Heavy Kids with Asthma More Prone to Hospital Stays
Overweight children who present to
the emergency room (ER) with an asthma
attack are more likely to be admitted to
the hospital than children of normal weight.
Researchers at Connecticut Children's
Hospital in Hartford reported that this was
the first study to examine the relationship
between pediatric patients with asthma
who are overweight and hospital admission
during asthma exacerbations. The
findings were based on a review of all children
over 2 years of age seen at the hospital's
ER for an asthma flare-up in 2005.
Only children who had no other chronic
medical conditions were included in the
study. Overweight in these children was
defined as being in the 95th or higher percentile
of weight-for-age. The results were
published in the October 2007 issue of
Pediatrics.
On average, 813 children made 884 ER
visits for asthma attacks during the study
period; of these visits, 27% resulted in a
hospital admission, including 4% to the
intensive care unit. Of all the ER visits
made for asthma attacks, 77% involved a
child of normal weight, and 23% an overweight
child.
No major differences in asthma severity
or in the treatment received in the ER
were noted between the overweight and
normal-weight children; 34% of the overweight
patients with asthma were admitted,
however, compared with 25% of the
normal-weight children. The researchers
concluded that "overweight children with
asthma have significant health-related
consequences as a result of their being
overweight."
Mom’s Asthma Affects Baby’s Eczema Risk
More information on the effects of maternal asthma on
breast-feeding infants has come from Maastricht University in
the Netherlands, where a study was conducted that found the
longer a mother nurses her infant, the lower the risk of the child
developing eczema. This risk increases, however, if the mother
has asthma or allergies. The findings were published in the
October 2007 issue of the Journal of Pediatrics.
Researchers analyzed data from the 2705 infants enrolled in
the Birth Cohort Study. Questionnaires had been given to the
mothers after 34 weeks of pregnancy, and at 3, 7, 12, and 24
months after birth, asking about breast-feeding, allergy manifestations,
and other information. Blood samples were taken during
home visits between 34 and 36 weeks of treatment.
Of all the infants studied, 2287 were breast-fed. A correlation
was found between a longer duration of breast-feeding and a
lower risk of eczema in infants of mothers without allergies or
asthma; there was no such association for mothers with asthma,
however.
Risk of Asthma Death Runs in Families
A study of genealogy records linked with death certificates in
Utah suggests that the risk of dying from an asthma attack is
hereditary.
Researchers at the University of Utah in Salt Lake City identified
1553 asthma-related deaths in a registry of all deaths in the
state since 1904, and found that the risk of dying from asthma
increased by 69% for first-degree relatives (children, full siblings)
of individuals who died from asthma, compared with patients
who died from asthma and had no family history of asthma
deaths. This asthma death risk was higher by 34% for second-degree
relatives (grandchildren, nephews, nieces, and half-siblings)
and higher by 15% among third-degree relatives (greatgrandchildren,
great-nieces, great-nephews, and first cousins).
The researchers concluded that the results should "provide
further incentive for asthma (health care) providers to thoroughly
question patients about family history, as it is a risk factor for
asthma mortality." The findings were published in the
November 2007 issue of American Journal of Respiratory and
Critical Care Medicine.
Powder-inhalers Commonly Misused
Researchers from Klinikum Offenburg in Germany reported
that 1 in 3 patients with asthma are currently using their drypowder
inhalers improperly. They also found that the older the
patient, and the more severe the lung disease, the less able the
patient to use the inhaler correctly.
The overall error rate was 32%, but this rate varied with age;
in patients younger than 60 years, the error rate was 20%,
whereas the rate for patients older than 60 was 41.6%, and
among those older than 80 years, the rate rose to >80%. The
findings were recently presented at CHEST 2007, the 73rd scientific
assembly of the American College of Chest Physicians.
The error rate also varied with disease severity. Among
patients with normal lung function, the rate was 25%, but in
those with severe airway obstruction, the rate was 63.6%. Error
rates were considerably lower in the patient groups who had
received training in the proper use of these inhalers by health
care providers and higher in those who had not been trained.
The researchers found that one third of patients surveyed had
only been referred to the package insert for use instructions.
They expressed concern that "caregivers must adopt modern
teaching techniques to meet the educational requirements of
their patients."
F A S T F A C T : Individuals who live with asthma patients are 3 times more likely to also be diagnosed with the disease.
