ASTHMA WATCH

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Adolescents Welcome Web-based Asthma Management

Researchers from Leiden University Medical Center in the Netherlands report that teens with poorly controlled asthma are open to the option of using the Internet and instant messaging (IMing) to help them manage their condition, whereas those whose asthma is already under control do not feel the same need. The study findings were reported in the July 2007 issue of Chest.

The investigators looked at 97 teens, who monitored their asthma for 1 month by checking lung function each day and entering the findings into a Web application or by way of a short message service. Patients then received an IM that rated their lung function as a percentage of expected or personal best values.

The researchers later conducted focus groups to evaluate participants' perceptions of the Web-based system. Those with poorly controlled asthma felt that studying their symptoms over time and being able to react to changes was beneficial. Those with well-controlled asthma thought that the system was "fun" but not very useful.

Athletes with Asthma Benefit from Warming Up

The results of a new study show that patients with asthma can reduce the tightening of the airway that can come with physical activity by warming up with shorter episodes of high-intensity exercise before working out. The researchers noted that previous studies showed that exercise-induced bronchoconstriction can be reduced after repeated exercise in about 50% of asthma patients. The findings were reported in the June 2007 issue of the International Journal of Sports Medicine.

The researchers had 8 athletes with asthma exercise on a treadmill 4 separate times: without warming up first; after performing eight 30-second runs at peak speed with a 45-second break between each run; after taking 200 ?g of a beta-2 agonist; after both sprinting and using the medication. Exercising alone was found to produce an 18% reduction in lung capacity; with the sprinting warm-up, however, lung capacity fell to only 9%. The drug alone produced a 9% drop also, and the warm-up plus the drug provided the greatest beneficial effect. The investigators noted, however, that the medicines could hamper lung function with regular use.

Printers and Nurses at Greater Risk for Asthma

A research team in Europe has found that nurses, printers, and woodworkers are at a greater risk of developing work-related asthma than the average population. The team is calling for more careful monitoring of workers' exposure to chemicals that could trigger the disease. The researchers discovered that workplace conditions could be behind 1 of every 4 new cases of asthma in industrialized countries. Their findings were published in the July 27, 2007, issue of the Lancet.

The researchers studied health information and workplace exposure details for more than 6800 people who had taken part in the European Community Respiratory Health Survey between 1990 and 1995. At the start of the 9-year study, none of the participants had asthma. Exposure to potential asthma-causing agents was determined using an "asthma-specific job exposure matrix," along with additional input from asthma experts.

The investigators found that exposure to known asthma-causing agents increased the risk of developing the disease by an average of 60%. The occupations at greatest risk were printing (137%), nursing (122%), and woodworking (122%), followed by agriculture/forestry (85%) and cleaning (71%). The risk was tripled following specific events, such as fires, chemical spills, or mixing different cleaning products.

Short Courses of Steroids Cut Relapses

Giving patients who present to the hospital emergency department with an asthma attack a short course of steroid therapy after release has been shown to reduce the rates of relapse. The use of steroids also cut down on the patients' use of inhalers.

Between 12% and 16% of asthma patients who are discharged from the hospital after an attack experience a relapse within 2 weeks. The benefits were found to last up to 3 weeks after discharge.

Researchers at the University of Alberta in Edmonton, Canada, looked at the data from 6 trials involving a total of 374 asthma patients. They stated, "Our research found clear evidence that people who arrived at a hospital with acute asthma and were well enough to be discharged benefited from the addition of corticosteroid therapy."

The investigators were not able to identify a difference in benefit between oral and intramuscular routes of steroid administration. That topic is the subject of a future Cochrane Systematic Review.

FAST FACT: Overweight and obese asthma patients experience more severe and persistent symptoms and use more medication than normal-weight patients.