Chicago Asthma Epidemic: The Status of Asthma in Chicago

Chicago is known for many things, our great food and architecture. Unfortunately, we are also known for being an epi-center for asthma. We lead the Nation in asthma deaths, emergency room visits and hospitalizations. More than half (58%) of all children with asthma in Chicago had a severe asthma attack in the past year and nearly one-third (31%) had an asthma attack so bad they thought their life was in danger. Additionally, asthma affects African Americans and Hispanics disproportionately. Asthma is a life long chronic illness that effects the airways and lungs. With proper education and management asthma can be controlled and people with asthma should be able to live life the same as others

Reslizumab in patients with inadequately controlled late-onset asthma and elevated blood eosinophils

INTRODUCTION: Asthma with adult onset and elevated blood eosinophils is a difficult-to-treat subgroup. This post hoc analysis evaluated reslizumab, an anti-interleukin-5 monoclonal antibody, in patients with late-onset eosinophilic asthma. METHODS: Data from two 52-week placebo-controlled trials of reslizumab IV 3 mg/kg every 4 weeks in patients aged 12-75 years with inadequately controlled asthma, ≥1 asthma exacerbation within 12 months, and screening blood eosinophils ≥400/μL (NCT01287039/NCT01285323) were stratified by age of asthma onset (<40 or ≥40 years). Annual clinical asthma exacerbation rates, change in lung function, and patient-reported outcomes were analyzed. RESULTS: 273 patients with late-onset asthma (placebo, n = 130; reslizumab, n = 143) and 658 with early-onset asthma (placebo, n = 336; reslizumab, n = 322) were included. Baseline demographics were similar between groups. The interaction between age at onset of asthma and effect of reslizumab on asthma exacerbations was statistically significant (p = 0.0083). Compared with placebo, reslizumab produced a 75% relative reduction in asthma exacerbations in patients with late-onset asthma (rate ratio [RR] 0.25; 95% confidence interval [CI], 0.16, 0.40), substantially larger than the reduction in earlier onset patients (RR 0.58; 95% CI, 0.44, 0.76). Similar findings were observed for other measures of asthma, including forced expiratory volume in 1 s (FEV1). The adverse event profile of reslizumab was similar in patients with early- or late-onset asthma. CONCLUSIONS: Compared with placebo, reslizumab produced larger reductions in asthma exacerbations and larger improvements in lung function in patients with late versus early-onset asthma

African American Asthma Statistics

Chicago is known for many things, our great food and architecture. Unfortunately, we are also known for being an epi-center for asthma. We lead the Nation in asthma deaths, emergency room visits and hospitalizations. More than half (58%) of all children with asthma in Chicago had a severe asthma attack in the past year and nearly one-third (31%) had an asthma attack so bad they thought their life was in danger. Additionally, African Americans are affected by disproportionately high rates of asthma. Asthma is a life long chronic illness that affects the airways and lungs. With proper education and management asthma can be controlled and people with asthma should be able to live life the same as others

Monitoring asthma in childhood : Lung function, bronchial responsiveness and inflammation

Peer reviewedPublisher PD

Estadsticas del Asma en Los Latinos

Chicago is known for many things, our great food and architecture. Unfortunately, we are also known for being an epi-center for asthma. We lead the Nation in asthma deaths, emergency room visits and hospitalizations. More than half (58%) of all children with asthma in Chicago had a severe asthma attack in the past year and nearly one-third (31%) had an asthma attack so bad they thought their life was in danger. Additionally, Latinos suffer from disproportionately high rates of asthma. Asthma is a life long chronic illness that effects the airways and lungs. With proper education and management asthma can be controlled and people with asthma should be able to live life the same as others

