and right main stem bronchi. These bronchi continue to branch into smaller bronchi or bronchioles until they end up in the microscopic air sacs or alveoli. It is the alveoli that oxygen and carbon dioxide are exchanged with a rich network of small blood vessels or capillaries. The bronchioles and bronchi are responsible for delivering the oxygen to the alveoli and for carrying the carbon dioxide from the alveoli to the outside. These air passages are more than just tubes — the linings are composed of cells and structures that serve many functions for lubricating the airways and removing debris from the airways. These cells can be damaged by infections or toxins like inhaled poisons or smoking. When these cells are irritated by various stimuli, they form mucus which can plug up the airways and make air movement difficult. In addition, the airways have muscles in the walls and these muscles will contract or dilate the airway depending on what kind of pressure is placed on them.

When we breathe in, our diaphragmas act like an accordion and pull air into the airways. When we breathe out, we squeeze our chests and the airways by pushing our diaphragms up to force the air out. This pressure to force the air out causes the bronchi to become narrow and slows down the speed of the air escaping from the lungs. If the airways are already partially blocked by mucus, or if the muscles are contracting due to irritation, the air cannot escape from the lungs as well, and we feel short of breath or you will hear a wheezing sound as the air tries to escape through narrow tubes.

Emphysema, on the other hand is a disease of the alveoli or air sacs, where the lining of the sacs become destroyed by specific enzymes or infections, and the small air sacs become larger and larger as the walls or membranes between them become destroyed. They tend to lose their elasticity and are unable to squeeze the air out of them as effectively. In addition, the walls or membranes contain the capillaries or small blood vessels that carry the oxygen to the tissues and remove the carbon dioxide from the tissues, so air exchange becomes compromised and we feel short of breath, because not enough oxygen is being delivered to our tissues. In severe cases we can actually see our fingernails turn blue from lack of sufficient oxygen. When there is not enough oxygen in the blood, the blood becomes dark or blue, like in our veins. When there is enough oxygen in the blood the blood becomes a bright red, like in the arteries.

Chronic Obstructive Pulmonary Disease or COPD is a combination of Chronic Bronchitis and Emphysema. The treatment is therefore three fold.

* Remove the toxins from the lungs. This is done by avoiding irritants like smoke, perfumes, dust, or allergens from the environment. In addition, direct toxins like cigarette, cigar or pipe tobacco smoke should be immediately discontinued.

* Treat the constriction of the airways with medicines that can open up the airways. These are called bronchodilators and are usually in inhalers or nebulizers, but can also be in cough medicine, or pills.

* Treat the inflammation of the airways with inhaled anti-inflammatory medications, or by pills or injections. These medications are derivatives of cortisone. Frequently in severe episodes you will be treated with doses of Prednisone tablets for short period of time, or injections of cortisone.

The treatment of COPD is therefore a combination of bronchodilators and cortisone as well as discontinuing smoking, treating any infections and avoiding an environment of smoke.

The prognosis varies depending on the severity of the condition, and this can be determined by doing pulmonary function tests to see how well you can breathe. A simple test that can be done in the office is the PEFR (Peak Expiratory Flow Rate). This is a simple flow meter that patients with COPD can obtain from the pharmacy to test the amount of airway restriction that is present. A more detailed test can be done by a pulmonary specialist, which we do have here in Nassau.

If caught early enough, like any other disease, the prognosis is excellent. I have seen patients with severe COPD who require oxygen all the time, still smoke even with the oxygen being administered. Those are extreme cases but, as you can see, the prognosis can vary widely depending on the severity of the disease and the compliance of the patient with prescribed treatment.

P.S. boost your asthma immunity by eating Vitamin C and Vitamin D rich foods and fruits.

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H1N1, asthma can be a dire combination in children

2009-12-05T11:24:00.000-08:00

The day before Halloween, T.J. Berndsen had what his parents believed was a little asthma flare-up. By Halloween night, he felt lousy enough to cut trick-or-treating short.

A week later, the 9-year-old was straining to breathe in the emergency room at Cincinnati Children's Hospital Medical Center because of complications from an H1N1 influenza infection.

"By Sunday, Nov. 8, his cough turned into a croupy bark, and he started running a fever. It got to 102.9. I knew it had gotten to be more than we could handle at home," says his mother, Jennifer Berndsen. She had suspected flu but wasn't sure. His school had had significant numbers of children out, but his classroom hadn't seemed to be hit hard, she says.

While H1N1's effects in a healthy child can range anywhere from mild congestion and sore throat to serious respiratory illness, and even death, the 7 million American kids who have asthma are at a higher risk for complications and death if they contract the novel flu virus, says Tom Skinner of the Centers for Disease Control and Prevention.

"We're seeing underlying health problems, including asthma, in about two-thirds of the estimated 540 children who have died from H1N1 complications," he says.

But the CDC and pediatric asthma experts say there are steps you can take to prevent H1N1, or swine flu, as well as seasonal flu, and ways to treat it if an infection does occur.

Prevention is best

"In children with asthma, the key issue is anticipation rather than reacting," says Erwin Gelfand, chair of pediatrics at National Jewish Health in Denver, a hospital that specializes in treating children with respiratory conditions.

Gelfand says a parent can ensure two things: vaccination and making sure a child's asthma is in control.

The advice goes even for children who get asthma only intermittently, says Tyra Bryant-Stephens, medical director of the Community Asthma Prevention Program at Children's Hospital of Philadelphia.

"Children who only get asthma during exercise, with a cold, or during allergy season can also have serious complications from flu," Bryant-Stephens says.

T.J.'s parents gave him what asthma experts call "maintenance medications" every day: an oral Zyrtec (cetirizine) for allergies and the inhaled corticosteroid Flovent (fluticasone), which reduces inflammation in the lungs. They knew he needed the H1N1 vaccine, says T.J.'s mom, but it hadn't become available in their area yet.

Unlike T.J., many asthmatic children do not take medications as prescribed, sometimes because of cost or parental concerns about side effects, Gelfand says.

"I'd say to any parent, this is not a time to relax compliance. The drugs we have for asthma are as a rule not effective if taken on an intermittent basis, except in possibly the mildest of cases," Gelfand says.

As for vaccines, the CDC recommends that children with breathing issues get the shot form of the vaccine – two doses spread out by a month in those under age 9 – instead of the nasal mist.

If a child does get flulike symptoms, there are steps caregivers should take, says Carolyn Kercsmar, director of the Asthma Center at Cincinnati Children's.

She says if a child develops a fever, is feeling poorly, has chest pain, a bad cough or extreme fatigue, see a doctor right away.

Rough night, quick comeback

T.J.'s parents took the correct steps, Kercsmar says. After additional home albuterol treatments didn't budge his symptoms, they scooted fast to the pediatrician, who sent him on to the ER. There, Jennifer Berndsen says, "they did three back-to-back albuterol treatments – continuous for about an hour. He was so sick by then, poor thing."

He then received a cornucopia of drugs: Motrin to help reduce fever, antibiotics for atypical pneumonia that a chest X-ray revealed, and an intravenous line of magnesium sulfate to help further open up his airways. They dosed him with the steroid prednisone to simmer down inflammation, and he received pure oxygen through a nose mask, Berndsen says.

After he was moved to a room well after midnight and an H1N1 swab came up positive, he was given Tamiflu (oseltamivir).

"These are the children who can benefit from starting Tamiflu right away. It can turn a very nasty disease into one that's tolerable," says Kercsmar, who adds that it works best started within 48 hours, but even within 72 hours can help.

Berndsen reports that though her son's night in the hospital was rough, the turnaround was fast.

"By noon the next day, Tuesday, Nov. 10, T.J. was feeling well enough to eat a chili dog and a pretzel with cheese," she says. He went home that night.

P.S. Boost your immune system by eating Vitamin C and Vitamin D rich foods and fruits.

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Users Complain About New Asthma Inhalers

2009-12-04T12:10:00.000-08:00

A year ago the government ordered a big change in asthma inhalers.

The propellant used to force the medication out of the inhaler was changed to a more environmentally safe chemical.

The old albuterol inhalers used chlorofluorocarbon (CFC), but it’s believed the CFC damages the ozone.

As of the first of the year, CFC inhalers were banned and hydroflouroalkane (HFA) was used as a propellant instead.

While the HFA may be better for the environment, some patients and doctors say the inhalers may be dangerous for patients.

Katie Mitchell of Pittsburgh suffers from severe asthma.

She described what an asthma attack feels like. “My chest gets tight, feels like an elephant on my chest, then your airways constrict and you kind of gasp for air.”

Mitchell, a junior at Slippery Rock University, relies on an albuterol inhaler to control her symptoms. Like all asthma patients, her inhaler now contains the environmentally friendly propellant HFA.

She said the new inhaler put her in a life-and-death situation.

“I went to use it and nothing came out and I started panicking because I didn't know what to do. I was shaking it and I had to prime the inhaler six times before I could actually use it, which is dangerous for someone with asthma,” Mitchell said.

Mitchell isn’t the only asthma sufferer who has had problems with the new inhalers.

The FDA told Channel 11 it has gotten many similar complaints about the new inhalers.

Dr. David Skoner, an asthma and allergy specialist at Allegheny General Hospital, said he’s also had patients complain about the inhalers.

Skoner said, “These have a tendency to plug up the little holes where the drug comes out. That can cause a life hyphen threatening situation.”

The medication is stickier, so it can clog the hole it comes out of and can reduce the amount of medication delivered.

Many patients don’t realize they must now take the inhaler apart and clean it at least once a week, which they didn’t have to do with the old inhalers.

Mitchell now cleans her inhaler after every use to make sure it will work the next time she needs it.

“If you're having an asthma attack and you use your inhaler and it's clogged, you can't go over to the sink and wash it out,” Mitchell said.

Skoner said the drug manufacturers recommend taking the inhaler mouthpiece apart and running warm water through it for 30 seconds. Then flip it over and run warm water through the other end for another 30 seconds. Then shake it off and let it air dry overnight before putting it back together.

Clogging isn’t the only complaint the FDA is getting.

The old propellant pushed the medication out with a lot of force, but the new propellant sends the medication out in a gentle plume.

Because it feels and tastes different, many of Skoner’s patients don't think it's working.

“The taste and feel are very different. The CFC felt cold in the back of the throat. This one doesn’t. They knew what the old one felt like . When they use the new one, they don’t feel that, so they don’t feel they are getting the drug and may take more puffs of it,” Skoner said.

Skoner and the FDA said tests show the new propellant still delivers the right amount of medication.

Another drawback of the new inhalers is the cost. The new inhalers are two to three times the price of the old generic inhalers.

P.S. prevent asthma attacks by eating Vitamin C and Vitamin D rich foods and fruits.

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Asthma drug developer raises $17 million

2009-12-03T11:07:00.000-08:00

Last week asthma drug developer Altair Therapeutics raised $17 million in a Series A funding round that was led by Domain Associates and capped a two-year startup financing period.

Other investors in the round include AgeChem Venture Fund, Thomas McNerney & Partners, Forward Ventures and Isis Pharmaceuticals.

San Diego-based Altair held its first close of $4 million in February, and it then raised the total to $11 million in August, according to Thomson Reuters. Previously, in late 2007, the company raised $6 million from Forward Ventures, Thomas McNerney & Partners, and an undisclosed investor, according to Thomson Reuters. CEO Joel Martin, formerly a partner at Forward Ventures, which helped seed the company, joined the startup in May.

Martin said the company is looking to open another fundraising round next year and added the current round will be used to fund phase II(a) trials for its asthma inhaler product, AIR645. Once it acquires the data from those trials, said Martin, it will go into phase II(b). Altair's goal is to prevent asthma attacks by targeting two different inflammatory pathways in the lungs.

Martin said the experimental data and the need in the market compelled him to join the company. About 16.4 million adults and 7 million children nationwide suffer from asthma, according to the Centers for Disease Control and Prevention.

Products that treat asthma produce about $7 billion annually in sales, Martin said. Most of the sales, or about $4 billion, come from small mid-sized drug companies instead of industry giants, he said.

P.S. prevent asthma attacks by eating Vitamin C and Vitamin D rich foods and fruits.

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Dr. Andy: Used correctly, inhaler effective

2009-12-02T11:00:00.000-08:00

The metered dose inhaler, also known as the pump inhaler, has been the main treatment for lung problems such as asthma since it was first sold in the 1950s. For most it is a convenient and cost-effective way to get medications such as Albuterol into the lungs. Earlier this year a major change in these devices occurred, a change which several of my patients are convinced has made their inhalers less effective.

In the past, the propellant in inhalers was a chlorofluorocarbon (CFC) such as freon. However, as freon has disappeared from our air conditioners, so it did from pump inhalers. In fact CFCs have been banned internationally. Today, the inhaler propellant is a hydrofluoroalkanes (HFA).

In the older CFC inhalers, up to 80 percent of the aerosol one breathed in from the inhaler was the propellant. The CFC also caused the cold sensation that many patients associate with their old inhaler medications. The newer HFA inhalers don't have the same cold sensation, and also do not propel the medication at as high a speed. This results in more medicine actually being delivered into the lungs.

Discussions of pump inhalers would also not be complete without mentioning spacers, or holding chambers. These are usually plastic tubes with the inhaler plugged into one end, and the other end in the patient's mouth. Using a spacer dramatically increases the effectiveness of pump inhaler medications.

Using a spacer with a pump inhaler has been shown in repeat studies to help kids with asthma improve faster than when treated with an inhaler without a spacer attached. There is also no need to coordinate the inhalation with the pumping of the inhaler.

The spacer allows more medication to get to the lungs by allowing it to slow down in the chamber, and may reduce some common complications with inhaled steroids, such as oral thrush. For younger children, a mask can even be fitted to the mouth end of the chamber.

Be sure to clean your spacer chamber prior to using it with a mild dishwashing detergent, and repeat that cleaning process occasionally. This will reduce the electrostatic charge that can build up on the plastic, which attracts the medication particles, reducing the amount available for inhaling into the lungs.

In regard to nebulizer machines vs. the pump inhalers with a spacing chamber, numerous repeat studies have shown that a correctly used pump inhaler with a spacing chamber is as effective, if not more effective, than a nebulizer treatment. The significantly lower cost of inhaler medication, ease of portability and lack of reliance upon electrical equipment are just added benefits of inhalers over nebulizer machines.

So if you, or your child, use an inhaled medicine, be sure to talk with your doctor to verify you are using it correctly. Don't be afraid to ask questions, and remember - we work for you.

P.S. prevent asthma attacks by eating Vitamin C and Vitamin D rich foods and fruits.

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Medco study finds doctors overprescribe inhalers for acute asthma attack sufferers

2009-11-30T00:56:00.000-08:00

EDITOR'S NOTE: In Monday's original headline, Drug Store News indicated that pharmacists were overprescribing inhalers, when it should have said that doctors or physicians were overprescribing such medication. Pharmacists cannot prescribe medication, only dispense it.

Pharmacists pushing physicians not to write prescriptions for excessive quantities of inhalers used to treat acute asthma attacks can help reduce overprescription of the inhalers without compromising patient safety while saving money, according to a study.

Pharmacy benefit manager Medco Health Solutions presented a study at the annual meeting of the American College of Allergy, Asthma and Immunology last week showing that when physicians receive educational materials and follow-up communications outreach, and have to give a response before the pharmacist can dispense a prescription, the number of new prescriptions for excessive quantities of rescue inhalers – defined as more than one inhaler per month – decreased by 60%.

Rescue inhalers, also known as short-acting beta2 agonists, are meant for patients experiencing acute asthma attacks, though many physicians will prescribe them for daily, long-term use. While wasting medicine, this also can have dangerous implications for patient health by masking exacerbations of the disease and causing more serious problems down the road.

The Medco study, conducted between July 2007 and June 2008 on 250,000 patients, found that as a result of the intervention, 200,000 fewer inhalers were used, saving $4.2 million.

“Excessive use of rescue inhalers wastes medicine, but even more importantly, it can be masking an asthma exacerbation,” study researcher Luis Salmun stated. “Rather than over-relying on rescue inhalers, patients should speak to their physicians to make sure that they’re using their daily asthma medications properly or to determine if an adjustment in those medications is needed.”

The researchers also looked at pharmacy and medical claims for a 1,835-patient subset of the study population. During the 12 months following the intervention, 67% of the patients no longer were prescribed excessive quantities of rescue inhalers, while the number of hospitalizations and emergency room visits stayed the same.

P.S. reduce your asthma sufferings by eating lots of Vitamin C and Vitamin D rich Foods and Fruits.

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Child asthma, mother's depression linked

2009-11-21T23:23:00.000-08:00

Maternal depression may aggravate a child's asthma but how often a child had symptoms did not seem to affect the mother's symptoms, U.S. researchers said.

Researchers at Johns Hopkins Children's Center in Baltimore analyzed data from interviews with 262 mothers of African-American children with asthma -- a population disproportionately affected by the inflammatory airway disorder.

The study, in the Journal of Pediatric Psychology, found children whose mothers had more depressive symptoms had more frequent asthma symptoms during the six-month study. Conversely, children whose mothers reported fewer depressive symptoms had less frequent asthma symptoms.

Senior investigator Kristin Riekert, a pediatric psychologist and co-director of the Johns Hopkins Adherence Research Center, and colleagues tracked ups and downs in maternal depression as related to the frequency of symptoms among children.

"Even though our research was not set up to measure just how much a mom's depression increased the frequency of her child's symptoms, a clear pattern emerged in which the latter followed the earlier," Riekert said in a statement.

"Intuitively, it may seem that we're dealing with a chicken-egg situation, but our study suggests otherwise. The fact that mom's depression was not affected by how often her child had symptoms really caught us off guard, but it also suggested which factor comes first."

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How to Use Your Albuterol in Asthma Treatment

2009-11-14T15:36:00.000-08:00

Albuterol, also commonly called salbutamol, is one of the most common medications that you would be given if you have asthma. Albuterol is a bronchodilator, and as such its main purpose is to relax the muscles in your airways to allow more air to pass through. It is one of the most effective weapons against asthma attacks and is important to have with you at all times. Call your doctor or get one from the nearest pharmacy if you think that you are running out. Having two inhalers just in case one gets lost is also a good idea. If you feel that you medication is not working as is used to, or if you are reacting negatively to the medication, inform your doctor right away.

Knowing the proper procedures when taking your inhaler can prove crucial and even life-saving. Here’s the list of the things that you need to take note of when using your Albuterol inhaler:

Make sure the inhaler canister is properly inserted. If you encounter difficulties inserting the canister refer to the manufacturer leaflets or diagrams that can be found either on the packaging or inside the box of medicine.

Shake the inhaler for about ten seconds and actuate the device at least once to test. Shaking ensures effectiveness of the medication while test spraying can help get rid of any foreign object that may be in the nozzle.

When having an asthma attack, lying down makes you feel worse. So to avoid rendering your inhaler useless, use it while sitting in an upright position. Using the inhaler while sitting or standing increases the rate at which the medicine can reach your lungs.

Place in inhaler about an inch away from your mouth, if you are having difficulty estimating you can also use a spacer to help you out. Remember to forcefully inhale every time you puff. Inhaling forcefully will ensure that the medicine goes directly into your lungs and not end up at the back of your throat or just circulate inside your mouth.

After inhaling the medication, hold your breath for five to ten seconds. This allows the medication to travel further into the air passages. If you need additional puffs, wait about thirty seconds before doing so again.

Replace the cap after use. Rinse your mouth with water to clear any residue of the medicine.

Depending on your asthma severity and advice taken from your doctor, you may be required to take more puffs. It is important that you adhere strictly to the instructions given to you. Bronchodilators can have side effects. Not using them to be as efficient as they should leads you to use them for a longer term. Your albuterol treatment effectivity is directly proportional to how well you use it.

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ULTRA PRONEB PARI NEBULIZER II NEW!!! SYSTEM

2009-11-12T17:46:00.000-08:00

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2009-11-11T11:40:00.000-08:00

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An Exercise in Better Breathing

2009-11-10T11:20:00.000-08:00

Life was active and healthy in early 2005 for Terri Lange, then 54. A successful massage therapist in Atlanta, she was practicing yoga, calisthenics and strength training to keep off the 60 pounds that had crept on her body in her 40s during the beginning stages of menopause.

Lange's health deteriorated in the summer of that year, however. A sinus infection quickly evolved into bronchitis, then into pneumonia and a diagnosis of residual asthma. The lung inflammation lingered, and a year later, she was diagnosed with exercise-induced asthma—coughing or shortness of breath that gets worse with activity.

Day-to-day tasks became a challenge as she labored to breathe. She couldn't walk up or down stairs without stopping to catch her breath and avoided putting the top down on her convertible for fear that the air pollution would make her wheeze.

Lange's exercise routine dropped off, too. "I worked as an allergy nurse for many years so I was very familiar with asthma," says Lange, who is also a registered nurse. "The asthma left me wheezing, short of breath and fatigued. It became more of a struggle to work out."

Luckily, as Lange learned, a diagnosis of exercise-induced asthma doesn't require cutting out exercise altogether—if you take precautions.

"I recommend that patients use an inhaler about 15 minutes prior to exercising," says Dr. Anthony Petracca, of Glens Falls, N.Y. It's also a good idea to warm up and cool down for about 15 minutes before and after your workout. And opt for low-intensity activities such as walking, yoga and swimming. (The warm, humid conditions in most pools are lung-friendly.)

