Cleaner Air Could Reduce Asthma, IBS, Diabetes Rates

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.

Medco study finds doctors overprescribe inhalers for acute asthma attack sufferers

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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An Exercise in Better Breathing

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

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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CHEST: Lower Doses Benefit Pediatric Asthma Patients

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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Pediatric Asthma Registry Provides Research Milestone

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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Clinical trials: Giving back to the community

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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How Exercise Can Trigger Asthma

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

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?

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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Rising Heat, Humidity Raise Risk of Asthma Flares

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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Changes in Weather May Trigger Child’s Asthma

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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Children with asthma more vulnerable to H1N1 virus

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

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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Recognizing and Managing Asthma in Children

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

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

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

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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