Choosing an Asthma Step-Up Treatment
March 15, 2010
Uncontrolled asthma occurs in many children who use a low-dose inhaled corticosteroid. Additional medication, called step-up treatment, is often recommended. But up to this point there's been little research to guide doctors toward which step-up treatment will work best for a particular child. So scientists conducted a study that tested three step-up treatments. Despite a "valiant effort," according to an accompanying editorial, the study published in the New England Journal of Medicine suggests there's "no compelling way" of predicting which step-up therapy will work best for a child with asthma.
Nearly all of the 165 children who completed the study responded better to one therapy than another. Of the three step-up treatments—2.5 times the original dose of the inhaled fluticasone (a corticosteroid); the original dose of fluticasone (100 micrograms) plus inhaled salmeterol (a long-acting beta agonist); and fluticasone plus oral montelukast (a leukotriene modifier)—the fluticasone plus salmeterol combination had the best response at about 45%. The other two therapies had a response just under 30%.
The study did garner a few insights. The study authors conclude that the findings highlight "the need to regularly monitor and appropriately adjust each child's asthma therapy within this level of care before further step-up."
An accompanying editorial agrees that the findings are somewhat helpful. But the editorialists point out that doubts linger about the safety of using long-acting beta agonists (such as salmeterol) for asthma treatment. The best course of action remains discussing the options with your child's doctor.
Some Penicillin Allergy Sufferers Can Take Related Antibiotics
March 15, 2010
Many people with penicillin allergy can safely tolerate antibiotics related to penicillin called cephalosporins, according to a study presented at the 2010 annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI).
For the study, Mayo Clinic researchers reviewed data on 15,298 patients with a history of penicillin allergy who were evaluated by an allergist. 193 reported a history of anaphylactic reaction (a life-threatening allergic reaction) to penicillin. Twelve of those individuals had positive skin test results to penicillin, but 156 had negative results. Eighty of the 156 later went on to receive cephalosporin for surgery. Almost all of those 80 patients safely tolerated the medication. Only one had a "possible mild adverse drug reaction."
The bottom line: "Even patients with a history of a serious reaction to penicillin can receive cephalosporins safely if the allergy tests are negative," says lead author James T. Li, M.D., FAAAAI in a press release. "The main message here is that patients with a history of penicillin allergy who need surgery can benefit from consultation with an allergist. They can get the best antibiotic with the lowest risk of drug reaction."
FDA Issues New Recommendations for An Asthma Med
March 2, 2010
Due to safety concerns, the Food and Drug Administration (FDA) is requiring changes to how long-acting beta agonists (LABAs) are used to treat asthma. Previously published studies show an increased risk with these medications of severe worsening of asthma symptoms leading to hospitalizations and some deaths.
LABAs relax bronchial muscles, helping to keep airways open for up to 12 hours. They are available as single ingredient medications—such as salmeterol (Serevent®) and formoterol (Foradil®)—and in combination with corticosteroids in medications such as Advair® and Symbicort®.
According to the FDA's new recommendations,
- LABAs should not be used alone. Single-ingredient LABAs should only be used in combination with an asthma controller medication.
- LABAs should only be used long-term in people whose asthma cannot be adequately controlled on asthma controller medications.
- LABAs should be used for the shortest duration of time to achieve control of asthma symptoms, and then discontinued—if possible. Patients should then be maintained on an asthma controller medication.
- To ensure safe use, children and teens who require the addition of a LABA to an inhaled corticosteroid should use a combination product containing both medications.
By limiting use, the FDA hopes to limit risk. The agency is asking manufacturers to update LABA medication guides and to implement a plan to educate healthcare professionals about the appropriate use of LABAs. They are also requesting additional studies.
An expert panel from the American Academy of Allergy, Asthma & Immunology agrees that LABAs should not be used exclusively to treat asthma. But the panel raises concerns about a few of the FDA's recommendations, asking for more scientific evidence. What's clear: you shouldn't simply stop taking your LABA-containing medication. Consult your doctor first. Your doctor can best explain the pros and cons of using LABA medication in your individual asthma treatment.
Will Peanut Allergy Soon Be Treatable?
