Asthma/*complications ; Asthma/epidemiology ; *Education, Medical ; Malaysia/epidemiology ; *Patient Education ; Prevalence ; Severity of Illness Index

OBJECTIVEChronic cough in children is a common pediatric symptom with complex causes and its diagnosis is difficult; chronic cough affects the life of children in both physical and mental health and also learning. Therefore this study aimed to investigate the causes of chronic cough in children in Fuzhou area of Fujian province.

METHODData were collected from 364 children with chronic cough who visited the asthma specialist clinic of Children's Hospital of Fuzhou, Fujian Province from March 2009 to April 2010. The diagnosis was made according to Guideline for Diagnosis and Treatment of Chronic Cough in Pediatrics published in 2008. Among the patients, 241 were boys and 123 girls. The patients were divided into 3 age groups: group 1, 1 to 3 years old (infants and young children group, n = 75); group 2, 4 to 6 years old (pre-school group, n = 215); and group 3, over 7 years (school-age group, n = 74), the mean age was (4.8 ± 1.1) years (3 months to 14 years), course of the illness was (4.5 ± 1.8) months (4 weeks to 38 months). Mycoplasma pneumoniae was detected by Enzyme-linked immunosorbent assay (ELISA).

RESULTThe causes of chronic cough were as follows: 171 cases (46.98%) had cough variant asthma; 104 cases (28.57%) had upper airway cough syndrome; 58 cases (15.93%) had respiratory infections; 17 cases (4.67%) had gastroesophageal reflux; 3 cases (0.82%) had foreign bodies. Totally 9 cases (2.47%) had chronic cough associated with 3 causes; 56 cases (15.38%) had 2 causes and 299 cases (82.14%) had single cause. The main causes of cough in the group of pre-school children were cough variant asthma and upper airway cough syndrome. The proportion of the upper airway cough syndrome in school-age children group was the highest among the 3 age groups, which is flowed by cough variant asthma.

CONCLUSIONThe causes of chronic cough in children were cough variant asthma, upper airway cough syndrome, respiratory infections, cough after infection, gastroesophageal reflux and foreign bodies in Fuzhou area of Fujian province. Children with chronic cough in different age groups had different etiology, in about 18% of the children the etiology of chronic cough was associated with 3 or 2 causes, indicating that the causes of chronic cough in children are multifactorial.

Adolescent ; Asthma ; complications ; Child ; Child, Preschool ; China ; epidemiology ; Chronic Disease ; Cough ; epidemiology ; etiology ; Female ; Humans ; Infant ; Infection ; complications ; Male

OBJECTIVE: To discuss the disease incidence of bronchial asthma (BA) complicated with allergic rhinitis (AR) and the correlation of their age, classification, concomitant symptom. METHOD: Four hundred-nine cases of AR were identified by means of random sampling, physical examination, laboratory test and questionnaire. According to the diagnostic criteria of BA, they were divided into two groups: group I ( control group) including 298 cases suffering from only AR, group II ( experimental group) 191 cases of BA concomittent with AR. RESULT: 1) This study showed that BA concomittent with AR account for 39% of all cases; 2) Incidence of aspirin triad syndrome (asthma, rhinopolyps and aspirin intolerance) was significantly different in two groups (P<0.01); 3) As for age group distribution, there was significant difference between groups in age segment 10-19 and 40-49 (P<0.05); 4) Disease classification: there were significant differences in the incidence of moderate to severe intermittent AR, mild continuous AR, and moderate to severe continuous AR between two groups (P<0.05); 5) Other major concomitant diseases and symptoms distribution; the concomittant occurrence of allergic pharyngitis, sinusitis, conjunctivitis, secretory tympanitis, hypertrophic rhinitis, dermatosis, discomfort of gastrointestinal tract, and headache of unknown origin were significantly different between two groups (P<0.05). The difference above showed that the occurrence in experimental group was higher than that in control group. CONCLUSION the incidence of BA complicated with AR were relatively high in Datong, with a peak incidence at age 10 to 19 and 40 to 49. The common types of disease were moderate to severe intermittent AR, mild continuous AR, and moderate to severe continuous AR. The number of patients with BA complicated with AR were growing.
Adolescent ; Adult ; Aged ; Asthma ; complications ; epidemiology ; Child ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Rhinitis, Allergic, Perennial ; complications ; epidemiology ; Rhinitis, Allergic, Seasonal ; complications ; epidemiology ; Surveys and Questionnaires ; Young Adult

Anti-Asthmatic Agents ; therapeutic use ; Asthma ; epidemiology ; etiology ; therapy ; Body Mass Index ; Child ; Child, Preschool ; Chronic Disease ; Humans ; Obesity ; complications ; epidemiology ; prevention & control ; Risk Factors

OBJECTIVETo establish the evidence of exposure to rural areas would reduce the risk of atopic asthma and sensitization.

METHODSA cross-sectional survey was carried out in 2986 school-age children and their parents completed standardized questionnaires on atopic asthma and sensitization, wheezing. A radioallergosorbent technique-fluorescence enzyme immunoassay (RAST-FEIA) was used to measure the level of specific IgE in serum.