Lange can attest to the benefits of such precautions. A few years after decreasing the intensity of her workouts, her lungs are stronger and she has stopped taking medication for her exercise-induced asthma.

"It was a challenge to find the right amount of exercise that would strengthen me but not wear me out. Yoga, plus the deep belly-breathing I do each day, have been critical in helping me build my lung capacity," says Lange, who also does 20-minute workouts on the elliptical machine and lifts free weights three days a week.

Lange keeps a positive outlook about her residual asthma, although she still takes medication to manage it. "Asthma can be a challenge, but I don't see it as a disease," she says.

Instead, she tries to control her environment as much as possible—shunning scented candles or harsh household chemicals, avoiding cats, using an air purifier in her bedroom, and eliminating dairy and gluten from her diet.

"When I don't eat inflammatory foods, my body feels stronger," she explains. "Nutrition is a powerful aid to controlling my asthma. I eat several servings a day of fruits and vegetables and make my own veggie juice drink for an afternoon snack. I keep well hydrated with water.

"I want people with asthma to know there are many tools for a better life, from nutrition and exercise to getting quality sleep. There are so many ways to help yourself."

P.S. Boost your health by eating lots of Vitamin C and Vitamin D rich foods and fruits.

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Sufferer finds relief with steroid puffer

2009-11-09T09:42:00.000-08:00

Until a new job in a new climate brought Stacey Fell to Dubai in 2005, the Briton thought little about her asthma.

There was the occasional bout of breathlessness during the summer in the UK, when her hay fever flared up. But in the UAE, her respiratory ailment was worse than ever.

Ms Fell, 29, saw several doctors after a persistent cough developed. She had chest X-rays as well as tests for allergies.

Eventually, she learnt that her asthma was aggravated by the local humidity, smoke, dust and air-conditioning.

“I noticed it was progressively getting worse,” said Ms Fell, who works in a bank. “There was a tightness in the chest and a feeling of compression.”

Diagnosed when she was 13, Ms Fell is among roughly 900,000 asthmatics living in the UAE.

About 15 per cent of the population here is believed to have the condition one of the highest rates in the world.

The World Health Organisation has warned that the prevalence of the lung disease is increasing worldwide by 50 per cent every decade, mainly affecting children.

It now afflicts 300 million people and may worsen due to pollution and climate change.

Asthmatics in the UAE may suffer more than in other countries, according to specialists, who say the humid climate and construction dust aggravate symptoms.

“I have a lot of my patients who are absolutely fine when they’re outside the UAE,” said Dr Bassam Mahboub, a pulmonologist and member of the Emirates Respiratory Society. “Once they come here, they start coughing and get the symptoms.”

Another respiratory specialist in the capital, Dr Zouhair Harb, said asthmatics now dominate his practice, accounting for “65 to 75 per cent” of his patients. For general practitioners in the US, the figure is about 20 per cent.

Ms Fell’s condition deteriorated so much that she sought out a chest specialist last week.

Previously, Ms Fell relied only on a Ventolin “rescue” inhaler during an asthma attack. Her doctor later prescribed a Symbicort inhaler that includes a dose of steroids to reduce inflammation in her airways, preventing symptoms.

“Now the routine I’m on at the moment, in the morning I’ll take two puffs of Symbicort, at lunchtime I’ll take two puffs of the Ventolin, and in the evening I take two puffs again of Symbicort.”

The inhaled steroids have made a difference for Ms Fell, but a recent study showed that only 5.5 per cent of asthmatics in the UAE used preventive therapies.

Dr Mahboub, who helped author the study, advised asthmatics to follow Ms Fell’s lead. “We need all asthmatics to be on controlled medications,” he said.

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Asthmatics shun prevention

2009-11-07T09:38:00.000-08:00

Asthmatics are endangering their lives and draining the health system of millions of dirhams annually by over-relying on “rescue” medications instead of preventive treatments, according to the region’s largest study of the disease.

The Asthma Insights and Reality in the Gulf and the Near East study found that only 5.5 per cent of the 200 asthmatics surveyed across the Emirates used preventive treatments such as inhaled steroids.

That figure is “shockingly low”, according to Dr Zouhair Harb, a lung specialist working in Abu Dhabi.

The report, released last month, interviewed 1,000 asthmatics in the UAE, Jordan, Kuwait, Lebanon and Oman between January 2007 and March 2008.

The study showed that more than 31 per cent of asthma sufferers surveyed had been hospitalised or sent to emergency rooms during the period, although most of the admissions had been preventable. Another 48 per cent fell back on emergency bronchodilators to bail themselves out of asthma attacks.

It concluded: “[Regional] asthma morbidity is high, with an unacceptably high reliance on the use of emergency or rescue care.”

Ignorance about the respiratory disorder, which constricts the airways, “places a great burden on the healthcare system and society as a whole, with substantial loss of time from work and school”, it added.

Patient denial is also to blame, the researchers said.

Dr Bassam Mahboub, who led the UAE surveys at the University of Sharjah, said most asthma-related fatalities occurred because patients “don’t perceive themselves as having a disease, so they stop medication”.

He is now studying the economic impact that poorly managed asthma has on the health sector, which he estimates to be in the “hundreds of millions” of dirhams.

“We actually need a majority of our asthmatic patients to be on the controlled medications,” said Dr Mahboub, a member of the Emirates Respiratory Society. “So 5.5 per cent is way too low.”

The findings are particularly grim given that the UAE has one of the highest rates of asthma in the world; doctors estimate that 15 per cent of the population suffers from the condition.

The European average is about seven per cent, based on 2004 figures from the Global Initiative for Asthma.

And in 2005, the prevalence of asthma in the US was just under eight per cent, according to the American Academy of Allergy, Asthma and Immunology.

“But it’s especially hard [in the UAE], where you have a lot of dust and dependence on airconditioning,” said Dr Harb, of the Advanced Cure Diagnostic Centre in Al Bateen. “That’s a lot of wear and tear on the airways.”

The Lebanese-American lung specialist was dismayed by the study’s finding that fewer asthmatics in the UAE than in any of the countries surveyed were proactively treating their illness.

“In a perfect world, I would be expecting 100 per cent of asthmatics [to use preventive inhalers],” he said. “Really 5.5 per cent in the UAE is quite low. Shockingly low.”

Dr Harb estimated that 30 to 50 per cent of asthmatics in the most developed countries use the recommended steroid therapies.

According to the report, nearly 30 per cent of Lebanese patients use preventive inhalers. Roughly 19 per cent of Kuwaitis are also on controlled treatments.

Quick-relief medications such as bronchodilator puffers reopen clogged airways during bouts of breathlessness. But daily steroid therapy prevents the attacks from happening in the first place.

“[The patients] have a choice between two medicines,” Dr Harb said. “A rescue medication will work within five minutes and the maintenance one will work maybe over a week. They’re going for the quick gratification, the immediate remedy, which isn’t the right remedy.”

Overusing the emergency devices can stress the lungs and cause long-term problems.

Fixed doses of preventive steroids control inflammation in the lungs, said Dr Asif Sattar, a pulmonologist at City Hospital in Dubai.

“It seems people in Dubai tend to use emergency departments more and tend not to follow up with their physicians regularly,” he said. “Well-controlled asthmatics shouldn’t need to use their reliever at all.”

Dr Sattar said patients might dismiss preventive treatments because they might not realise they have a chronic disease.

There may also be negative connotations associated with the idea of taking steroids, although the inhaled steroids are safe, he said.

Dr Ashraf al Zaabi, the head of the respiratory division at Zayed Military Hospital, hoped the study would better inform physicians and patients about the importance of preventive therapies.

“This low compliance with the controlled medication is not surprising,” he said. “But there are explanations.”

For one, he said “especially younger patients tend to get fed up with taking medicines” over a long period of time.

Dr al Zaabi also noted that half of the UAE respondents in the study were Emiratis, while the remainder were mostly other Arabs and South Asians.

“A lot of those guys can’t afford the Dh200 or Dh300 medications, so that might explain the low percentage, with those non-nationals perhaps not having health insurance.”

Unlike in the UK, many asthma medications in the UAE can be purchased over the counter. In some cases, patients who self-medicate might buy only rescue puffers.

“We know that asthmatics tend to have poor perception of the control over their condition, so patients sometimes delay seeking medical advice until they are really bad,” he said.

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CHEST: Lower Doses Benefit Pediatric Asthma Patients

2009-11-06T11:57:00.000-08:00

In children who are hospitalized with asthma, a reduced-dose steroid regimen has no effect on hospital stays, and low-dose albuterol treatment is associated with a lower risk of metabolic acidosis than high-dose treatment, according to research presented at the 75th annual international scientific assembly of the American College of Chest Physicians, held from Oct. 31 to Nov. 5 in San Diego.

In one study, Courtney Edwards, of Kosair Children's Hospital in Louisville, Ky., and colleagues compared outcomes in children who were hospitalized with status asthmaticus, 152 of whom received a maximum steroid dose of 240 mg/day and 141 of whom received a maximum dose of 60 mg/day. No difference was found in the median length of stay between the high-dose and low-dose groups (2.01 versus 1.98 days).

In a second study, Muhammad A. Rishi, M.D., of the Yale School of Medicine in Bridgeport, Conn., and colleagues studied 201 children admitted to the pediatric intensive care unit with a diagnosis of severe acute asthma. Compared to low-dose albuterol treatment, they found that high-dose treatment was associated with increased heart and respiratory rates and a significantly higher rate of metabolic acidosis (43.3 versus 8.3 percent).

"We conclude that lower dose inhaled corticosteroids may be helpful in most children admitted with status asthmaticus," Edwards and colleagues conclude. "Further prospective studies are needed to confirm our findings."

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Asthma remains a chronic ailment affecting children

2009-11-05T09:50:00.000-08:00

The impact of childhood asthma on the health care system is considerable. As one of the most chronic ailments among children, asthma is a frequent cause of emergency room visits and hospitals admissions.

Chronic asthma is one of the most common long-term children’s diseases. Statistics indicate that approximately one to two percent of all children will develop chronic asthma during their childhood, while 15 to 20 percent of all children will show signs of wheezing, despite not having chronic asthma.

Saudi Gazette spoke to Dr. Mohammed Barzanji, a pediatrician and allergy specialist at Dr. Soliman Fakeeh hospital who said: “There are many factors why children become asthmatic, including exposure to cigarette or pipe smoke, pollution, dust and exercise or exertion.” He pointed out that exercise should still be encouraged, with asthmatic symptoms being treated by medication.