March 2, 2010
Oral immunotherapy holds promise as a treatment for peanut allergy, according to two new studies presented at the 2010 Annual Meeting of the American Academy of Allergy, Asthma & Immunology. In the first study, children allergic to peanuts consumed tiny incremental amounts of peanut flour to a threshold amount over a number of months. Peanut tolerance was then assessed during an oral food challenge. The results: Kids in the oral immunotherapy group were able to tolerate 5,000 mg—roughly the equivalent of 15 peanuts—compared to only 315 mg or one peanut for the placebo group, according to a press release.
In the second small study, children who completed oral immunotherapy participated in a final oral food challenge one month following treatment. The goal: to see if peanut tolerance continued past treatment. Nine of the 12 children passed the food challenge and were able to have peanut in their diets.
These findings are encouraging, researchers say. But they caution that there is still a lot more to learn about using immunotherapy for peanut allergy. In the meantime, the research findings will help guide future studies.
Experts strongly warn that no one should attempt to perform peanut tolerance tests at home. Peanut allergies can cause serious reactions, including life-threatening anaphylactic shock.
Massachusetts Restaurants To Be Safer for People With Food Allergies
February 16, 2010
Massachusetts is poised to become the first state to require restaurants to educate staff about food allergies. It's a move applauded by some advocates—and no doubt everyone with food allergies—who hope that other states will follow suit.
Under the Massachusetts regulations, restaurant managers would be required to obtain a food allergy certification by viewing a training video on safe food preparation and avoiding cross-contamination. In the kitchen where meals are prepared, a poster that lists common food allergies—such as shellfish, peanuts, soy, wheat, egg, milk—would be prominently displayed. Finally, menus would carry a statement reminding allergic patrons to notify staff of their food allergies.
Critics of the measure say that the responsibility of avoiding dangerous food allergy reactions lies with customers. But people with food allergies know all too well that, when communicating an allergy, a lot can get lost in translation. A case in point: according to a 2007 study, 54% of restaurant staffers considered a buffet "safe" if kept clean, and 25% thought that removing an allergen from a finished meal—by, say, taking off the nuts—was adequate. The study concluded, "The [100] restaurant personnel surveyed expressed a relatively high comfort level in providing safe meals to allergic consumers, but there are deficits in their knowledge base, indicating the need for more training and consumer caution."
Low Vitamin D May Worsen Asthma
February 16, 2010
People with asthma who have low blood levels of vitamin D have worse lung function than those with higher levels, according to a new study. They also experience increased airway constriction and poorer response to steroid treatment.
In the study, published in American Journal of Respiratory and Critical Care Medicine, researchers assessed vitamin D levels and tested lung function in 54 nonsmoking adults with asthma. The lower the vitamin D level, the worse breathing test results were. For example, airway hyperresponsiveness—a marker of airway constriction—nearly doubled in those with vitamin D levels below a threshold of 30 ng/mL.
What may be at work: Low vitamin D was associated with increased production of a protein (TNF-alpha) involved in inflammation.
Having a higher body mass index also correlated with lower vitamin D levels. "Asthma is known to be associated with obesity," says E. Rand Sutherland, M.D., MPH, chief of the pulmonary division at National Jewish Health in Denver and the lead study author. "The lower levels of vitamin D in obese subjects may illuminate one factor that ties obesity and asthma together."
Will taking vitamin D supplements improve asthma treatment? That's still unclear, say the researchers. They hope future trials will clarify the issue.
What is becoming clear is that vitamin D is important for good health; in addition to possibly maintaining lung function, the vitamin helps keep bones strong and the immune system healthy.
Among the best food sources of vitamin D are fish (such as salmon, tuna, and mackerel) and fish liver oils. Vitamin D is also produced through exposure to sunlight. According to current NIH recommendations, adults under age 50 may take 200 IU of vitamin D daily and adults over 50, 400 IU—but those amounts will likely change.
5 Ways to Enjoy an Allergy-Free Valentine's Day
February 2, 2010
Spread the love this Valentine's Day. But if you or a loved one has allergies, also keep a lookout for potential allergy triggers that lurk in popular goodies and gifts. Follow these savvy pointers, culled from information from the American Academy of Allergy, Asthma & Immunology (AAAAI).