RESULTSThe risks of atopic and non-atopic asthma (OR = 0.45, 95% CI:0.13-0.96 and OR=0.41, 95% CI:0.15-0.95), atopic sensitization. and wheezing (OR= 0.32, 95% CI:0.11-0.62; OR =0.44, 95% CI:0.13-0.91) were lower in subjects living in village area compared with those living in towns. The risks of atopic asthma and sensitization were lower in subjects exposed to stables in first year (OR=0.23, 95% CI:0.04-0.91 and OR =0.32, 95% CI:0.17-0.78) and were lowest in those exposed continually until the age of 6 (OR = 0.21, 95% CI:0.03-0.87 and OR = 0.31, 95% CI:0.15-0.78) compared with those non-exposed in the first 6 years.

CONCLUSIONExposure to rural environment might have a protective effect on children against atopic asthma and sensitization while continual exposure could strengthen the effects.

Anaphylaxis ; complications ; epidemiology ; prevention & control ; Asthma ; epidemiology ; etiology ; prevention & control ; Child ; China ; Environmental Exposure ; Female ; Humans ; Male ; Rural Population ; Surveys and Questionnaires

PURPOSE: This study aimed to evaluate the correlation between associating factors of moderate to severe asthma with obstructive sleep apnea (OSA). MATERIALS AND METHODS: One hundred and sixty-seven patients who visited the pulmonary and sleep clinic in Severance Hospital presenting with symptoms of sleep-disordered breathing were evaluated. All subjects were screened with ApneaLink. Thirty-two subjects with a high likelihood of having OSA were assessed with full polysomnography (PSG). RESULTS: The mean age was 58.8+/-12.0 years and 58.7% of subjects were male. The mean ApneaLink apnea-hypopnea index (AHI) was 12.7+/-13.0/hr. The mean ApneaLink AHI for the 32 selected high risk patients of OSA was 22.3+/-13.2/hr, which was lower than the sleep laboratory-based PSG AHI of 39.1+/-20.5/hr. When OSA was defined at an ApneaLink AHI > or =5/hr, the positive correlating factors for OSA were age, male gender, and moderate to severe asthma. CONCLUSION: Moderate to severe asthma showed strong correlation with OSA when defined at an ApneaLink AHI > or =5/hr.
Aged ; Asthma/complications/epidemiology/*etiology ; Comorbidity ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Polysomnography/instrumentation ; Severity of Illness Index ; Sleep Apnea Syndromes/epidemiology/etiology ; Sleep Apnea, Obstructive/complications/epidemiology/*physiopathology

BACKGROUND: Eosinophilic inflammation of the airway is usually associated with airway hyper-responsiveness in bronchial asthma. However, there is a small group of patients which has the eosinophilic inflammation in the bronchial tree with normal spirometry and no evidence of airway hyper-responsiveness, which was named eosinophilic bronchitis. The objectives of this study are 1) to investigate the incidence of eosinophilic bronchitis in the chronic cough syndrome and 2) to evaluate the clinical features and course of eosinophilic bronchitis. METHODS: We evaluated 92 patients who had persistent cough for 3 weeks or longer. In addition to routine diagnostic protocol, we performed differential cell count of sputum. Eosinophilic bronchitis was diagnosed when the patient had normal spirometric values, normal peak expiratory flow variability, no airway hyper-responsiveness and sputum eosinophilia (>3%). RESULTS: The causes of chronic cough were post-nasal drip in 33%, cough variant asthma in 16%, chronic bronchitis in 15% and eosinophilic bronchitis in 12% of the study subjects. Initial eosinophil percentage in the sputum of patients with eosinophilic bronchitis was 26.8+/-6.1% (3.8-63.7%). Treatment with inhaled steroid is related with a subjective improvement of cough severity and a significant decrease of sputum eosinophil percentage (from 29.1+/-8.3% to 7.4+/-3.3%). During the follow-up period, increase in sputum eosinophil percentage with aggravation of symptoms were found. CONCLUSION: Eosinophilic bronchitis is one of the important cause of chronics cough. Assessment of airway inflammation by sputum examination is important in investigating the cause of chronic cough. Cough in eosinophilic bronchitis is effectively controlled by inhaled corticosteroid, but may follow a chronic course.
Adult ; Aged ; Anti-Inflammatory Agents, Steroidal/therapeutic use ; Asthma/complications/epidemiology ; Bronchitis/*complications/diagnosis/drug therapy/epidemiology ; Budesonide/therapeutic use ; Chronic Disease ; Cough/epidemiology/*etiology ; Eosinophilia/*complications/diagnosis/drug therapy/epidemiology ; Female ; Gastroesophageal Reflux/complications/epidemiology ; Human ; Male ; Middle Age ; Respiratory Function Tests ; Severity of Illness Index ; Sputum/chemistry/immunology

The purpose of this study was to investigate the association between asthma and invasive pneumococcal disease (IPD) in Korea. A retrospective population-based cohort study was conducted using the Korean Health Insurance Review and Assessment database 2010-2011. The subjects included 935,106 (2010) and 952,295 (2011), of whom 398 (2010) and 428 (2011) patients with IPD were identified. There was significant difference in the prevalence of IPD in patients with and without asthma (0.07% vs. 0.02% in 2010 and 0.08% vs. 0.01% in 2011; P<0.001). After adjusting for age and gender, patients with asthma showed over a three-fold increased risk of IPD compared with patients without asthma (adjusted odds ratio [aOR] 3.90, 95% confidence interval [CI] 3.02-5.03 in 2010 / aOR, 5.44; 95% CI, 4.10-7.22 in 2011; P<0.001). These findings were also significant in children (aOR, 2.08; 95% CI, 1.25-3.45 in 2010; P=0.005 / aOR, 3.26; 95% CI, 1.74-6.11 in 2011; P<0.001). Although diabetes mellitus was also significantly associated with IPD, relatively low ORs compared with those of asthma were noted (aOR, 1.85; 95% CI, 1.35-2.54 in 2010 / aOR, 2.40; 95% CI, 1.78-3.24 in 2011; P<0.001). Both children and adults with asthma are at increased risk of developing IPD.
Adolescent ; Adult ; Aged ; Asthma/complications/*epidemiology ; Child ; Cohort Studies ; Diabetes Mellitus/epidemiology ; Heptavalent Pneumococcal Conjugate Vaccine/immunology ; Humans ; Immunologic Deficiency Syndromes/complications/*epidemiology ; Middle Aged ; Pneumococcal Infections/complications/*epidemiology ; Pneumococcal Vaccines/immunology ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Streptococcus pneumoniae/pathogenicity ; Young Adult

To validate the prevalence rate of symptoms of asthma produced by the phase I ISAAC (International Study of Asthma and Allergies in Childhood) study, hypertonic saline challenge test was carried out during the phase II study at a year after the phase I study. For the phase II study, six middle schools from three cities in the phase I study were selected. Finally, 499 children who responded to both studies were analyzed. All subjects were asked to complete the written questionnaire (WQ) first, followed by a video questionnaire (AVQ 3.0) during the phase I study. Of the 499 children, only 19 (3.8%) were positive to the hypertonic saline bronchial challenge test. The degree of agreement between responses to the two corresponding questions "wheezing at rest" and "nocturnal wheeze" in the AVQ 3.0 and WQ were moderate and weak with a Kappa indices of 0.45 and 0.23, respectively. The question on "severe wheeze" in the AVQ 3.0 had the highest Youden's index among the five questions related to asthma symptoms in the previous 12 months, but its specificity was low whereas it 's sensitivity was 1.0. There was no consistency of priority between the two questionnaires in predicting bronchial hyperreactivity in a group of Korean schoolchildren. Therefore we need to develop more appropriate WQ or AVQ to compare the prevalences of asthma to other countries.
Adolescent ; Asthma/diagnosis* ; Asthma/epidemiology ; Asthma/etiology ; Bronchial Hyperreactivity/complications ; Bronchial Hyperreactivity/diagnosis* ; Bronchial Hyperreactivity/epidemiology ; Bronchial Provocation Tests ; Comparative Study ; Female ; Human ; Korea/epidemiology ; Language ; Male ; Prevalence ; Questionnaires* ; Random Allocation ; Respiratory Sounds ; Saline Solution, Hypertonic/diagnostic use ; Sampling Studies ; Videotape Recording ; Writing

The objective of this study was to evaluate the prevalence of asthma, allergic rhinitis, and atopic dermatitis, as well as the risk factors of wheezing among young adults in the Korean military. Young military conscripts in five areas completed a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. For subjects with current wheeze in one sample area, baseline spirometry and bronchodilator response were measured. For subjects without a significant response to bronchodilator (improvement in FEV1 of more than 200 mL and 12%), methacholine challenge tests (MCT) were also performed. Of 3,359 subjects that completed the questionnaire, 354 (10.5%) had current wheeze, 471 (14.0%) had current allergic rhinitis, and 326 (9.7%) had current eczema. Current wheeze was associated with family history of allergic disease, overweight, current smoking, allergic rhinitis, and atopic dermatitis. Of 36 subjects with current wheeze who underwent PFT with or without MCT in the Anyang area, 24 (66.7%) were confirmed to have current asthma. In conclusion, the prevalence of allergic disease in young adults of Korean military is not low, and the risk factors of wheezing include family history of allergic disease, overweight, current smoking, allergic rhinitis, and atopic dermatitis.
Adult ; Asthma/*complications/epidemiology/*immunology ; Bronchial Provocation Tests ; Humans ; Hypersensitivity/*epidemiology/*immunology ; *Military Personnel ; Prevalence ; Questionnaires ; Republic of Korea/epidemiology ; Respiratory Function Tests ; Respiratory Sounds/*etiology ; Risk Factors ; Young Adult