Posted by: Kurnia | April 6, 2009

Journal Watch Allergy/Asthma Alert

Allergy / Asthma for April 2, 2009
SUMMARY AND COMMENT

What Causes Childhood Asthma?

April 1, 2009 | F. Bruder Stapleton, MD | Pediatrics and Adolescent Medicine

One study links asthma with birth during months with high spore or pollen concentrations, and another links asthma with TV watching for 2 or more hours per day.

Reviewing: Harley KG et al. Thorax 2009 Apr 64:353

Sherriff A et al. Thorax 2009 Apr 64:321

SUMMARY AND COMMENT

School-Based Treatment to Improve Asthma Control

April 1, 2009 | Cornelius W. Van Niel, MD | Pediatrics and Adolescent Medicine

Children who received supervised inhaled-steroid therapy at school had marginally better asthma control than those who received usual care at home.

Reviewing: Gerald LB et al. Pediatrics 2009 Feb 123:466

SUMMARY AND COMMENT

Photopatch Tests

March 27, 2009 | Mark V. Dahl, MD | Dermatology

Photopatch testing can differentiate photoallergic dermatitis from other reactions; many sunscreen ingredients may be involved.

Reviewing: Scalf LA et al. Dermatitis 2009 Jan/Feb 20:44

NEWS IN CONTEXT

Oral Immunotherapy for Peanut Allergies? Free!

March 25, 2009 | Peggy Sue Weintrub, MD | Pediatrics and Adolescent Medicine

Preliminary results suggest that tiny incremental daily doses of peanut flour increase tolerance in some children.

Free Full-Text Article

Summary and Comment

What Causes Childhood Asthma?
One study links asthma with birth during months with high spore or pollen concentrations, and another links asthma with TV watching for 2 or more hours per day.

Birth in certain months and sedentary behavior in children have been associated with increased risk for developing asthma. Two studies examine these associations further.

Investigators in California enrolled 514 newborn infants of Mexican-immigrant mothers and followed them until age 24 months to examine whether seasonal ambient exposure to fungi and pollens during the first months of life was associated with wheezing at age 2 years. Birth in autumn and winter was associated with increased risk for wheezing (odds ratio, 3.1). Exposure to increasing levels of basidiospores, ascospores, or pollen during the first 3 months of life also was associated with increasing risk for wheezing. The associations persisted after adjusting for other known asthma risk factors. No clear association was noted between spores or pollen levels and Th1 or Th2 cells.

In an unrelated study, investigators in the U.K. examined the association between duration of television watching (a proxy for sedentary behavior) at age 3.5 years and onset of asthma by age 11.5 years in 3065 children without symptoms of wheezing before age 3.5 years who were enrolled in a prospective longitudinal study of parents and children. The prevalence of asthma at age 11.5 years was 6%. Increasing duration of daily TV watching at age 3.5 years was associated with increasing prevalence of asthma at age 11.5 years. In adjusted analysis, children who watched TV for 2 or more hours per day at age 3.5 years were nearly twice as likely to develop asthma as those who watched TV for fewer hours. The increased risk was independent of body-mass index or sedentary behavior at 11.5 years.

Comment: These two studies suggest that multiple environmental factors increase risk for developing asthma. At the very least, we can advocate for cleaner air and try to limit the amount of time children spend watching TV. Recently, researchers reported an association between use of paracetamol (acetaminophen) during the first year of life and risk for asthma symptoms at age 6 to 7 years (JW Pediatr Adolesc Med Sep 24 2008). Unfortunately, we still don’t know how these exposures lead to development of wheezing.

– F. Bruder Stapleton, MD

Published in Journal Watch Pediatrics and Adolescent Medicine April 1, 2009

Citation(s):

Harley KG et al. Fungi and pollen exposure in the first months of life and risk of early childhood wheezing. Thorax 2009 Apr; 64:353. (http://dx.doi.org/10.1136/thx.2007.090241)

Original article (Subscription may be required)

Medline abstract (Free)

Sherriff A et al. Association of duration of television viewing in early childhood with the subsequent development of asthma. Thorax 2009 Apr; 64:321. (http://dx.doi.org/10.1136/thx.2008.104406)

Original article (Subscription may be required)

Medline abstract (Free)


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