- Trustworthy Treats: Read the ingredient label on gifts of chocolate, cookies, candies or desserts that you or your child receives. Many treats—including those you wouldn't suspect—contain peanuts, tree nuts, milk, egg, wheat and/or soy. "You may not recognize the names of some ingredients made from these foods; for example, ovalbumin from egg," says Rebecca G. Piltch, M.D., an allergist/immunologist in San Rafael, CA. "For a primer on troublesome ingredients, visit the Food Allergy and Anaphylaxis Network's web site."
Remember, smaller sizes of popular candies may contain different ingredients than the regular size. Goodies also may be processed in facilities, where exposure to allergens like peanuts is possible, so be especially vigilant: check the label for notes such as, "Made on equipment that processes peanuts." "Although any given batch of the food may or may not include the allergens listed, think of these allergens as additional ingredients to avoid," says Dr. Piltch. Holiday food boxes and baskets may not carry labels; so when in doubt about the ingredients, don't eat from them.
- School Rules: If there will be a Valentine's Day party in the classroom, explain to the teacher that your child can't eat certain treats. "Make sure the teacher understands that a food allergy is involved, which foods need to be avoided and what may happen if those foods are eaten," says Dr. Piltch. "Don't be shy: If a life-threatening reaction is possible, tell the teacher outright."
"You probably discussed these precautions with your child's teacher at the beginning of the school year. Now is a good time to remind the teacher of your instructions and the emergency action plan."
To help your child celebrate the holiday safely, send along an allergy-free dessert, such as this Chocolate Snicker Doodle Cookies recipe from the AAAAI.
- Flower Power: If you're allergic to pollen, Valentine's Day flowers may bring on sneezing and watery eyes, not smiles. What provokes an allergic reaction differs from person to person.
Quick tips: "Plants with large, colorful flowers are less likely to have pollens that cause allergic reactions,” says Dr. Piltch.
These flowers and plants are also less likely to cause a reaction: azalea, begonia, bougainvillea, cacti daffodil, daisy, dahlia, gladiola, iris, lily, marigold, narcissus, orchid, pansy, petunia, snapdragon, sunflower, tulip, violet, and zinnia.
Drop a gentle hint to your special someone about the gift you prefer to receive.
- Common Scents Advice: Perfumes, colognes and scented products (e.g., candles, bath and beauty items, lingerie, teddy bears, etc.) may trigger reactions or asthma attacks in people who are sensitive. If that's you, be sure to tell your honey to cross those items off the gift list.
When you go shopping, beware that perfumed products may appear in unusual locations for Valentine's Day—such as near the cash register—not just in the perfume section. To stay on the safe side, bring along your rescue medication.
- Better Bling: Jewelry is a girl's best friend, except if you have nickel allergies. Even some gold jewelry contains traces of nickel, so it pays to be cautious. Before you try anything on, be sure that it won’t irritate your skin.
Armed with these tips and the right management strategies, you can enjoy Valentine's Day allergy-free.
Before You Wine and Dine…
- Think twice before you toast. Some wines and champagnes contain sulfites, which can trigger a reaction in someone who's allergic to them.
- Chat with the restaurant chef. If you'll be eating out, call ahead to the restaurant to discuss your dietary restrictions. The best time to reach the chef is around 2:00 in the afternoon, between the lunch and dinner rush. Discuss how the food will be prepared to avoid cross-contamination.
- Scrutinize the menu. Are dinner reservations a surprise? Some restaurant menus list potential allergens in the ingredient list or note when something is, say, wheat-free. If you have further questions about the ingredients in a dish or how it's being prepared, ask the chef.
Is Your Child Truly Allergic to Peanuts?
February 2, 2010
Peanut allergy is one of the most commonly diagnosed food allergies, and it's believed to be on the rise. But a majority of children with peanut sensitivities may not actually have peanut allergy, according to a British study. When it comes to peanut allergy diagnosis, standard tests—including the skin prick test and radioallergosorbent blood test or RAST—appear to have limitations.
Currently, the best way to identify peanut allergy—a true allergic reaction to peanuts—is a food challenge. During a challenge, a child is exposed to increasing amounts of peanuts while being monitored by health care professionals.
Unfortunately, food challenges can be time-consuming and expensive. And many parents avoid them because they worry that exposing children to even tiny amounts of peanuts will trigger an allergic reaction or anaphylaxis. Finding a more accurate and tolerable way to diagnose peanut allergy is an important goal.
For the study, published in the Journal of Allergy and Clinical Immunology, researchers looked at over 900 children and found that 110 had peanut sensitivity. Twelve clearly had peanut allergy. The remaining 79 children were presented with food challenges to sort out who had allergic reactions and who didn't. Remarkably, just 7 of the 79 children were found to have real peanut allergies.
Next, blood tests results from the children with true peanut allergies were compared to those with peanut sensitivity using a novel testing method called component-resolved diagnostics (CRD). The result: The CRD test revealed that a reaction to a peanut protein called Ara h 2 correctly identified peanut allergy. While intriguing, more research needs to be done before such testing would be available through doctors' offices.
Allergy Shots Save Money
January 19, 2010
If your child has allergic rhinitis, also known as hay fever, immunotherapy (allergy shots) might help lower your medical and prescription costs in the long run. This news comes from recent research published in the January issue of the Annals of Allergy & Asthma Immunology.
The 10-year study looked back at Florida Medicaid claims to examine whether immunotherapy—which is a series of allergy shots that contain a small amount of the substance to which you are allergic (called an allergen), thereby allowing your body to become used to the substance—saved money. Researchers compared data from more than 2,700 children with allergic rhinitis who had immunotherapy to about 11,000 children who also had allergic rhinitis but did not receive allergy shots.
The researchers found that after 18 months, the total healthcare costs for children receiving allergy shots were less compared with the kids who didn't receive the shots. Pharmacy costs were also less.
Immunotherapy is a good option for children and adults with allergic rhinitis, so talk to your doctor about allergy shots to see whether they are right for you or your kids.
Don't Let Exercise-Induced Asthma Keep You Down
January 19, 2010
If you love skiing down a mountain, the cold air hitting your face as you rush down the slope, then exercise-induced asthma can certainly put a damper on your favorite winter sports. For many people this is the case, according to the American Academy of Allergy Asthma & Immunology (AAAAI).
According to the AAAAI, symptoms of exercise-induced asthma, also called exercise-induced bronchoconstriction, usually occur about 5 to 20 minutes into exercise and include wheezing, coughing, and shortness of breath.
Why does it occur? The cold, dry winter air irritates the bronchial tubes in your lungs, which leads you to develop symptoms of asthma. If you find yourself having trouble breathing, especially when running outside in the cold air, sledding, skiing, or doing other winter activities, make an appointment to see your doctor.
For more information on exercise-induced asthma visit the AAAAI website.
Transmission of H1N1 at Home
January 5, 2010
If someone in your home has the H1N1 flu, will you get it? That's exactly what a group of British and American researchers sought to find out.
The study, published in the December 31st issue of The New England Journal of Medicine, looked at data from the United States Centers for Disease Control and Prevention (CDC) of 216 patients infected with the H1N1 virus and their 600 household members (family members, etc.). Among household members, such as a sibling or spouse, the researchers analyzed age, date of onset symptoms (which would demonstrate that they may have contacted the flu too), and symptoms themselves, such as runny nose, fever, cough, or diarrhea, that occurred within seven days of the original patient contracting the flu.
The results: Among the 600 household members, 13% developed an acute respiratory illness, which according to the researchers may have been the flu, and 10% developed an influenza-like illness. Plus children four years of age and younger and kids ages five to 18 were at a much higher risk of getting an acute respiratory illness. The good news? In 72% of households no one developed an acute respiratory illness. This means the H1N1 virus may have a lower rate of transmission than other pandemics, report the authors.
If you have asthma you may be particularly concerned about the flu—since the respiratory illness could cause complications. If you develop symptoms of the flu, such as a cough or fever, and have asthma make an appointment to see your doctor immediately.
Air Pollution May Affect Asthma Meds' Success
January 5, 2010
Past research has shown that people with asthma may use their rescue inhalers more frequently when they are in an air-polluted environment. And now a new study from the University of Pittsburgh found that outdoor air pollution may actually affect how well certain asthma inhalers work.
The study, published in the journal Chest, included 85 children with asthma ages seven to 12. All of the children were from Mexico City. Researchers measured nitrogen oxide, ozone, and fine particle matter in the air to determine air pollution. Then they tested the participants' lung function before and after they used their inhalers, particularly short-acting β (beta) agonists (SABA).