The real problem lies with the fact that many parents have a lack of knowledge of asthma symptoms. Dr. Wid Kattan from the King Abdulaziz University described asthma as “bronchial asthma that is related to airway hypersensitivity, which causes reversible obstruction of the airways.” This means that an individual with bronchial asthma is oversensitive to things in the environment like dust; this causes an immune reaction, leading the airways in the lungs to narrow, constricting air flow.

“The most characteristic symptom is wheezing in which whistling and coughing sounds are heard as the child breathes, particularly while exhaling,” explained Dr. Kattan.

The most important thing in the management of asthma is a prevention of the factors that can cause attacks - such as inhalation of dust and pollen and severe exercise - though these vary from child to child.

A mother of two asthmatic children in Jeddah, Basma Hassan Mohammed, shared her experience with Saudi Gazette. “My eldest son developed asthma when he was a year old and I wasn’t aware of the symptoms until a doctor told me that he will get these attacks frequently,” she said. “Each time he used to get this attack, he was hospitalized for at least three days until I learned to use the inhaler correctly and at the necessary time.”

Dr, Kattan added that the correct use of medication will prevent children from getting more of such attacks. The most common medication is, of course, the steroid inhaler, but he pointed out that most parents are fearful of administering it to their children on a regular basis. “I must point out that every child is different though, so some children who experience very mild symptoms only require occasional medication,” he remarked. It is therefore, necessary to consult with the doctor on a regular basis.

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CAFFEINE CAN REDUCE ASTHMA SYMPTOMS

2009-11-03T09:29:00.000-08:00

A study presented at a conference at the American College of Sports Medicine found that those who ingested caffeine within an hour of exercise reduced their symptoms of exercise-induced asthma (EIA), which is characterised as a shortness of breath during sustained aerobic activity.

The randomised, double-blind, double-dummy crossover study was led by University of Utah researcher Timothy A. VanHaitsma and fellow researchers at Indiana University and involved ten asthmatic people who had also had EIA. Each took either three, six, or nine milligrams of caffeine per kilogram of body weight or a placebo, an hour before exercising on a treadmill. Tests of pulmonary function were taken 15 minutes before exercise commenced, then again 1, 5, 10, 15 and 30 minutes after the exercise stopped.

At nine milligrams of caffeine per kilogram of body weight, considered a large dose, the effects were comparable to using an albuterol inhaler, something commonly used to prevent or treat EIA. This would be the equivalent of about six cups of coffee. Smaller amounts of caffeine, such as three and 6 milligrams per kilogram of body weight, were also found to be useful, reducing coughing, wheezing and other EIA symptoms.

All participants received all doses, including the placebo, at one point or another during the experiment.

Associate professor in the Department of Kinesiology and a co-investigator of the study, Timothy Mickleborough, said that no additional benefit was found when caffeine was combined with an albuterol inhaler.

For someone who weighs 150 pounds, for example, 3 to 9 milligrams of caffeine per kilogram of body weight equals from about 205 to 610 milligrams of caffeine. This study adds to earlier work that found caffeine can reduce the symptoms of EIA and is the first to examine any synergistic effect of caffeine use along with an albuterol inhaler.

Mickleborough and his fellow researchers have also investigated the efficacy of a number of nutritional factors on EIA, with research to date showing that a diet high in fish oil and antioxidants and low in salt has the potential to reduce the severity of EIA and perhaps reduce the reliance on pharmacotherapy. With growing concern about the potential side effects of inhaled corticosteroid use, this is especially important. Also, prolonged usage of daily medications can result in their reduced effectiveness.

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Pediatric Asthma Registry Provides Research Milestone

2009-11-02T08:41:00.000-08:00

RemedyMD’s solution addresses Institute of Medicine’s top 100 priorities and shifts focus towards research based on more comprehensive scientific evidence

RemedyMD (www.RemedyMD.com), the leading provider of disease registry software, today announced the first nationwide pediatric Asthma registry to help clinicians and researchers identify which interventions are most appropriate for specific patient populations.

Details about the registry: www.remedymd.com/cer100/asthma.html

Aligned with the Institute of Medicine’s Top 100 Priorities for Comparative Effectiveness Research (CER), RemedyMD’s asthma registry tracks the effectiveness of an integrated approach combining:

1.Counseling
2.Environmental mitigation
3.Chronic disease management
4.and legal assistance

with a non-integrated episodic care model in managing asthma in children. The registry includes all of the applications, data infrastructure, and tools that clinicians and researchers need to gather, synthesize and analyze both phenotypic and genotypic data simultaneously.

“Our experience has shown when researchers view and report across all data types at the same time, they discover patterns and associations that are indistinguishable using traditional methodologies” said Gary D. Kennedy, Founder and CEO of RemedyMD.

RemedyMD’s new pediatric asthma registry includes a comprehensive set of electronic data collection (EDC) forms that are specific to pediatric asthma research, ad hoc reporting capability, and pattern recognition tools that assist users in identifying the most effective treatment options.

In support of this initiative RemedyMD is seeking additional partners who have existing data that addresses the specific needs of pediatric asthma researchers. All institutions involved in comparative effectiveness research that are planning on submitting grant proposals for AHRQ funding are invited to visit: www.remedymd.com/cer100/asthma

RemedyMD Resources:
Resource Kit for Comparative Effectiveness Research: www.remedymd.com/cer_kit
Ways to leverage Asthma Registry: www.remedymd.com/cer100/asthma
Comparative Effectiveness Research: www.remedymd.com/cer_home
Disease Registry Software: www.remedymd.com/registries_home
Institute of Medicine’s Top 100 Priorities for CER: www.remedymd.com/cer_kit

About RemedyMD
RemedyMD® is the leading provider of specialized software applications, tools, and data necessary for comparative effectiveness research with more than 100 pre-built clinical, disease, and patient registry software applications. RemedyMD solutions are personalized to the institution, the clinical specialty, and to the individual provider’s preferences enabling researchers to identify new patterns, facilitate new discoveries, and improve medical outcomes. For more information, visit www.RemedyMD.com.

Press Contact:
Lane Peterson
RemedyMD
SALT LAKE CITY, US
801.733.3383
lpeterson@remedymd.com
http://www.RemedyMD.com

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Pediatric Asthma - Information and Tips

2009-10-31T08:32:00.000-07:00

As children, we ve all been to the doctor for some kind of illness or the other multiple times. But there is one disease that affects almost 5 million children in the United States and that can cause the life of a child to change dramatically because of the effects it tends to have on the child s lifestyle. That disease is asthma. As mentioned before, millions of children are affected by asthma, and the causes of pediatric asthma have been found to be mainly irritants or allergens in the environment.

Symptom of pediatric asthma can vary from individual to individual, but there are some common signs that indicate the possibility of pediatric asthma. Those signs include tightness of the chest, wheezing or coughs, with other symptoms present in adults not being present in children. Diagnosing pediatric asthma in children less than 5 years of age is done mostly on the basis of the parents’ observations, and so there will be a lot of things that a parent will have to look into when taking the child to the doctor.

Pediatric asthma can lead to children not being able to experience everyday life as other kids do. For example a child suffering from pediatric asthma will feel out of breath every time he or she is on the playground and so will not take part in many games. They will also probably become tired easily, and may do things to prevent a coughing fit or wheezing. If you notice your kid engaging in such behavior, he/she is probably having some respiratory issue. So it’d be best to take the kid to a pediatrician.

Triggers for pediatric asthma can come in many forms, due to allergies or due to other triggers such dust mites, pollen, cockroach and mold. It is up to the parents to know what the child is allergic to and make sure he or she is not allowed contact with anything that may trigger an asthma attack. Pediatric asthma is something that could either get better or remain the same in children. Some children are seen to outgrow the asthma while there are others who do not get attacks for years until it flares up suddenly when they are older. It is hard to say if pediatric asthma is something that can be fully cured, but precautions will definitely help the healing process. The best way to help a child with pediatric asthma is to help him or her understand what the disease is about, get them the proper medication, and allow them the joy of being able to live a normal life.

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Asthma inhaler may not work for many children, study shows

2009-10-29T05:42:00.000-07:00

Those with gene variant and using inhaler daily 30% more likely to have asthma attack than those who do not.

The most commonly-prescribed asthma inhaler may not work for a significant proportion of children who use it to relieve their symptoms every day, a new study shows.

Researchers from the Universities of Brighton and Dundee have found that children with a particular gene change do not get the benefit they should from Salbutamol – the "blue" inhaler most often prescribed by GPs – which goes under the brand name Ventolin.

One million children have asthma. The researchers say that 100,000 of them may have the particular form of gene that prevents the inhaler working when used daily.

The authors of the study say that no child should stop using the inhaler, which works for many. But they say more research needs to be done to find out whether there are alternative treatments that will work better for those with the gene change – in which case genetic testing might become routine.

The research, led by Prof Somnath Mukhopadhyay at Brighton and Prof Colin Palmer at Dundee, involved nearly 1,200 children and is published in the Journal of Allergy and Clinical Immunology. It found that a specific change, called the Arg16 variant, in the gene that makes the body molecule that binds Salbutamol, may cause the medicine to be less effective as a reliever when used at least once a day. Salbutamol is used to relieve the symptoms of an asthma attack. Children are often on long-term medication as well.

Those who had the gene variant and used an inhaler daily were 30% more likely to have an asthma attack than those who did not. Those with a double copy of Arg16 were twice as likely not to respond to the drug.

Researchers said it was possible that the presence of this gene change in young people with asthma and who were taking Salbutamol frequently could be worsening their health and driving up healthcare costs.

Mukhopadhyay said: "Salbutamol via the blue inhaler is effective 'reliever' treatment in most children but it is common experience among doctors that a proportion of children do not seem to respond to this medicine as well as others.

"Some of these children could progress to develop asthma attacks with wheeze and cough that leads to days off school, visits to GPs, courses of oral steroids and, often, hospital admissions, despite the use of concurrent controller medication.

"Our study shows that common gene changes may predict the children with asthma who will have a worsening of symptoms with this commonly used medicine. We need to find out if alternative reliever medication will provide better asthma control in these children."

But he stressed that children should continue using the inhaler as their doctor has directed until more research has come up with alternatives. "Our work does not alter current consensus guidelines for the treatment of asthma," he said.

Palmer said the research was "just scratching the surface" of the move towards using genetic information to give people personalised medicine – the drugs that will work best for them. It is known that not all drugs work on all people.

"This study gives us a better understanding as to who is at risk of poor asthma control using these drugs," said Palmer. "However, this information is not useful if we do not have a better treatment for these children.

"We now need to determine if other medications might be more effective in the children with the Arg16 variant."

P.S. protect yourself naturally against asthma by eating lots of Vitamin C and Vitamin D rich foods and fruits.

