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Conference Highlights: WISC 2016

Conference Highlights: WISC 2016

Assessing Asthma Exacerbation Susceptibility Previous research indicates that 50% of patients with asthma report having had an exacerbation in the previous year despite the majority of these individuals reporting that they have “mild” disease. Few studies have assessed the characteristics and determinants of exacerbations. For a study, researchers assessed exacerbations and their associations among African Americans with asthma. Asthma control was assessed using the 5-item Asthma Control Questionnaire (ACQ5). The likelihood of a future exacerbation increased with worsening ACQ5 scores. The investigators identified an exacerbation susceptibility phenotype that was independent of asthma control and may require more precise therapeutic targeting. ————————————————————–   Milk Allergy & QOL Current data are lacking on quality of life (QOL) measures among patients with an allergy to cow’s milk. Patients who are allergic to cow’s milk (or their guardians) and were candidates for oral food challenge or desensitization completed a QOL questionnaire over a 3-year period for a study. Among respondents, 45% reported in the fields of “emotional impact” and “symptoms of disease” that food allergies affected their life in moderation. About 52% reported that they were affected somewhat by the negative repercussions of their allergy. Nearly half (49%) of participants reported that the impact of social and dietary restrictions was serious. Also, 55% said they were slightly affected by personal expectations regarding their disease and its repercussions. Additionally, 72% had only discrete future expectations regarding improvement of their disease. ————————————————————–   Selecting Patients for Thermoplasty Brochial thermoplasty (BT) is an endoscopic treatment for severe persistent asthma in which heat is applied to the small airway for 10 seconds, causing atrophy of the small...
Treating Asthma in Older Women

Treating Asthma in Older Women

Among older individuals, women are significantly more likely than men to report having asthma and also have a 30% higher asthma-related mortality rate. In addition, women are nearly twice as likely to visit the emergency department for asthma when compared with men. Older women have been shown to have the highest hospitalization rates among all people with asthma (Figure). “However, little is known regarding why older women are more likely to suffer from the adverse events of asthma,” says Alan P. Baptist, MD, MPH. To better understand the specific issues that are unique to older women with asthma, Dr. Baptist and colleagues conducted a literature review and published their findings in Annals of Allergy, Asthma, & Immunology.   Unique Factors Menopause and hormone replacement are unique features among older women that may play a role in how asthma affects them differently from others. “Adult women experience the most asthma exacerbations around age 50, which is also the average age of menopause,” explains Dr. Baptist. “Studies also show that hormonal changes during the menstrual cycle often play a large role in asthma symptoms. Although we can’t say menopause and asthma symptoms are definitely related, we did find data suggesting this may be the case.” Dr. Baptists and colleagues also found that women with no history of asthma who were started on hormone replacement therapy were more likely to develop asthma than women who did not. “Conversely, among women who had asthma, hormone replacement actually improved symptoms and decreased asthma exacerbations,” Dr. Baptist says. “Hormone replacement therapy has many side effects, but it may be worthwhile to consider it in some...
Conference Highlights: ACAAI 2016

Conference Highlights: ACAAI 2016

New research was presented at ACAAI 2016, the annual scientific meeting of the American College of Allergy, Asthma & Immunology, from November 10 to 14 in San Francisco. The features below highlight some of the studies presented at the conference.   Smoking Among Asthmatic Teens Previous research has shown that smoking rates among teens with asthma are relatively high. However, data are lacking on how smoking and smoking dependence differ between teens with asthma and those without the condition. For a study, researchers surveyed adolescents aged 13 to 19 about their smoking habits. When compared with participants who did not have asthma, teens with asthma were more likely to smoke, have some degree of nicotine dependence, and have tobacco dependence. Curiosity about cigarette smoking was identified as the primary reason why teens with asthma started smoking. ————————————————————–   Asthma Risk & Access to Fresh Foods Recent studies have linked obesity with a higher incidence of asthma and worse outcomes. A lack of access to healthy foods has been established as a driver of obesity, but few studies have assessed the impact of this phenomenon on asthma. Study investigators compared the prevalence of pediatric asthma between children with and without access to fruits, vegetables, and other fresh foods for a study. Among children without access, 21% had asthma, compared with a rate of 17% observed among those with access. Children in the study who lived more than 1 mile from a grocery store had 53% greater odds of having asthma. ————————————————————–   The Effect of Introducing Allergenic Foods Early Evidence suggests that the timing of introducing allergenic foods into an...
Asthma Linked With Shingles

Asthma Linked With Shingles

Previous research has suggested that children with asthma are at increased risk for developing herpes zoster (shingles or zoster), but this association has not been assessed in adults. Recent estimates show that asthma affects up to 17% of the United States population, and shingles affects nearly 1 million Americans every year, particularly the older adult population. For a study published in the Journal of Allergy and Clinical Immunology, Young J. Juhn, MD, MPH, and colleagues sought to determine whether or not asthma is associated with an increased risk of zoster in older adults.   Making the Link Prior to the current study, Dr. Juhn and colleagues found that asthma was linked to an increased risk of various respiratory infections, including community-acquired pneumonia, whooping cough, and ear infections. “Although this research was helpful, it didn’t explain whether the associations were due to airway structure or issues surrounding immune function,” says Dr. Juhn. “For the new study, we analyzed the association between asthma and zoster, which is not an airway infection, in order to help determine the epidemiologic relationship between asthma and the risk of zoster.” For the analysis, researchers compared the frequency of asthma among adults aged 50 or older with zoster with that of age- and gender-matched controls who did not have a history of zoster. Asthma status was based upon predetermined criteria rather than having physicians diagnose the disease using ICD-9 codes or self-reported asthma status, according to Dr. Juhn. Of the 371 patients with shingles, 23% had a history of asthma, compared with a rate of 15% that was observed among the 742 control subjects, Dr. Juhn...
CME: The Increasing Costs of COPD

CME: The Increasing Costs of COPD

Chronic lower respiratory disease—the large majority of which is COPD—currently ranks as the third leading cause of mortality in the United States. Recent estimates of the costs associated with chronic lower respiratory disease have presented asthma and COPD together, which does not allow for a true understanding of the costs of COPD to the national healthcare system. Fur-ther complicating available data is the fact that patients with COPD often have a multitude of comorbidities. “Most COPD is attributable to smoking, which can also cause heart disease, cancer, and many other conditions,” explains Earl S. Ford, MD, MPH. “This makes it difficult to understand what costs are directly attributable to COPD and what costs are actually attributable to conditions that co-exist with COPD. Some of the previous studies looking at the costs of COPD have likely included ‘double counting’ from not factoring in costs that are actually attributable to these comorbidities.” A Thorough Analysis For a study published in Chest, Dr. Ford and colleagues estimated national and state-specific COPD-attributable annual medical costs by payer and absenteeism in 2010 and projected medical costs through 2020. The team used the 2006 to 2010 Medical Expenditure Panel Survey, 2004 National Nursing Home Survey, and 2010 CMS data to generate cost estimates and 2010 census data to project medical costs through 2020. “We felt that the most presentable costs were those that were estimated after accounting for 11 comorbidities, including heart disease, pneumonia, diabetes, asthma, and depression,” adds Dr. Ford. After accounting for these other comorbidities, the researchers estimated that the 2010 costs attributable to COPD and its sequelae were $32.1 billion (Figure). By...
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