The researchers found that when participants were exposed to air pollution, SABA inhalers did not work as well in improving lung function.
If your child has asthma and you live in an air polluted environment, make sure to talk to your doctor about different therapies that can help control the chronic lung condition.
Celebrating the Holidays with Asthma & Allergies
December 22, 2009
Picking the perfect Christmas tree, eating cookies and sweets, going for walks in the cold winter air—all of these activities are fun, especially during the holiday season. But if you or a loved one has seasonal allergies, asthma, or are allergic to certain foods, the holidays can be stressful—and not just because of last minute shopping. Luckily, the Asthma and Allergy Foundation of America (AAFA) has compiled some helpful tips for making this holiday season your healthiest and happiest.
Food Allergies
- Heading to a holiday party? Let your friends or family know if you or your child has a food allergy. For instance, if your son is allergic to peanuts, ask that they offer some non-peanut treats or meals. Or, consider bringing some "safe" foods from home so he can enjoy the festivities too.
- Eating out. If you are going out for a special holiday dinner, call the hostess or manager beforehand to see what menu items contain the food. Make sure to ask about oils and additives too.
- Always carry your epinephrine injection kit in case an allergic reaction occurs.
Allergies
- If you have a mold allergy, try to avoid doing chores where you are exposed to mold, such as cleaning the gutters. If it's your turn to do the yardwork make sure to wear gloves, a facemask, and other protective gear. Also, keep your allergy medicine on hand.
- Monitor humidity levels in your house—since humidity can cause mold to grow. Consider using a dehumidifier.
- If you have a real evergreen, "Wipe the trunk thoroughly with a solution of lukewarm water and diluted bleach (1 part bleach to 20 parts water) to eliminate any mold," says the AAFA. Make sure to vacuum around the tree to remove any pollen.
Asthma
- Wood-burning stoves can certainly be cozy, but the smoke can irritate your lungs. Speak to your doctor about how to limit irritants.
- Avoid using scented candles, potpourri, and air fresheners. All of which may irritate the chronic lung disease.
- Cold air can exacerbate your asthma. To protect yourself, cover your mouth and nose with a scarf or muffler to warm up the cold air before it enters your lungs.
- If you plan to exercise outside, ask your doctor for medications to help prevent exacerbations.
A Gene's Effect on Asthma, COPD
December 22, 2009
A gene variant may protect lung function in children with asthma and adult smokers—and lower some smoker's risk of developing chronic obstructive pulmonary disease (COPD). This news comes from a recent study published online in The New England Journal of Medicine.
To arrive at their findings, researchers from across the globe analyzed seven groups of people, which included more than 8,300 adults and children. They tested for an association between lung function and the MM12 gene.
The study authors found that a variant of MM12 was associated with better lung function in kids with asthma. The same went for smokers, both past and current. Plus, people who had a variant of the gene and smoked were less likely to develop chronic obstructive pulmonary disease.
What does a variant gene have to do with asthma or COPD? According to an editorial accompanying the study, MM12 may play a role in lung inflammation and elasticity of the lungs.
Although this study certainly won't affect your life right now, it is important because it adds to our knowledge about the link between asthma and other chronic lung diseases.
Educate at Home to Improve Your Child's Asthma
December 4, 2009
Managing asthma well, such as using your inhaler regularly—is the key to living a healthy life with the chronic lung disease. Unfortunately, many kids, especially low-income minority children, continue to have poor asthma control. But recent research from Johns Hopkins Children's Center found that working with an asthma educator at home could improve this control.
The study, published in the December issue of the journal Pediatrics, included 250 inner-city children with an average age of seven, who had been hospitalized for an asthma attack in the past year, and their families.
The families were randomly divided into three groups. One group received usual care, which was an asthma education booklet and information on asthma providers for low-income families. The second and third groups met with an asthma educator at their home for 30 to 45 minutes five times over an eight-week period.
In both groups, the asthma educators worked on the following five points:
- Reviewed asthma medication and treatments. Demonstrated how to use the inhaler properly.
- Developed an asthma action plan. For example, identifying asthma triggers, recognizing symptoms and signs of an asthma attack, and learning what to do if the child has an asthma exacerbation.
- Identified problems the family had in accessing healthcare and developed ways to reduce these issues.
- Discussed concerns about the lung disease and asthma medications.
- Provided written asthma educational materials.
However, among families in the third group, the asthma educator also used various strategies, such as goal setting and electronic monitoring of medication, to give feedback on adherence.
After follow-up at six, 12, and 18 months, the researchers found children in the asthma educator groups were less likely to visit the emergency department because of an asthma attack. They were also more likely to have a shorter course of steroids, a common treatment for asthma. However, most of these benefits were for the short-term.
Traffic Pollution and Indoor Allergens Could Add Up to Big Trouble
December 4, 2009
Research has shown exposure to air pollution can exacerbate existing asthma and certain indoor allergens may cause airway inflammation. But can these substances cause asthma? Well, according to a recent American Journal of Respiratory and Critical Care Medicine study, when infants already at high-risk of developing asthma because of a family history are exposed to air pollution and allergens, it increases their chance of developing persistent wheezing, a symptom of asthma.
In the study, researchers from the University of Cincinnati College of Medicine measured exposure to traffic pollution and certain indoor allergens (called endotoxin, a type of bacteria found in dust) among 624 young children.
They found that 36% of children exposed to both high levels of traffic air pollution and high levels of endotoxin had persistent wheezing by the time they turned three-years-old. However, 18% of children who were exposed to high levels of traffic pollution but low levels of endotoxin still developed wheezing.
This study demonstrates that there seems to be a link between traffic pollution exposure and wheezing, and this link may be exacerbated by exposure to endotoxin. Speak to your doctor about how to limit your child's exposure to air pollution.
More Kids With Food Allergies
November 23, 2009
If your child has food allergies, you certainly are not alone. According to a study published in the November issue of Pediatrics, food allergy rates among children in the United States are on the rise.
The study used data from the large-scale National Health Interview Survey that asked questions regarding various medical conditions, including food allergies.
The researchers found that, according to survey results, from 1997 to 2007 the number of children ages 17 and younger with food allergies increased by 18 percent. This means, by 2007, 3.9 percent of children in the United States had food or digestive allergies. Plus, from 2003 to 2006, there were approximately 317,000 visits to ambulatory care facilities that resulted in food allergy diagnoses. This increase in food allergies was similar among both boys and girls.
The higher prevalence of food allergies might actually be because there is more awareness among parents, physicians, and other health care providers, say the researchers. But regardless of why more children have food allergies, if yours does—or if you suspect they might—make an appointment to see your doctor right away.
Birth Control Pills Ease Asthma Symptoms
November 23, 2009
Past research had found a link between a woman's hormone levels during her menstrual cycle and varying asthma symptoms. A new small study, however, found that women who take oral contraceptives are less likely to experience changes to their asthma symptoms during their period than women not on the pill.
In the study, published in the November issue of Chest, 17 women with asthma—eight on a birth control pill containing estrogen and progesterone—were followed during their menstrual cycle. Researchers took daily measurements of their asthma symptoms, lung function, and hormone levels starting from the first day of their period.
Among women not on birth control, the researchers found that when estrogen levels were high (before menstruation) levels of exhaled nitric oxide, which indicates there is a decrease in airway inflammation, were low. On the flipside, when progesterone levels were high (during menstruation), nitric oxide levels increased—meaning the airways were more inflamed, which exacerbates asthma symptoms. This link did not exist among women taking birth control pills.
Now, this study is certainly interesting, but it is very small and the women in the birth control pill group were 25-years-old on average and the women not taking the pill were 37.5 on average. This means, the two groups were not completely similar. More importantly, these results do not mean you should go get a prescription for birth control pills to reduce your asthma symptoms. The best way to control your asthma is through good management with medication and lifestyle.
Common Pain Reliever Linked to Asthma
November 10, 2009
You probably have acetaminophen (Tylenol®) stocked in your medicine cabinet for fever and pain relief. But a recent review of 19 studies, published in the journal Chest, found that this commonly used drug might be linked to asthma and wheezing in children and adults.
In the study, Canadian researchers pooled together data from clinical and observational trials that involved more than 420,000 people and focused on acetaminophen use and asthma diagnosis. After analyzing the data, the researchers found that participants who used acetaminophen were 63 percent more likely to be diagnosed with asthma or develop asthma symptoms, such as wheezing than those who did not use the pain reliever.