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Clinical trials: Giving back to the community

2009-10-26T19:57:00.000-07:00

It's hard for families to volunteer for clinical research trials in asthma. It means added time and attention tracking the smallest changes of a frustrating and life-threatening disease.

By participating in these important trials, however, parents and children not only help themselves, they also further our knowledge of new treatments for the entire asthma community.

There are many benefits to participating in clinical trials, including personalized attention from a team of specialists.

But there is also added benefit in the knowledge of doing something good for fellow patients with asthma, since asthmatics, particularly children, need help.

Pediatric Asthma is the most common chronic childhood disorder, affecting nearly 6.7 million children in the United States. That's roughly one out of every 10 children.

Pediatric Asthma - either inadequately controlled or undiagnosed - is a leading cause of missed school and missed participation in healthy activities like sports.

We are near the top in per capita emergency room visits for children's asthma in the state.

Too often, children in our community need intensive care to treat asthma attacks that could have been avoided. Without a dedicated pediatrician, children with asthma may go undiagnosed, leaving them at risk for severe asthma attacks and families unaware and unable to control the disease.

Just as patient families volunteer themselves for clinical trials to help, we can also donate our time and experience to make an impact on the Jacksonville community.

We as providers and citizens can also promote the importance of primary care for all children and the importance of detecting asthma symptoms.

At Nemours, we have one of the leading pediatric asthma research teams in the country.

Our group finds it imperative to act locally by supporting events like the American Lung Association's recent Night Air Affair, the recent GreenWalk at the University of North Florida and their Climb Jacksonville event in February.

New Nemours clinical studies are available to pediatric asthma sufferers, as well as educational programs.

It will take all of us - patients, families, providers and everyday citizens - to combat this growing problem and make Jacksonville an easier place to breathe.

So go ahead, do something good for others.

Join us.

P.S. Boost your over-all health by eating lots of Vitamin C and Vitamin D rich foods and fruits.

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Inhaled Steroids Still Most Effective Treatment for Asthma

2009-10-23T20:41:00.000-07:00

Children who have been prescribed steroidal inhalers to control asthma symptoms should continue to use them, despite questions raised by a medical study concerning their long-term benefits.

The study, published in the New England Journal of Medicine in 2006, found strong evidence that steroidal inhalers effectively control symptoms in toddlers at high risk for chronic asthma. However, the study found, the treatment did not ultimately prevent children from developing the disease.

"Most experts agree inhaled steroids are the most effective treatment for chronic asthma," said Dr. Jamshed F. Kanga, a pediatric pulmonologist at Kentucky Children's Hospital and professor of pediatrics and chief of pediatric pulmonology in the University of Kentucky College of Medicine. "The question we don't yet know the answer to is whether treatment for a long period of time will result in the disease being cured."

Kanga says that although the study raised some interesting questions for further study, it has not changed treatment guidelines.

"Asthma is a serious disease and children with chronic asthma should be on controller therapy," Kanga said.

Diagnosing asthma

Kanga says diagnosing asthma in young children can be difficult because symptoms are often very similar to those of viral infection. However, if the symptoms become more chronic and persistent, then a diagnosis of asthma should be considered.

Treatment options

Once a diagnosis of asthma is made, Kanga says, the symptoms need to be controlled and treated to prevent damage to the airway. Asthma medication falls into two groups: rescue or reliever medication and controller medication.

Rescue medication is a temporary treatment and does not address inflammation in the airways. These medications are taken at the first sign of asthma symptoms, such as wheezing. Rescue medications work quickly to relax muscles surrounding the airways, making it easier to breathe almost immediately. If needed, rescue medications are sometimes taken before exercise to help prevent asthma symptoms. The most common rescue medication is albuterol, which is sold under many brand names.

The second type of medication, controller medication, addresses inflammation in the airways. These medications are used every day in an effort to keep asthma under control. When taken daily, controller medications reduce inflammation in the lungs, helping to reduce and even prevent symptoms of asthma. Inhaled corticosteroids, the same drug tested in the journal study, are a common controller medication. Leukotriene modifiers, mast cell stabilizers and long-acting bronchodilators are also examples of controller medications.

Inhaled corticosteroids: risks, benefits, alternatives

"The best medications we have to treat chronic asthma are inhaled steroids," said Kanga. "Although there is a lot of concern that in children long-term steroid use leads to a decrease in growth, most experts agree the benefits outweigh any potential short-term growth decrease. Most three- to five-year studies show only a slight growth difference. That difference often disappears as the child ages."

Minimizing side effects

Nonsteroidal controller medications such as Singulair (montelukast) are the latest drug treatment option to become available. There is not yet enough data to determine if they are better than corticosteroids, Kanga says, but they do provide an alternative for children with mild asthma. If growth is a concern, it is also possible to give a lower-dose steroid.

"In our clinic, all patient heights are monitored closely," Kanga said. "If a child is in good control, we always try to cut back the dose of their inhaled steroid. We attempt to optimize treatment by monitoring the inflammation of the airways with a regular lung function test, every three to six months."

Spirometry is a simple lung function test that can be performed on children 5 and older. A nitric oxide monitor is another way to measure inflammation in the airway to help ensure the patient is receiving the correct dose of steroids and thus the optimal treatment.

Future of asthma treatment

Doctors once thought children would 'outgrow' their asthma; however, long-term follow-up has shown that many childhood asthma patients continue to have asthma as adults. Longer studies are needed, Kanga says, to address the important question of whether treatment helps with long-term obstruction.

"It is important to remember asthma is still underdiagnosed and often inappropriately treated," Kanga said. "To optimize your treatment, talk with your doctor about appropriate medications. We want every child to be able to live a normal life and participate in sports. We have very good medications today and most children with asthma can lead a very normal life."

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What You Should Know About Asthma Pediatric Cases

2009-10-18T10:26:00.000-07:00

What You Should Know About Asthma Pediatric Cases

Asthma in children is one of the most trying experiences that parents may have while their children are still very small. Asthma pediatric cases are very common nowadays because of the many triggers in the environment, as well as in the food that our children eat everyday. More often than not, children who are living in the city are often the hardest affected by asthma pediatrics due to the smoke emitted from vehicles and other pollutants in the air.

Common Symptoms in Asthma Pediatric Cases

If you are a parent with very young children who have asthma, taking note of the common symptoms of asthma pediatric cases is very important. Unlike adolescence and adults, very young children often cannot express what they feel very well. In most cases, they will just appear to be irritable and cry a lot, and it is really hard to tell what is wrong with them. Since your child could not aptly express what he or she is feeling at the moment, you will need to be very perceptive.

To determine the first signs and symptoms of asthma pediatric attack in you child, you should note the common signs and symptoms of the disease. Note that most asthma pediatric cases have different signs and symptoms. To determine what are the early signs and symptoms of pediatric asthma in your child, you will need to take notes of what happened during the last time your child had an attack.

Is There Such a Thing as a Pattern for Asthma Pediatric Episodes?

Technically, each child may have some unique experiences with asthma pediatric episodes. However, if you are a very keen observer, in most cases, asthma pediatric attacks on very young children follow a pattern. For instance, every time your child is exposed to smoke, he or she will start sneezing followed by coughing. After a few hours of coughing, he or she will start wheezing and getting out of breath. If you have noticed this pattern in your child, chances are this will happen every time he or she is exposed to smoke.

Preventing Asthma Pediatric Episodes

Recognizing the triggers of your child’s asthma is very important. Knowing what triggers asthma in your child would help you prevent such attack. For instance, if you observe that your child would react strongly towards smoke, then, make sure that he or she is not exposed to smoke to prevent an attack. Knowing what to prevent can mean everything in the case of asthma.

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The Link Between Allergies and Asthma

2009-10-11T05:49:00.000-07:00

Allergies and asthma frequently often go together. Pediatric asthma is actually very common in the US especially in children. Your child's body's reaction to an allergen can often lead to an asthma attack, or it might cause an existing condition to become worse. This is a serious issue for those who suffer from both allergies and asthma, because it involves twice the discomfort and a greater risk of health problems.

Allergens cause your body to produce antibodies to get rid of the irritant, causing you to experience a reaction that usually involves sneezing and watering of the eyes. The airways and nasal linings become inflamed as a result of your body's response, which frequently leads to an asthma attack in those who suffer from the condition. Those who have respiratory allergies along with asthma typically experience more severe attacks.

Can treating your child's allergies prevent pediatric asthma? It can certainly lower your chances of experiencing an asthma attack. Receiving injections to treat your allergies is beneficial because it restricts your antibodies from reacting to the allergens. And so the chances of an asthma attack are reduced.

For those children who suffer from pediatric asthma attacks, it's essential that parents should do their best to avoid the irritants that lead to inflamed airways. The most typical culprits are dust mites, pet dander, pollen and certain foods. Those who have family members with allergic asthma are more likely to acquire the disease. These people are advised to be very careful with possible allergens. Most allergy induced asthma is triggered by more than one factor.

You don't always have to use medication if you are successful at avoiding the situations that lead to an attack. However, if you do use medication, it's important that you treat the symptoms of both conditions. Nasal sprays can reduce inflammation caused by allergies. Inhalers can reduce inflammation caused by asthma. Be aware, though, that self-medication can have serious consequences. First of all, you should visit your doctor to discuss the most appropriate course of treatment. You can use medication to cure either of these conditions, but caution is advised because they can aggravate certain health problems.

People are advised to take control of their problem by making sure they know which factors trigger their attacks. Discuss all this information with your physician so he or she can formulate the best possible asthma treatment for your situation. The doctor will try to gauge the factors that you have encountered before and the reactions of your body towards past treatments.

P.S. Boost your immunity against pediatric asthma by taking Vitamin D rich foods.

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How Exercise Can Trigger Asthma

2009-10-09T03:22:00.000-07:00

Although it comes as a surprise to many people, exercise is one of the most common triggers of pediatric asthma attacks. As many as 9 out of 10 people with asthma experience exercise-induced asthma, an exacerbation of their symptoms during or after a workout.

Exercise is still one of the best things you can do for your body, but if you have exercise-induced asthma, it can be tricky to work out without triggering asthma symptoms such as shortness of breath and coughing. But it’s not impossible. Indeed, many star athletes suffer from exercise-induced asthma, and the symptoms can be minimized by taking medication and precautions, such as avoiding exercise in cold weather.

With the right treatment, children with exercise-induced asthma can still be active and participate in sports.

To learn more about exercise-induced asthma and how to prevent it, check out the following information from our A–Z Health Library.

An asthma attack is a short period when breathing becomes difficult, sometimes along with chest tightness, wheezing, and coughing. When this happens during or after exercise, it is known as exercise-induced asthma or exercise-induced bronchospasm. About 70% to 90% of people with persistent asthma and about 10% of the population without asthma have exercise-induced asthma.
Exercise-induced asthma develops most often in athletes, especially those who train or perform in cold air. Swimming appears to cause the fewest problems for children with asthma; it may even help reduce the severity of exercise-induced asthma.