A Twin Study of Early-Childhood Asthma in Puerto Ricans

Background:The relative contributions of genetics and environment to asthma in Hispanics or to asthma in children younger than 3 years are not well understood.Objective:To examine the relative contributions of genetics and environment to early-childhood asthma by performing a longitudinal twin study of asthma in Puerto Rican children ≤3 years old.Methods:678 twin infants from the Puerto Rico Neo-Natal Twin Registry were assessed for asthma at age 1 year, with follow-up data obtained for 624 twins at age 3 years. Zygosity was determined by DNA microsatellite profiling. Structural equation modeling was performed for three phenotypes at ages 1 and 3 years: physician-diagnosed asthma, asthma medication use in the past year, and ≥1 hospitalization for asthma in the past year. Models were additionally adjusted for early-life environmental tobacco smoke exposure, sex, and age.Results:The prevalences of physician-diagnosed asthma, asthma medication use, and hospitalization for asthma were 11.6%, 10.8%, 4.9% at age 1 year, and 34.1%, 40.1%, and 8.5% at 3 years, respectively. Shared environmental effects contributed to the majority of variance in susceptibility to physician-diagnosed asthma and asthma medication use in the first year of life (84%-86%), while genetic effects drove variance in all phenotypes (45%-65%) at age 3 years. Early-life environmental tobacco smoke, sex, and age contributed to variance in susceptibility.Conclusion:Our longitudinal study in Puerto Rican twins demonstrates a changing contribution of shared environmental effects to liability for physician-diagnosed asthma and asthma medication use between ages 1 and 3 years. Early-life environmental tobacco smoke reduction could markedly reduce asthma morbidity in young Puerto Rican children. © 2013 Bunyavanich et al

Does asthma impair wealth accumulation or does wealth protect against asthma?

OBJECTIVE: We investigate the association between adult asthma and wealth, testing whether the disease impairs wealth accumulation (social selection model) or if wealth protects against asthma (social causation model). METHODS: We use the National Longitudinal Survey of Youth (n = 7,644) and linear and logistic regressions to estimate the association between wealth and asthma. Changes in relative wealth following an asthma diagnosis and asthma status by increases in wealth through inheritance provide evidence on the causal direction. RESULTS: Asthma, particularly severe asthma, is associated with lower wealth. Wealth ranking does not change after a diagnosis of asthma, but inheriting a substantial sum is associated with a lower risk of severe asthma. CONCLUSION: Wealth appears to protect against severe asthma, supporting the social causation model of disease.Accepted manuscrip

Occupational Asthma or Work-Related Exacerbation of Asthma

[Excerpt] Occupational asthma is asthma due to work exposures. It can be caused by a specific workplace agent with a specific immune system response – the agent is called a sensitizer. It has been recommended that whenever an adult experiences new-onset asthma, occupational asthma should be suspected. The respiratory symptoms of occupational asthma include wheezing, shortness of breath, chest tightness, cough, and sputum production. While these are similar to asthma that is not work-related, these symptoms occur due to a work-related exposure

Asthma Prevalence, Knowledge, and Perceptions among Secondary School Pupils in Rural and Urban Costal Districts in Tanzania.

Asthma is a common chronic disease of childhood that is associated with significant morbidity and mortality. We aimed to estimate the prevalence of asthma among secondary school pupils in urban and rural areas of coast districts of Tanzania. The study also aimed to describe pupils' perception towards asthma, and to assess their knowledge on symptoms, triggers, and treatment of asthma. A total of 610 pupils from Ilala district and 619 pupils from Bagamoyo district formed the urban and rural groups, respectively. Using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, a history of "diagnosed" asthma or the presence of a wheeze in the previous 12 months was obtained from all the studied pupils, along with documentation of their perceptions regarding asthma. Pupils without asthma or wheeze in the prior 12 months were subsequently selected and underwent a free running exercise testing. A >= 20% decrease in the post-exercise Peak Expiratory Flow Rate (PEFR) values was the criterion for diagnosing exercise-induced asthma. The mean age of participants was 16.8 (+/-1.8) years. The prevalence of wheeze in the past 12 months was 12.1% in Bagamoyo district and 23.1% in Ilala district (p < 0.001). Self-reported asthma was found in 17.6% and 6.4% of pupils in Ilala and Bagamoyo districts, respectively (p < 0.001). The prevalence of exercise-induced asthma was 2.4% in Bagamoyo, and 26.3% in Ilala (P < 0.002). In both districts, most information on asthma came from parents, and there was variation in symptoms and triggers of asthma reported by the pupils. Non-asthmatic pupils feared sleeping, playing, and eating with their asthmatic peers. The prevalence rates of self-reported asthma, wheezing in the past 12 months, and exercise-induced asthma were significantly higher among urban than rural pupils. Although bronchial asthma is a common disease, pupils' perceptions about asthma were associated with fear of contact with their asthmatic peers in both rural and urban schools

Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity.

BackgroundThe morbidity and mortality from asthma have markedly increased since the late 1970s. The hospitalization rate, an important marker of asthma severity, remains substantial.MethodsIn adults with health care access, we prospectively studied 242 with asthma, aged 18-50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization.ResultsThirty-nine subjects (16%) reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1-8.8) and lower income (OR, 1.1 per $10,000 decrement; 95$10,000 decrement; 95% CI, 1.02-1.4).ConclusionIn adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality