Clinically diagnosed childhood asthma and follow-up of symptoms in a Swedish case control study

BACKGROUND: Childhood asthma has risen dramatically not only in the western societies and now forms a major and still increasing public health problem. The aims of this study were to follow up at the age of ten the patterns of asthma symptoms and associations among children with a clinically diagnosed asthma in a sizeable urban-rural community and to in compare them with demographic controls using a standardised questionnaire. METHODS: In a defined region in Sweden with a population of about 150 000 inhabitants, all children (n = 2 104) born in 1990 were recorded. At the age of seven all primary care and hospital records of the 1 752 children still living in the community were examined, and a group of children (n = 191) was defined with a well-documented and medically confirmed asthma diagnosis. At the age of ten, 86 % of these cases (n = 158) and controls (n = 171) completed an ISAAC questionnaire concerning asthma history, symptoms and related conditions. RESULTS: Different types of asthma symptoms were highly and significantly over-represented in the cases. Reported asthma heredity was significantly higher among the cases. No significant difference in reported allergic rhinitis or eczema as a child was found between cases and controls. No significant difference concerning social factors or environmental exposure was found between case and controls. Among the control group 4.7 % of the parents reported that their child actually had asthma. These are likely to be new asthma cases between the age of seven and ten and give an estimated asthma prevalence rate at the age of ten of 15.1 % in the studied cohort. CONCLUSION: A combination of medical verified asthma diagnosis through medical records and the use of self-reported symptom through the ISAAC questionnaire seem to be valid and reliable measures to follow-up childhood asthma in the local community. The asthma prevalence at the age of ten in the studied birth cohort is considerably higher than previous reports for Sweden. Both the high prevalence figure and allowing the three-year lag phase for further settling of events in the community point at the complementary roles of both hospital and primary care in the comprehensive coverage and control of childhood asthma in the community

A survey of the quality of information leaflets on hayfever available from general practices and community pharmacies

Background: Hayfever affects at least one in 10 people. The majority of hayfever is managed in the community setting where the management options are pharmaceutical and behavioural. Hayfever medications are available over the counter and on prescription from the general practitioner. Patient information leaflets are published to augment the advice given and to promote self‐management, but these leaflets have rarely been subjected to critical review. Objective: To assess the quality of patient information leaflets written for people with hayfever and available from general practices and from community pharmacists. Method: A structured review of patient information leaflets about hayfever. During the peak grass pollen season copies of all leaflets available were collected from a random sample of community pharmacists and general practices in Wessex. The characteristics of the leaflet were recorded and the contents and presentation of each one was reviewed using the British Medical Association patient information appraisal system. Readability was assessed using the Simple Measure of Gobbledegook (SMOG). Two allergy‐accredited specialists assessed each leaflet for accuracy. Results: During the peak pollen season no leaflets were available in 30% of the Community Pharmacists and 23% general practices. In total, 38 different leaflets were identified. All the leaflets reviewed were written for adults. Forty‐seven percent of the leaflets had no publication date and one‐third of those dated were at least 5 years old. In general the leaflets scored highly on issues of presentation, but less than half contained information on the full range of management and treatment options, many being biased towards a single or limited range of interventions. Seventy‐nine percent leaflets were produced or sponsored by pharmaceutical companies and gave prominence to their own products. All the leaflets had readability scores requiring at least secondary education (SMOG score equal or greater than 9). At least one factual inaccuracy was identified in four‐fifths of leaflets. Conclusion: A large number of leaflets are published for people with hayfever, but they are of variable quality and not accessible to all patients because of limited distribution or high readability scores. If all patients are to benefit from written information the authors and publishers of leaflets need to follow published recommendations, especially with respect to content and readability. In the absence of a national public health information strategy or a body that systematically vets patient information materials, clinicians must pay attention to the quality of information provided for or obtained elsewhere by their patients

Effects of bioaerosol exposure on work-related symptoms among Swiss sawmill workers

Objective Exposure to bioaerosols in the occupational environment of sawmills could be associated with a wide range of health effects, in particular respiratory impairment, allergy and organic dust toxic syndrome. The objective of the study was to assess the frequency of medical respiratory and general symptoms and their relation to bioaerosol exposure. Method Twelve sawmills in the French part of Switzerland were investigated and the relationship between levels of bioaerosols (wood dust, airborne bacteria, airborne fungi and endotoxins), medical symptoms and impaired lung function was explored. A health questionnaire was distributed to 111 sawmill workers. Results The concentration of airborne fungi exceeded the limit recommended by the Swiss National Insurance (SUVA) in the twelve sawmills. This elevated fungi level significantly influenced the occurrence of bronchial syndrome (defined by cough and expectorations). No other health effects (irritations or respiratory effects) could be associated to the measured exposures. We observed that junior workers showed significantly more irritation syndrome (defined by itching/running nose, snoring and itching/red eyes) than senior workers. Lung function tests were not influenced by bioaerosol levels nor dust exposure levels. Conclusion Results suggest that occupational exposure to wood dust in a Swiss sawmill does not promote a clinically relevant decline in lung function. However, the occurrence of bronchial syndrome is strongly influenced by airborne fungi levels. [Authors]]]> Air Pollutants, Occupational ; Air Microbiology ; Bacteria ; Endotoxins ; Fungi ; Dust ; Environmental Monitoring ; Wood ; Occupational Exposure ; Occupational Diseases ; Respiratory Tract Diseases eng https://serval.unil.ch/resource/serval:BIB_B4AA3AA89E66.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_B4AA3AA89E664 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_B4AA3AA89E664 info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_B4AA7325E6FA 2022-02-19T02:29:06Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_B4AA7325E6FA Guidelines for the use and interpretation of assays for monitoring autophagy in higher eukaryotes. info:eu-repo/semantics/altIdentifier/pmid/18188003 Klionsky, D.J. Abeliovich, H. Agostinis, P. Agrawal, D.K. Aliev, G. Askew, D.S. Baba, M. Baehrecke, E.H. Bahr, B.A. Ballabio, A. Bamber, B.A. Bassham, D.C. Bergamini, E. Bi, X. Biard-Piechaczyk, M. Blum, J.S. Bredesen, D.E. Brodsky, J.L. Brumell, J.H. Brunk, U.T. Bursch, W. Camougrand, N. Cebollero, E. Cecconi, F. Chen, Y. Chin, L.S. Choi, A. Chu, C.T. Chung, J. Clarke, P.G.H et, al. info:eu-repo/semantics/review article 2008 Autophagy, vol. 4, no. 2, pp. 151-175 info:eu-repo/semantics/altIdentifier/pissn/1554-8635 <![CDATA[Research in autophagy continues to accelerate,(1) and as a result many new scientists are entering the field. Accordingly, it is important to establish a standard set of criteria for monitoring macroautophagy in different organisms. Recent reviews have described the range of assays that have been used for this purpose.(2,3) There are many useful and convenient methods that can be used to monitor macroautophagy in yeast, but relatively few in other model systems, and there is much confusion regarding acceptable methods to measure macroautophagy in higher eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers of autophagosomes versus those that measure flux through the autophagy pathway; thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from fully functional autophagy that includes delivery to, and degradation within, lysosomes (in most higher eukaryotes) or the vacuole (in plants and fungi). Here, we present a set of guidelines for the selection and interpretation of the methods that can be used by investigators who are attempting to examine macroautophagy and related processes, as well as by reviewers who need to provide realistic and reasonable critiques of papers that investigate these processes. This set of guidelines is not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to verify an autophagic response

Prevalência de asma brônquica e de sintomas a ela relacionados em escolares do Distrito Federal e sua relação com o nível socioeconômico Prevalence of bronchial asthma and related symptoms in schoolchildren in the Federal District of Brazil: correlations with socioeconomic levels

OBJETIVO: Avaliar a prevalência de asma e sintomas a ela relacionados no Distrito Federal e sua relação com o nível socioeconômico, utilizando o questionário escrito do International Study of Asthma and Allergies in Childhood. MÉTODOS: Foram avaliadas 6.437 crianças, em escolas públicas e particulares, divididas em: 3.183 crianças de seis a sete anos e 3.254 de treze a catorze anos. Os dados foram analisados por sexo e grupo socioeconômico (teste do qui-quadrado). RESULTADOS: A prevalência encontrada de asma brônquica no Distrito Federal foi de 12,1% e 13,8% nas faixas etárias de seis a sete anos e treze a catorze anos, respectivamente (p < 0,04). Na faixa etária de seis a sete anos, o sexo masculino apresentou prevalências significativamente maiores de asma diagnosticada e de sintomas (p < 0,001), enquanto que na de treze a catorze anos, a maior prevalência de sintomas ocorreu no sexo feminino (p < 0,05). O grupo de piores condições socioeconômicas apresentou maiores taxas de sintomas relacionados à asma nas duas faixas etárias (p < 0,05). O diagnóstico de asma foi mais freqüente na classe social menos favorecida (p < 0,001) para o questionário respondido pelos pais. Entre os adolescentes, houve maior número de diagnósticos de asma no grupo de nível socioeconômico mais elevado (p = 0,001). CONCLUSÃO: O grupo economicamente desfavorecido apresentou prevalências maiores de sintomas de asma, assim como crises de maior gravidade. Também a prevalência de asma provável foi maior neste grupo que a de asma diagnosticada, o que sugere seu subdiagnóstico.<br>OBJECTIVE: To evaluate the asthma prevalence in the Federal District of Brazil, using the questionnaire developed for the International Study of Asthma and Allergies in Childhood to look for correlations with socioeconomic levels. METHODS: A total of 6437 children (3183 from six to seven years old and 3254 from thirteen to fourteen years old), attending public or private schools, were evaluated. The data were analyzed by gender and socioeconomic status (chi-square test). RESULTS: The prevalence of asthma in the Federal District was 12.1% among the six- and seven-year-olds and 13.8% among the thirteen- and fourteen-year-olds (p < 0.04). In the six-to-seven age bracket, asthma prevalence was significantly greater, and asthma-related symptoms were more frequent, among males (p < 0.001). In contrast, asthma-related symptoms were more frequent among females in the thirteen-to-fourteen age bracket (p < 0.05). Children belonging to the lowest socioeconomic class, as determined by the responses given on the questionnaire completed by the parents, presented the highest prevalence of asthma, regardless of age bracket (p < 0.001). Among such children, asthma-related symptoms were also more frequent (p < 0.05). In the thirteen-to-fourteen age bracket, the prevalence of asthma was greater among those belonging to the highest socioeconomic class (p = 0.001). CONCLUSIONS: Overall, economically disadvantaged children more frequently presented asthma-related symptoms and experienced asthma attacks that were of greater severity. In addition, the prevalence of suspected asthma was higher than that of diagnosed asthma in this group, suggesting that asthma is underdiagnosed in children belonging to the lowest socioeconomic class