For most people:

* Shortness of breath may occur early in an exercise period. Some people get worse 5 to 10 minutes after exercise stops.
* Difficulty breathing usually goes away within 20 to 30 minutes after stopping exercise.

Exercise-induced asthma is often not diagnosed, especially in children. Most experts agree that a medical history and a physical exam are not accurate tools for diagnosing exercise-induced asthma. If you notice the symptoms of asthma (such as wheezing or shortness of breath) after your child exercises, it is important that you bring this to the attention of your health professional. However, children with asthma should still be encouraged to exercise and should not be excused from exercise unless really necessary.

For people with pediatric asthma symptoms during exercise, using asthma-controlling medicine before exercise may help reduce symptoms, especially in cold, dry weather. For these people, some asthma experts recommend the following:

* Take your medicine daily, if needed, to decrease airway inflammation Click here to see an illustration. and decrease the overreaction (hyperresponsiveness) of the airways that carry air to the lungs (bronchial tubes).
* Use an inhaled bronchodilator (beta2-agonists), cromolyn, nedocromil, or leukotriene pathway modifier before exercising.
* Warm up before exercising.

Other steps you can take to decrease asthma symptoms when you are exercising include the following:

* Avoid exposure to air pollutants and allergens whenever possible. Exercise indoors when air pollution levels are high.
* Wear a mask or scarf wrapped around your nose and mouth if you are exercising in cold weather. This may help warm and moisten the air you breathe in.
* Exercise slowly for the first 10 to 15 minutes.

If your child has exercise-induced asthma, be sure his or her teachers and coaches know when your child’s daily medicines should be given and what to do if your child has an asthma attack, especially before and during physical exercise. Your child’s daily treatment and asthma action plans provide this information. School officials need to know the early warning signs of an asthma episode, how your child’s medicines are used, and how to give the medicines. School personnel also should know how to contact your child’s health professional.

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Pediatric Asthma Treatment: How to Avoid Indoor Asthma Triggers

2009-09-28T07:20:00.000-07:00

Asthma is a long-lasting disease wherein the airways tend to become reversibly narrowed and results to shortness of breath. Coughing and wheezing often accompany the main symptom. An asthma attack is an immediate progression of asthma from a steady state to acute. This occurs when the asthmatic is exposed to triggers. Triggers are usually airborne irritants that an asthmatic may inadvertently inhale.

Outdoor triggers include molds, pollen, and smoke. While most families keep their asthmatic child inside the house, the childs condition may not get better because indoor triggers are not eliminated. Indoor triggers pose as much of a risk as outside triggers. Pets, for instance, should be left outdoors or at least outside the childs bedroom.

Cigarette smoke is pretty popular in their role as an asthma trigger. Not only are they triggers, but they can also contribute to the development of asthma in a child. The earlier the child is exposed to cigarette smoke, the earlier their lungs start deteriorating. An already asthmatic child should not be exposed to cigarette smoke. If theres a smoker around, it should be done outside the home. Even if the child has left, indoor smoking should be avoided. There is a study going on to prove that smoke residue inside the home can trigger asthma.

Low humidity levels decreases growth rate of indoor molds. Damp or wet bathroom tiles are ideal grounds for mold growth. With this in mind, it would be a good idea to fix water leaks. The house should also be kept clean. Food should be kept in closed containers or refrigerators. Trash cans must be kept closed. This attracts less cockroaches ” which is a well-known asthma trigger.

Peak flow meters are handy devices that can help measure the amount of air that a person breathes out. Its readings are color coded with green, yellow, and red. Peak values falling under the green indicates good breathing, while red signifies an asthma attack. A peak flow may also help you monitor lung function. Regular use of it may warn you of upcoming asthma attacks as it can detect airway obstruction even in the absence of symptoms.

P.S., Boost your resistance to asthma by heavy intake of Vitamin C rich foods or fuits.

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How to Use a Nebulizer?

2009-09-25T08:54:00.000-07:00

Nebulizers are commonly used to deliver asthma medications to children, including albuterol when your child is wheezing and Intal, an anti-inflammatory medication used to prevent asthma attacks.

For many children without a nebulizer, using a metered dose inhaler with a spacer and mask, can be just as effective as a nebulized treatment. Still, younger children under age 5, those that have trouble using an inhaler and children with severe asthma may benefit from having a nebulizer to use at home.

Here are tips for using your nebulizer correctly:

* Always use clean equipment.
* Assemble the air source, nebulizer and tubing per the manufacturers instructions.
* Measure the medications and place them in the nebulizer (remember that ml and cc are the same). Measure your child's dose of Albuterol with 2cc of Bronchosaline or with an ampule of Intal if it has also been prescribed.
* Turn on the nebulizer and hold it close to your child's nose and mouth (or you can use a mask and strap it in place). Older children can use a mouthpiece that is held in their mouth with their lips closed, as long as they only breathe through their mouth (or consider using a nose clip).
* Teach your child to take long, slow, deep breaths during the treatment (and hold his breath for a few seconds if possible).
* Continue the treatment until all of the medicine is gone from he measuring cup. Most treatments last about 10 minutes.
* Turn off the nebulizer and clean your equipment when the treatment is finished per the manufacturers instructions, including rinsing the mask, mouthpiece and T-shaped part (but not the tubing) in warm water, allow it to air dry and then store everything properly.

Important Reminders

* Use your medications as directed by your Pediatrician. Do not change the medication's dosage or stop using a medication unless instructed to do so by your Pediatrician.
* If your nebulizer breaks, get a replacement as soon as possible, and before your child needs another treatment.
* Always have medication for your nebulizer on hand. Call in advance for refills.

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NEBULIZER: another way to cure for Pediatric Asthma

2009-09-25T08:41:00.000-07:00

A nebulizer, also known as an atomizer, is a machine that vaporizes liquid medication into a fine mist to be inhaled into the lungs via a mouthpiece or mask. A nebulizer is used to administer medication primarily for those with asthma, but also for those with cystic fibrosis or other respiratory illnesses. Although studies have shown that both inhalers and nebulizers tend to be equally effective in delivering medications, nebulizers are preferred for use in more serious rescue situations when one is experiencing a severe asthma attack. Nebulizers can administer a higher dosage of medication, but inhalers are easier to use, preferred for their portability and low cost and good for everyday use.

Nebulizers can vary greatly in size and can run on either electricity or battery power. It consists of a compressor that pumps oxygen through plastic tubing into a cup that holds the liquid medication. Once the oxygen mixes with the liquid, it is delivered in vaporized form through the mouthpiece or facemask to the lungs.

Under normal circumstances, it should take about five to fifteen minutes to complete the nebulizer treatment. However, if a child taking the medication is uncooperative or crying, the treatment may take longer or the effectiveness of the dose may be reduced. A face mask may also need to be used for the elderly or for those unable to use an inhaler themselves.

Medications used in a nebulizer usually include Albuterol, which is a bronchodilator, as well as Atrovent, which is also known as ipratropium bromide. In order to use a nebulizer, a child must have some degree of coordination and be able to cooperate in order for the medicine to be delivered effectively. One of the benefits of using a facemask with a nebulizer is that an infant or elderly person can passively receive the medication when the mask is strapped on and he or she is sitting quietly.

In the case of an emergency involving a power outage, or when a patient needs a nebulizer treatment on the road, there are some nebulizers available on the market with batteries or cigarette lighter adapters. As with any piece of medical equipment, a nebulizer should be sanitized after each use per manufacturer’s instructions.

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Rising Heat, Humidity Raise Risk of Asthma Flares

2009-09-23T09:32:00.000-07:00

Although many parents already know that changes in the weather can cause their children's asthma symptoms to flare up, a new study backs up their intuition.

If the humidity levels in the air rose by more than 10 percent or if the temperature increased by more than 10 degrees Fahrenheit in a single day, more children ended up in the emergency department of a Detroit hospital reporting asthma symptoms, the new research found.

"Parents need to be mindful of days when there are dramatic changes in temperature or humidity. A child's asthma may flare more on those days," said study senior author Dr. Alan Baptist, director of the University of Michigan asthma program, in Ann Arbor.

The findings were published in the September issue of the Annals of Allergy, Asthma & Immunology.

As many as 9 million children in the United States have asthma, according to the background information in the study. There are numerous known triggers that can exacerbate the inflammatory airway disease, including viral infections, air pollution, exposure to tobacco smoke and airborne allergens, such as pollen, the study authors noted.

Baptist said that another asthma trigger reported by many parents is weather changes. While some past studies have looked at this phenomenon, Baptist and his colleagues pointed out that none of the previous studies controlled for air pollution and airborne allergens.

For the current study, the researchers reviewed data from two years of emergency department admissions for asthma at Children's Hospital of Michigan in Detroit. During the study time period -- Jan. 1, 2004 through Dec. 31, 2005 -- more than 25,000 youngsters between the ages of 1 and 18 were admitted for an asthma exacerbation, according to the study. That works out to about 35 children a day, according to Baptist.

The researchers then reviewed weather data for that time period, along with data on airborne allergens and air pollution. And, their statistical model was designed to control for these factors, Baptist added.

"A 10 percent increase in humidity two days before the admission day was associated with one additional visit to the emergency department," said Baptist. "For temperature, an interday change of 10 degrees one day before the admission resulted in two additional visits."

Although previous studies have found an association between barometric pressure and asthma symptoms, the current study found no link.

Asked why weather changes might affect asthma symptoms, Baptist said, "Asthma, at its core, is inflammation of the airways, and maybe these changes could be triggering more inflammation. But, it's really unknown why temperature and humidity changes exacerbate asthma, and it should be looked at further."

"This study brings up good discussion points, but I don't think this is going to be strong enough evidence to change practice," said Dr. Shean Aujla, a pediatric pulmonologist at Children's Hospital of Pittsburgh.

Aujla said that cold air is a known trigger for asthma, and confirmed that many parents say a change in weather triggers their children's asthma symptoms.

Until more research is done, she recommended focusing on each child's individual symptoms. "If your child is going outside to play and having persistent symptoms, they should use their albuterol inhaler whether or not it's humid," said Aujla.

And, she added, very few children need to stay inside because of their asthma and weather changes. "Unless a child has very severe asthma, I wouldn't say stay indoors," she said.

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When Allergies attack, Fight Back with Natural Remedies

2009-09-20T08:22:00.000-07:00

According to the 2008 National Health Survey from the National Center for Health Statistics, it is estimated that about 19.6 million adult Americans suffer from hay fever, with 6.8m children also suffering. Even more, physicians state that more than 11 million office visits are by patients seeking relief from hay fever, which is also known as allergic rhinitis.

