Search Results (9)

Background: Airway diseases, particularly asthma and chronic obstructive pulmonary disease (COPD), pose significant respiratory problems. The prevalence and risk factors of these diseases among community dwellers vary geographically and because of underdiagnosis. This study aims to determine the prevalence and factors associated with these diseases in a provincial-metropolitan area in Thailand. Methods: A cross-sectional study was conducted between April 2023 and November 2023 on individuals aged 18 years or older residing in Pathumthani, Thailand. Data on demographics, pre-existing diseases, respiratory symptoms, and pulmonary functions assessed by spirometry, including forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and bronchodilator responsiveness (BDR), were collected. COPD was defined as having respiratory symptoms, a risk factor, and post-bronchodilator FEV₁/FVC < 70%. Asthma was defined as having respiratory symptoms and a positive bronchodilator responsiveness. Results: A total of 1014 subjects (71.7% female) were included, with a mean age of 56.6 years. The smoking history was 10.4% (13.4 pack-years). Common symptoms included cough (18.4%), sputum production (14.5%), and dyspnea (10.0%). COPD was found in 8.3%, while asthma was found in 10.3%. Logistic regression analysis indicated that these diseases were significantly associated with older age (odds ratio [OR] 1.023; 95% confidence interval [CI] 1.007–1.039 for every 1-year increase in age), smoking (OR 2.247; 95% CI 1.068–4.728), heart disease (OR 2.709; 95% CI 1.250–5.873), wheezing (OR 3.128; 95% CI 1.109–8.824), runny nose (OR 1.911; 95% CI 1.050–3.477), and previous treatment for dyspnea (OR 6.749, 95% CI 3.670–12.409). Conclusions: COPD and asthma were relatively prevalent in our study. Being elderly, smoking, having heart disease, and experiencing any respiratory symptoms with a history of treatment are crucial indicators for these airway diseases. Pulmonary function testing might be needed for active surveillance to detect these respiratory diseases in the community. Full article

Allergic rhinitis (AR), traditionally considered as a childhood condition, is increasingly recognized among older adults, driven by rising life expectancy and environmental factors. Although allergic sensitization declines with age, AR prevalence in the elderly is underestimated, with 3–12% of geriatric patients affected. Diagnosis is challenging due to nonspecific symptoms and overlapping conditions, leading to underdiagnosis and inadequate treatment. AR significantly impacts the quality of life (QoL), often exacerbating respiratory comorbidities like asthma and COPD. Presbynasalis, encompassing age-related sinonasal changes, includes reduced allergic responses, increased chronic rhinosinusitis, altered nasal structure, and impaired mucociliary clearance. Non-allergic rhinitis, atrophic rhinitis, and overlapping rhinitis further complicate AR diagnosis in the elderly. Effective management involves personalized pharmacotherapy, allergen-specific immunotherapy (AIT), and addressing comorbidities and polypharmacy risks. Despite safety concerns, recent studies demonstrate AIT efficacy in elderly patients, reducing symptoms and medication use. Given AR’s impact on cognitive and respiratory health, accurate diagnosis and treatment can enhance QoL and mitigate health decline. Greater awareness and further research are essential to understand AR prevalence and improve outcomes for geriatric patients. Full article

Dysfunctional breathing (DB) describes a respiratory condition that is mainly characterized by abnormal breathing patterns, affecting both children and adults, often leading to intermittent or chronic complaints and influencing physiological, psychological, and social aspects. Some symptoms include breathlessness; dizziness; palpitations; and anxiety, while its classification lies in breathing pattern disorders and upper airway involvement. Its prevalence among the pediatric population varies with a female overrepresentation, while the existence of comorbidities in DB, such as asthma, gastro-esophageal reflux, nasal diseases, and anxiety/depression, frequently leads to misdiagnosis or underdiagnosis and complicates therapeutic approaches. The basic diagnostic tools involve a detailed history, physical examination, and procedures such as structured light plethysmography, cardiopulmonary exercise testing, and laryngoscopy when a laryngeal obstruction is present. The management of DB presumes a multidimensional approach encompassing breathing retraining, disease-specific advice through speech and language therapy in the presence of laryngeal obstruction, psychotherapy for fostering self-efficacy, and surgical therapy in a structural abnormality. The current review was developed to provide a summary of classifications of DB and epidemiological data concerning the pediatric population, comorbidities, diagnostic tools, and therapeutic approaches to enhance the comprehension and management of DB in children. Full article

Many thousands of articles relating to asthma appear in medical and scientific journals each year, yet there is still no consensus as to how the condition should be defined. Some argue that the condition does not exist as an entity and that the term should be discarded. The key feature that distinguishes it from other respiratory diseases is that airway smooth muscles, which normally vary little in length, have lost their stable configuration and shorten excessively in response to a wide range of stimuli. The lungs’ and airways’ limited repertoire of responses results in patients with very different pathologies experiencing very similar symptoms and signs. In the absence of objective verification of airway smooth muscle (ASM) lability, over and underdiagnosis are all too common. Allergic inflammation can exacerbate symptoms but given that worldwide most asthmatics are not atopic, these are two discrete conditions. Comorbidities are common and are often responsible for symptoms attributed to asthma. Common amongst these are a chronic bacterial dysbiosis and dysfunctional breathing. For progress to be made in areas of therapy, diagnosis, monitoring and prevention, it is essential that a diagnosis of asthma is confirmed by objective tests and that all co-morbidities are accurately detailed. Full article

Residents of the Imperial Valley, a rural, agricultural border region in California, have raised concerns over high rates of pediatric asthma symptoms. There is an urgent need to understand the influences and predictors of children’s respiratory health in Imperial Valley. We assessed the impacts of sociodemographic, lifestyle, and household factors on children’s respiratory health and asthma prevalence by administering a survey to parents of elementary school children (n = 357) in northern Imperial Valley. We observed an overall asthma prevalence of 22.4% and respiratory symptoms and allergies were widely reported, including wheezing (35.3%), allergies (36.1%), bronchitic symptoms (28.6%), and dry cough (33.3%). Asthmatics were significantly more likely to report respiratory symptoms, but high rates of wheezing, allergies, and dry cough were observed among nonasthmatics, suggesting the possibility for underdiagnosis of respiratory impairment in our school-age population. Having an asthmatic mother and exposure to environmental tobacco smoke were also associated with greater odds of asthma. Our findings provide evidence to support community concerns about children’s respiratory health, while also suggesting that household and demographic characteristics have limited explanatory power for assessing asthma in this population. This work provides critical baseline data with which to evaluate local environmental factors and their influence on asthma and respiratory symptoms. Full article

Allergic bronchopulmonary aspergillosis (ABPA), a progressive fungal allergic lung disease, is a common complication of asthma or cystic fibrosis. Although ABPA has been recognized since the 1950s, recent research has underscored the importance of Th2 immune deviation and granulocyte activation in its pathogenesis. There is also strong evidence of widespread under-diagnosis due to the complexity and lack of standardization of diagnostic criteria. Treatment has long focused on downregulation of the inflammatory response with prolonged courses of oral glucocorticosteroids, but more recently concerns with steroid toxicity and availability of new treatment modalities has led to trials of oral azoles, inhaled amphotericin, pulse intravenous steroids, and subcutaneously-injected anti-IgE monoclonal antibody omalizumab, all of which show evidence of efficacy and reduced toxicity. Full article

The aim of this study was to estimate the prevalence of asthma and other allergic diseases among Estonian schoolchildren of the cities lacking special (pediatric allergological) health care.
Material and Methods. The study, carried out through 1 March to 8 May, 2003, enrolled 5thto 12th-grade schoolchildren of 4 schools in different regions of Estonia. A three-step protocol was followed: screening questionnaire, examination by a pulmonary resident, and consultation by a pediatric allergologist.
Results. Of the 3132 questionnaires distributed, 1561 (49%) were returned. A total of 828 schoolchildren answered positively to any of the questions about possible allergic disease. After examination by the pulmonary resident, 255 schoolchildren (15.7%) were referred to an allergologist for final diagnosis. Asthma was diagnosed in 4.8%, allergic rhinoconjunctivitis in 4.9%, and atopic eczema in 8.3% of schoolchildren. Asthma, allergic rhinoconjunctivitis, and urticaria occurred more frequently in Narva as compared with Võru.
Conclusion. The 12-month prevalence of asthma among Estonian schoolchildren was 4.8%, and the prevalence of allergic diseases varied from region to region. Less than half (40%) of all asthma cases identified during the study were newly diagnosed, and this clearly indicates that there is a considerable underdiagnosis of the disease among schoolchildren living outside of the centers in Estonia. Full article

Background: Asthma is the most common chronic respiratory disease in the paediatric population. Underdiagnosis is a frequent phenomenon and is associated with undertreatment, which results in increased morbidity and mortality. The delay in the diagnosis of asthma reflects problems with the correct implementation of diagnostic goals set by the Global Initiative for Asthma (GINA). The aim of our study was to describe the clinical profile of children referred to the Clinic of Allergic Diseases and subsequently diagnosed with asthma. We evaluated the reasons for referral, demographic data and social data. Material and methods: We analysed a group of 907 children up to 18 years of age diagnosed with asthma at allergy clinic between 2000 and 2009. This was a cross-sectional study to assess the patients’ demographic, social and clinical data. Results: Our study revealed a shift in the clinical profile of children referred to allergy clinics over a period of ten years, subsequently diagnosed with asthma. The profile is characterised by a younger age, a higher incidence of recurrent infections and a lower incidence of wheezing and atopy as the reasons for referral to allergologists. Conclusions: The new clinical profile of children referred to allergologists reveals the necessity of conducting the costly differential diagnosis of asthma at specialist facilities. These data should be taken into account while developing new healthcare strategies in Poland. Full article

Introduction: Hundreds of studies investigating the epidemiology of asthma in various populations have been conducted in the past 30 years, yielding a large body of interesting data, including data on prevalence and risk factors. Less information is, however, available on the accurate diagnosis of asthma and its correct treatment. Epidemiological studies of the prevalence of asthma in the general population was conducted between 1998 and 2000 in the Lodz Province in Poland. The present analysis is an evaluation of the detectability and treatment of this disease. Material and methods: The study group consisted of 1522 randomly selected residents of the Lodz Province aged 3 to 80 years. The demographics and medical history were collected using standardised questionnaires. All the respondents underwent skin prick tests and screening spirometry. Additional diagnostic tests were performed in doubtful cases. Results: Complete data collected from 1340 subjects (1057 adults and 283 children) were included in the analysis. The prevalence of asthma was calculated at 7.3% in adults and 8.5% in children. The accurate diagnosis of asthma had not been made in 71% of symptomatic children and 49% of the adults. Forty-eight percent of adult asthmatics had not used any antiasthmatic medication in the previous 12 months. Subjects suffering from asthma had most commonly used the following drugs in the previous 12 months: β₂-agonists (46.8%), anticholinergics (13%), inhalation glucocorticoids (36.4%), oral glucocorticoids (16.9%), parenteral glucocorticoids (3.9%), xanthine derivatives (33.8%) and cromones (11.7%). Conclusions: The results of this study reveal shortcomings in the healthcare system which require appropriate actions aimed at early diagnosis and improvement of allergy treatment before the patient’s health deteriorates irreversibly. Full article