BACKGROUND: An association between obesity and asthma has been reported. The prevalence of airway hyperresponsiveness (AHR), results of skin prick tests, body mass index (BMI), and asthma symptoms were examined in schoolchildren. METHODS: The results of BMI (kg/m2) determination, skin prick testing, spirometry, asthma questionnaires, and methacholine challenge tests were obtained in a cross-sectional survey of 667 schoolchildren. The methacholine concentration causing a 20% fall in FEV1 (PC20) was used as the threshold of AHR. If the PC20 was less than 16 mg/mL, the subject was considered to have methachloine mediated AHR. RESULTS: The mean BMI was 17.1+/-0.09 kg/m2. The prevalence of AHR was 42.7%. The sensitization rate to common inhalant allergens was 30.3%. PC20 in children with BMIs >or=17.1 kg/m2 was significantly lower than that in children with BMIs 17.1 kg/m2. The mean BMIs of boys and girls were not significantly different. The levels of PC20 by sex were not different. The children were grouped by sex into percentile of BMI. PC20 in boys was lower in the obese group than in the non-weight and overweight groups (p<0.05). PC20 in boys and girls with atopy was significantly lower than in those without atopy. In a multiple logistic regression model that included all of the children and adjusted for confounding variables, independent associations with AHR were seen with BMI, asthma symptoms, and atopy . CONCLUSIONS: BMI had an association with AHR in school-age boys.
Sex Factors ; *Schools ; Risk Factors ; Questionnaires ; Obesity/*physiopathology ; Methacholine Chloride/*pharmacology ; Male ; Korea/epidemiology ; Hypersensitivity, Immediate/epidemiology/physiopathology ; Humans ; Health Surveys ; Female ; Comorbidity ; Child ; Bronchial Hyperreactivity/epidemiology/*physiopathology ; Body Mass Index ; Asthma/*physiopathology ; Age Factors

: Anaphylaxis is a predominantly childhood disease. Most of the literature on anaphylaxis has emerged from Western countries. This study aimed to describe the incidence, triggers and clinical presentation of anaphylaxis among children in Singapore, look for predictors for anaphylaxis with severe outcomes, and study the incidence of biphasic reactions.: We retrospectively reviewed records of children presenting with anaphylaxis to our paediatric emergency department from 1 January 2007 to 31 December 2014.: We identified 485 cases of anaphylaxis in 445 patients. Cutaneous symptoms (urticarial/angio-oedema) were the most common across all age groups (481 cases, 99%), followed by respiratory (412, 85%), gastrointestinal (118, 24%) and cardiovascular (35, 7.2%) symptoms. Central nervous system symptoms (drowsiness/ irritability) were rare across all age groups (11, 2.2%). Food was identified as the most common trigger across all age groups (45% to 63%). Seafood was the most common food trigger (57, 25%). A total of 420 (86.6%) children were treated with adrenaline, 451 (93%) received steroids and 411 (85%) received antihistamines. Sixty-three (13%) children fulfilled the criteria of severe anaphylaxis. There was no statistically significant association between severe anaphylaxis and the type of trigger (= 0.851), nor an overall past history of atopy (= 0.428). The only independent predictor for severe anaphylaxis was a previous drug allergy (= 0.016). A very low prevalence of biphasic reactions (0.6% of study population) was noted in our study.: We described the presentation and management of anaphylaxis in the Singapore population. A history of drug allergy is associated with severe presentation. Biphasic reactions are rare in our population.
Adolescent ; Adrenal Cortex Hormones ; therapeutic use ; Anaphylaxis ; drug therapy ; epidemiology ; etiology ; physiopathology ; Angioedema ; epidemiology ; etiology ; physiopathology ; Child ; Child, Preschool ; Drug Hypersensitivity ; epidemiology ; Emergency Service, Hospital ; Epinephrine ; therapeutic use ; Female ; Food Hypersensitivity ; complications ; epidemiology ; Gastrointestinal Diseases ; epidemiology ; etiology ; physiopathology ; Histamine Antagonists ; therapeutic use ; Humans ; Hypotension ; etiology ; physiopathology ; Incidence ; Infant ; Male ; Pediatrics ; Prevalence ; Respiratory Tract Diseases ; epidemiology ; etiology ; physiopathology ; Retrospective Studies ; Risk Factors ; Seafood ; Severity of Illness Index ; Singapore ; epidemiology ; Sympathomimetics ; therapeutic use ; Tertiary Care Centers ; Urticaria ; epidemiology ; etiology ; physiopathology

Passive smoking is a major cause of respiratory morbidity, and is associated with increased bronchial responsiveness in children. To evaluate the effect of smoking by a parent on asthma symptoms, atopy, and airway hyperresponsiveness (AHR), we conducted a cross-sectional survey of 503 schoolchildren that involved questionnaires, spirometry, allergy testing, and a bronchial challenge test. If the PC20 methacholine was less than 16 mg/mL, the subject was considered to have AHR. The prevalence of a parent who smoked was 68.7%. The prevalence of AHR was 45.0%. The sensitization rate to common inhalant allergens was 32.6%. Nasal symptoms such as rhinorrhea, sneezing, nasal itching, and nasal obstruction were present in 42.7%. Asthma symptoms such as cough and wheezing were present in 55.4%. The asthma symptoms were significantly more prevalent in children who had a parent who smoked than in those whose parents did not. The nasal symptoms, atopy, and AHR did not differ according to whether a parent smoked. In a multiple logistic regression model, the asthma symptoms and atopy were independently associated with AHR, when adjusted for confounding variables. Passive smoking contributed to asthma symptoms in schoolchildren and was not an independent risk factor of airway hyperresponsiveness in an epidemiological survey.
Adult ; Asthma/*epidemiology/physiopathology ; Bronchial Hyperreactivity/*epidemiology/physiopathology ; Child ; Data Collection ; Female ; Human ; Hypersensitivity/*epidemiology/physiopathology ; Male ; Parents ; Prevalence ; Risk Factors ; Support, Non-U.S. Gov't ; Tobacco Smoke Pollution/*adverse effects/*statistics & numerical data