Symptoms of hay fever include itchy eyes, runny nose, congestion, and an endless amount of sneezing. All of these symptoms are caused by an overacting immune response to a variety of possible triggers, which include pollen from plants, dust, dust mites, airborne pollutants, mold, and pet dander.

Hay fever is marked by inflammation of mucous membranes in the eyes, throat, ears, sinuses, nose, and lungs. Although the development of inflammation in allergies is complex, one of the most influential factors is immunoglobulin E (IgE), which responds to protein allergens. Although there is a genetic component to susceptibility to allergic response to certain triggers, the focus of allergy relief is on the events that occur as a reaction.

Various natural products offer allergy relief by targeting the factors in allergy pathology. Similar to other areas of immune health, fruits and vegetables are suggested for the vitamins, minerals and antioxidants that they provide. Vitamin C is a major antioxidant in the airway surface liquid of the lungs; therefore, it can severely impact allergies and asthma. Low levels of vitamin C have actually been associated with asthma in both adults and children. Also, low levels of vitamin E have been associated with asthma and other wheezing illnesses. Combining antioxidant ingredients also provides additional relief. Therefore, by combining vitamins C and E with the antioxidant NAC, pollen-induced airway inflammation is inhibited by blocking ragweed oxidases which cause oxidative stress and inflammation in the airways.

On its own, NAC reduces mucous viscosity and protects against lung tissue damage. According to scientists, lycopene may also be beneficial. As far as minerals are concerned, both magnesium and zinc have been proven to help. Quercetin has both antihistamine and anti-inflammatory properties, allowing it to inhibit the release of histamine in nasal mucosa of allergic patients. Glucomannan was shown in a study to suppress allergy symptoms, while CLA reduces allergy symptoms such as sneezing.

One of the best natural remedies for allergies is comprised of botanicals such as licorice root, skullcap, pine bark extract, and butterbur. Licorice root offers anti-inflammatory activities along with aide in fighting IgE allergic reactions, while skullcap can restrict inflammatory cytokine production.
Pine bark extract blocks the release of allergy troublemakers in the body even better than a known pharmacological histamine inhibitor.

Similarly, butterbur has abilities in blocking histamine release by IgE-sensitized mast cells and relieving allergy symptoms as effectively as drugs without the drowsy side effects. Although allergies are widespread and disrupt the daily lives of many people, they strike one out of every four Americans, affecting six times more than cancer. The mechanisms of allergic reactions in the body, especially those in the upper respiratory system, are becoming more and more well-known.

Natural products are available that can help to address these mechanisms, along with the mediators that produce the inflammation and symptoms that allergies create. Natural vitamin supplements are available at your local or internet health food store.

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Changes in Weather May Trigger Child’s Asthma

2009-09-15T11:10:00.000-07:00

Changes in humidity and temperature result in a increase in Emergency Department (ED) visits for pediatric asthma exacerbations according to a report published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

“We found a strong relationship between temperature and humidity fluctuations with pediatric asthma exacerbations, but not barometric pressure,” said Nana A. Mireku, M.D., an allergist at Dallas Allergy Immunology in Dallas, formerly at Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, Mich. “To our knowledge, this is the first study that demonstrates these correlations after controlling for levels of airborne pollutants and common aeroallergens.

“Our study is also one of the few to examine the possibility that the weather one or two days before the asthma exacerbation may be as important as that on the day of admission, observing additional ED visits on these days,” she said.

According to the report, patients experiencing an asthma attack often complain that weather fluctuations are a major trigger. Authors note, “the latest National Institutes of Health guidelines list ‘change in weather’ as a possible precipitating factor for asthma, but do not cite any references for this opinion.”

The retrospective 2-year study was performed at a large urban hospital of 25,401 children visiting the ED for an pediatric asthma exacerbation. Data on climactic factors, pollutants and aeroallergens were collected daily. The relationship of daily or between-day changes in climactic factors and asthma ED visits was evaluated using time series analysis, controlling for seasonality, air pollution and aeroallergen exposure. The effects of climactic factors were evaluated on the day of admission and up to five days before admission.

A 10 percent daily increase in humidity on a day or two before admission was associated with approximately one additional ED visit for asthma. Between-day changes in humidity from two to three days prior to admission were also associated with more ED visits. Daily changes in temperature on the day of or the day before admission increased ED visits, with a 10°F increase being association with 1.8 additional visits.

Asthma is a chronic inflammation of the lung airways that causes coughing, chest tightness, wheezing or shortness of breath. More than 22 million Americans have asthma, including 6.5 million under age 18.

"Pediatric Asthma is the most common chronic illness in childhood,” said allergist Richard G. Gower, M.D., president of ACAAI. “Allergists have always known that weather conditions such as extremely dry, wet or windy weather can affect asthma symptoms. This study further defines the role of temperature and humidity on children's asthma and confirms the importance of working with patients to identify the source of their symptoms and develop treatment plans that help prevent them.”

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Asthma May Start in the Womb

2009-09-13T03:40:00.000-07:00

Children born in areas of heavy traffic areas could be at greater risk of developing asthma due to genetic changes brought on by pollution and acquired in the womb, a new study suggests.

In a study of umbilical cord blood from New York City children, researchers found a change in a gene called ACSL3 that is associated with prenatal exposure to chemical pollutants called polycyclic aromatic hydrocarbons (PAHs), which are byproducts of incomplete combustion from carbon-containing fuels, resulting in high levels in heavy-traffic areas.

Exposure to PAHs has previously been linked to diseases such as cancer and childhood asthma.

Researchers say this finding provides a potential clue for predicting environmentally related asthma in children — particularly those born to mothers who live in high-traffic areas like Northern Manhattan and South Bronx when pregnant.

The genetic alterations are called epigenetic changes, which may disrupt the normal functioning of genes by affecting their expression but do not cause structural changes or mutations in the genes.

"Our data support the concept that environmental exposures can interact with genes during key developmental periods to trigger disease onset later in life, and that tissues are being reprogrammed to become abnormal later," said Shuk-mei Ho, University of Cincinnati researcher and lead author of a paper on the results published in the Feb. 16 issue of the journal PLoS ONE.

http://www.livescience.com/common/media/video/player.php?videoRef=040907Staying_clean

Too Clean?

Just to confuse things, scientists also say a super-clean lifestyle can lead to more allergies in children.

The researchers analyzed umbilical cord white blood cell samples from 56 children for epigenetic alterations related to prenatal PAH exposure in Northern Manhattan and the South Bronx. The mothers' exposure to PAHs was monitored during pregnancy using backpack air monitors.

The researchers found a significant association between changes in ACSL3 methylation — a gene expressed in the lung — and maternal PAH exposure. ACSL3 also was associated with a parental report of asthma symptoms in the children prior to age 5.

"This research is aimed at detecting early signs of asthma risk so that we can better prevent this chronic disease that affects as many as 25 percent of children in Northern Manhattan and elsewhere," said Frederica Perera, co-author on the paper from Columbia University Mailman School of Public Health.

More research is needed to confirm the findings, the scientists said. If the study is confirmed, changes in the ACSL3 gene could serve as a novel biomarker for early diagnosis of pollution-related asthma.

"Understanding early predictors of asthma is an important area of investigation," said study team member Rachel Miller of the Columbia Center for Children's Environmental Health. "because they represent potential clinical targets for intervention."

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Children with asthma more vulnerable to H1N1 virus

2009-09-09T09:38:00.000-07:00

Secretary of Health Kathleen Sebelius met with students and their parents at Thurgood Marshall Elementary, one of 16 schools in Philadelphia that partners with the Merck Childhood Asthma Network, Inc. (MCAN). The program works to help students better manage their asthma. She talked about the importance of education and creating healthy habits to avoid missing school.

"Nothing is more important than keeping our children healthy, in school and ready to learn as we start the new school year," said Dr. Floyd Malveaux, Executive Director of MCAN and former Dean of the College of Medicine at Howard University. "We applaud Secretary Sebelius for recognizing that staying healthy can be a challenge for students with asthma – a factor that is even further complicated with the possibility of being exposed to the H1N1 virus, which can increase the severity of asthma symptoms, leading to possible hospitalizations."

During the meeting, Secretary Sebelius highlighted the work of the Philadelphia MCAN project as a model for inner-city childhood asthma management. Launched in 2005, the Philadelphia MCAN project has improved asthma outcomes for children and reduced school absenteeism by using a community-based approach that integrates families, community agencies, schools and health care providers to implement scientifically proven asthma interventions.

The Philadelphia program brings hope into communities that shoulder a disproportionate share of the childhood asthma burden. Screening conducted with the Philadelphia MCAN project in partnership with The School District of Philadelphia found that one out of four students in the West, Southwest, Olney, Logan and Germantown communities – target communities for the program – have been diagnosed with asthma or have been admitted to the hospital for wheezing, compared to one out of ten nationwide. The Philadelphia program provides children with asthma and their families access to three key services: Community Asthma Prevention Program (CAPP) classes that educate parents, other caretakers and children with asthma; CAPP home visits where community health workers help families eliminate or control allergens and irritants within the home; and Health Promotion Council (HPC) Link Line services that connect families to asthma care coordinators.

"The unique structure of our program allows us to bring multiple stakeholders to the table to create a successful team that can get children to care and services for better long-term and immediate asthma management," said Dr. Michael Rosenthal of Thomas Jefferson University and co-lead investigator of the Philadelphia MCAN program. "By collaborating with specific schools to identify children that have asthma, the Philadelphia MCAN project has armed school nurses with essential information to assist students who are at higher risk for complications with H1N1 and seasonal flu virus, allowing them to be better prepared to manage these children at school."

Nationally, MCAN, a non-profit organization funded by the Merck Company Foundation, provides funding to four other local programs that target low-income, urban populations with high rates of pediatric asthma in Chicago, Los Angeles, New York and Puerto Rico. The goal is to evaluate the effectiveness of these programs and use the findings to develop model programs that can be replicated and tailored in communities across the country.

"The Philadelphia MCAN program has shown that we can help children manage their asthma and that means improved quality of life, significantly fewer trips to the ER or stays in the hospital, and best of all, more days in school," said Dr. Tyra Bryant-Stephens from The Children's Hospital of Philadelphia and co-lead investigator of the Philadelphia MCAN project. "Empowering caregivers and children with this knowledge has helped to greatly decrease the school days missed by children in Philadelphia, a segment of the nearly 13 million schools days missed each year by the millions of children nationwide that have been diagnosed with asthma."

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Dealing With Childhood Asthma

2009-09-08T02:15:00.000-07:00

Asthma is a terrible disease, one that is hard enough to live with if you are an adult, but if you are a child it is especially traumatic. Childhood asthma can be so severe that it is practically debilitating, and can really take one’s childhood away from them. If your child has childhood asthma, also known as pediatric asthma, it is important that you make yourself as educated as you can on the disease and also that you watch and make sure that their symptoms do not worsen. If their symptoms ever do worsen and they start to have an asthma attack, they are going to need medical attention right away to treat the asthma. Symptoms would include anything from tightness in the chest and wheezing to coughing and shortness of breath. Keep in mind that these are not the only childhood asthma symptoms and that the asthma symptoms in children will vary from one to another.

Of course one of the most important issues on the subject of childhood asthma is management. There is no cure for the disease as of yet, but there are many effective treatments and remedies that you can use to keep the symptoms under control and help avoid the onset of attacks.

pWhen you are treating asthma in a child it will be much different than it would be in an adult. This is because children are much more susceptible to the effects of asthma, and also because their bodies are smaller and so therefore they are not able to use some of the treatments and remedies that are available to adults.

Combination therapy is the best option when it comes to keeping childhood asthma under control. This means using an inhaler that contains two or more medications rather than just one. Using inhaled corticosteroids only when needed may improve compliance which is likely to occur in patients with mild asthma who have infrequent symptoms.

Taking just one medication or another may help but for childhood asthma you want to avoid asthma attacks even more than you would in adults and so therefore using a combination of medications in the inhaler is going to be your best bet.

If your child has asthma, take every step that you can to become more informed and aware, and that you take every precaution possible to ensure that your child’s pediatric asthma stays under as best control as possible. Work as a team with your doctor to make sure that this happens.

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Natural Cure for Asthma

2009-09-04T06:21:00.000-07:00

For people who have asthma, taking medication for a prolonged period of time could really aggravate the situation instead of make things better. It is a common experience for people with asthma that after taking certain medications for sometime, such medication will no longer be able to relieve them during an attack. If you are one of those people who have this kind of problem with your medication, it might be a good idea to start seeking for a natural cure for asthma.

Is there really a natural cure for asthma?

You may not believe it, but nature has the way of healing itself. There is a natural cure for asthma and many people who have tried it would really say that their condition did improve after sometime. The good news about natural cure for asthma is that it has a lasting effect without the ugly side effects that are closely associated with pharmaceutical drugs.

Speleotherapy as a Natural Cure for Asthma

In European countries, speleotherpy is very popular when it comes to a natural cure for asthma. Speleotherapy, which is otherwise known as climatotherapy, is the process of treating asthma by spending some time underground in subterranean caves about 2-3 hours a day for a period of 2-3 months. This practice is based on the belief that salt air is very potent when it comes to treating asthma.

Speleotherapy have been practiced in Eastern Europe for ages. In fact, this type of treatment is so old that this has been handed over from generation to generation and has been proven to be very effective. However, there is no concrete scientific explanation why such treatment could really help in treating asthma.

Aromatherapy as a Natural Cure for Asthma

Another popular natural cure for asthma is aromatherapy. There are a number of scents and oil, which you can use to produce the desired relaxing effect in aromatherapy. For people with asthma, the use of a rock salt crystal lamp has been proven to be quite beneficial. Not only will this rock salt crystal lamp calm the nerves of a person, it is said to relieve bronchial constrictions brought about by an asthma episode.

Purifying the Air You Breathe

You can help prevent asthma symptoms by identifying and avoiding your known asthma triggers. In fact, identifying and avoiding asthma triggers should be part of a detailed treatment plan to help successfully manage your asthma.

A natural way for preventing asthma attacks is to purify the air you breathe. Most asthma attacks are brought about allergic reactions to dusts and pollens that are suspended in the air. If you can minimize the existence of these asthma triggers by purifying the air you breath, you can effectively prevent asthma episodes.

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Recognizing and Managing Asthma in Children

2009-08-31T05:27:00.000-07:00

Childhood asthma is a disease that can lead to death if left untreated. The problem is that it can be hard to see the signs of asthma in children. It can be more difficult to control as well. The reason is that kids just aren’t paying attention to the warning signs or just doesn't know about it.

Effective treatment of pediatric asthma requires that parents should be alert for the signs and symptoms of the condition. The most noticable signs of an asthma attack are coughing, wheezing, shortness of breath and difficulty breathing. These symptoms are pretty much the same in both children and adults.

But it can be harder to notice them among children. For instance, children frequently run around while they’re playing, and subsequently become hot and breathless. However, these are also signs of an asthma attack taking place. It’s possible that your child is experiencing more difficulty in breathing than you think.

Until this time, there is still no cure for asthma. Fortunately, there are lots of ways that the problem can be managed. Most often, an inhaler is prescribed for children with asthma symptoms. This is the fastest way of getting medicine to the lungs when it’s required immediately. Frequently, pediatric asthma is treated with something known as combination therapy. This means using an inhaler that contains two or more medications rather than just one.

Some parents like to supplement pharmaceuticals with a more natural approach to managing this disabling condition. But before starting any new treatments, it’s important that you consult with your doctor. Natural asthma treatments can interact with the prescribed medications your child is taking. They might seem harmless because they’re natural. The truth is, though, that they sometimes have ingredients that don’t react well with other medications.

Some natural treatments involve lifestyle factors rather than supplements. These are considered to be a safe and effective supplement to medication. For example, developing an asthma treatment plan is a common approach to managing the condition. You and your child need to be aware of the triggers that can set off an attack. It’s important that you know what the signs are that trigger it. And of course, you both need to know exactly how to treat an attack once you recognize the signs.

Your child could still enjoy a wonderful life even with pediatric asthma. He or she can experience the normal joys of being a child when the condition is well managed. The key to this is learning as much as you can about the condition and how to treat it.

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Symptoms of Asthma in Infants

2009-08-20T08:13:00.000-07:00

The symptoms of asthma in infants can be so subtle that you don't even realize infant asthma might be involved. Baby asthma is challenging to diagnose too, because your infant can't tell you in words how he or she is feeling. So doctors rely more on the parent's description of a pattern of symptoms and behavior, as well as family medical history, in deciding what type of breathing problem your baby may have.

Asthma is the most common chronic disease in babies and children. In fact, 1 out of every 10 kids has asthma today. So, if you find out your baby has asthma too, you'll have lots of company. If you do suspect infant asthma is causing your child's breathing problems, it's important to find out for sure as soon as you can. The inflammation of the airways that asthma causes can cause severe respiratory distress and may even lead to death, if left untreated or uncontrolled. Babies are especially susceptible to complications, because their lungs are not as mature to begin with, so early diagnosis and treatment are essential.

What Are the Symptoms of Asthma in Infants?

Common asthma symptoms in adults include:

* Wheezing
* Coughing
* Shortness of breath
* Chest tightness

But it's important to note that the pattern and intensity of asthma symptoms can vary greatly from person to person. With infant asthma, symptoms can be even more variable. They are also different, to some extent, than in adults.

In baby asthma, coughing is often the only symptom the infant will have. Some kids cough all night, but have no noticeable symptoms during the daytime hours. Other infants may cough intermittently throughout the day. Also, when babies wheeze, it's not always because of asthma. It could just be a viral respiratory infection.

So, doctors look closely at patterns when trying to decide whether your infant has asthma. First off, they'll ask you if you've noticed repeated instances of:

* Coughing, especially at night
* Wheezing
* Trouble breathing or fast breathing

The doctor will also look for symptoms that are worsened by:

* Frequent viral infections, such as colds or bronchitis, that seem to "go right to the chest" and last
* Exposure to tobacco smoke or other strong odors / fumes
* Active play
* Contact with common allergic triggers, such as pets, pollen, and dust
* Changes in the weather
* Crying or laughing

Diagnosing asthma in infants can be hard because symptoms must be observed, rather than described. And common testing used to diagnose asthma, such as spirometry, can't be used with infants. And just having any one of the above findings is probably not going to lead your baby's doctor to an asthma diagnosis. But having several of them may. In the end, doctors often diagnose asthma by ruling out other possibilities.

What Other Diagnoses Have Similar Symptoms?

As noted above, wheezing in infants can be caused by more than just asthma. And the good news is that these other conditions are often milder than asthma and may go away completely within a few years, as opposed to asthma, which usually lasts throughout childhood and maybe even into adulthood.

Some of the names for conditions that cause recurrent wheezing and coughing episodes in infancy are:

* Wheezing bronchitis, which is a viral infection
* Bronchiolitis
* Asthmatic bronchitis
* Wheezing associated with respiratory illness or breathing problems
* Para-infectious bronchial hyperreactivity
* RAD

The common factor with all of these labels is that the wheezing is not associated with allergic disease as asthma usually is in children. One of the most common catch-all terms for non-asthma wheezing is reactive airway disease, which is also called RAD for short. RAD may be used to avoid labeling an infant too soon with a more serious diagnosis of asthma.

However, both RAD and infant asthma are often treated the same, because doctors really can't tell for sure if an infant has asthma, and won't know until at least age 5. So, they treat "as if" the infant has asthma.

But parents' worries about their babies taking possibly unnecessary medicine can be soothed by the knowledge that asthma treatment is safe, even for infants. What risks there may be are considered to be offset by the very real benefits of keeping asthma – if it does exist – under control. Preventing more serious respiratory problems down the line is well worth it.
In Summary

If you notice a chronic cough in your infant, especially if it is waking your baby and you up at night, it would be wise to talk with your pediatrician about it. The same is true if you notice your baby having frequent and / or severe chest colds. And remember, wheezing does not have to be present in infants with asthma, as it almost always is with adults. And if your baby does wheeze, it doesn't necessarily mean he or she has asthma.

Don't ignore such symptoms or fear an asthma diagnosis. Asthma is fairly easy to manage with medicine and environmental changes, and taking such steps can help ensure that your infant is able to have a normal, active life.

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Inhalers for Asthma

2009-08-11T08:40:00.000-07:00

From my childhod days until I turned 23 years of age, my asthma medication consists only of tablets and capsules or just leave it be. But right after that, I tried the asthma inhaler and immediately I got hooked. The healing time of tablets ranges from 2 hours to 3 hours but for the inhaler it took only 1 or 2 seconds.

Inhalers are the main source of treatment for asthmatic patients and enables them to lead active lives without the fear of an attack. There are different types of inhalers available in the market which can make things confusing.

This article will give some more information about the inhalers for asthma.

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Pediatric Asthma

2009-08-07T22:18:00.000-07:00

Ever since I was a child I far as I can remember, I already have asthma. Most of it would occur at night. I cannot breathe properly when lying down. So I have to sit down while relaxing my breathing. There came a point wherein my parents use a nebulizer to calm my asthma.

Asthma is commonly seen in children. It is a leading cause of hospital stays and school absences. Children with asthma may be able to breathe normally most of the time. When they encounter a substance that can cause problems (a "trigger"), an asthma attack (exacerbation) can occur.

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