What does a pain reliever have to do with asthma? Acetaminophen, according to the researchers, has been shown to lower levels of a certain antioxidant found in the lung tissue, called glutathione. This antioxidant is important because it helps protect the lungs from damage and inflammation. Since chronic inflammation is a component of asthma, this could explain why frequent use of acetaminophen may increase a person's risk of the lung disorder.
However, no randomized clinical trial has proved that using acetaminophen causes asthma, so you certainly should not toss out your Tylenol or be afraid to use the medicine. It may simply be that children and adults who often develop respiratory infections use acetaminophen more often. Just remember that if you or your child has symptoms of asthma, such as trouble breathing, coughing, or wheezing, make sure to see your doctor.
Stress and Asthma?
November 10, 2009
Stressful events, such as divorce, or having a personality that tends to fall on the neurotic side might increase your risk of developing asthma, reports German researchers.
The study published in the journal Allergy, used questionnaires to gather information on personality, stressful life events, and asthma diagnosis among more than 4,000 middle-aged adults. The participants answered these questionnaires (with questions such as: Do you have asthma? Are you currently unemployed?) between 1992 and 1995 and then, those who were still available, answered again in 2002 and 2003.
Among the participants, 334 or 6.8 percent reported asthma at baseline—and 68 more people (1.8 percent) developed the lung disorder after a median of 8.5 years according to the second questionnaire. Adults who were highly neurotic were three times as likely to have developed asthma as those with low neuroticism. Stressful life events, like breaking off a relationship, were also linked to higher rates of developing asthma.
Past studies have shown a link between personality, stress, and inflammation—and since chronic inflammation is the trademark of asthma, this could explain the link.
5 Ways to Have an Allergy-Free Halloween!
October 29, 2009
The pumpkins are carved, costumes planned, and house decorated. But if your child has food allergies, Halloween can be more worrisome than fun. Luckily, there are steps you can take to make sure your son or daughter has a healthy and safe holiday.
Below is a summary of allergy tips from the Food Allergy & Anaphylaxis Network and the American Academy of Allergy, Asthma & Immunology, for having a food allergy-free Halloween.
- Let your neighbors know beforehand about your child's food allergy. Consider providing your neighbors a special treat or candy bag that is safe for them to give to your child to eat.
- Before Halloween, carefully read the ingredients label of popular candies. Make sure to check both the bite-size and full-size candy labels because a regular-size chocolate bar might have different ingredients than the mini-version. Once you determine which candy is safe, write a list of "off-limit" candies and go over it carefully with your child. Explain why certain candies would cause them to have an allergic reaction.
- Ask your child what they would like to do with the candies they can't eat, rather than just taking the candy and throwing it away.
- Have a Halloween party at your house and ask guests to only bring candy or snacks that are food allergy safe. Consider making the party about Halloween movies, games, or pumpkin carving—taking the focus off candy and food.
- Make sure your child does not eat any candy before getting home so you can check it off the list of "safe" candies.
Low-Weight Babies at Greater Risk for Asthma?
October 29, 2009
Past research demonstrated a link between low birth weight and gestational age with asthma, but experts were unsure whether this association was related to family history or the infant's birth characteristics—until now. A recent Swedish study, published in the October issue of Pediatrics, found that an infant's birth weight and gestational age might influence his or her risk of developing asthma later in life.
Using the Swedish Twin Register and Medical Birth Register, researchers gathered data about birth weight, gestational age (how long a baby was in the womb), maternal characteristics (such as if the woman smokes, age, weight), asthma history, and other variables on 10,918 nine- and 12-year-old twins.
After analyzing the data, researchers found 13.7 percent of the twins had asthma. They also found, children with a birth weight of 4.4 lbs or less were the most likely to develop the chronic lung condition. As for gestational age, infants who were born at 31 weeks or earlier were twice as likely to develop asthma compared with infants born between weeks 39 to 40. (The average length of pregnancy is 38 weeks; less than 37 weeks in the womb is considered premature birth.)
This link between birth weight, gestational age, and asthma supports the idea that impaired fetal growth affects lung development—increasing the risk of chronic lung disease later in life, say the study authors.
If your baby was premature or had a low birth weight, be sure to keep an eye out for signs he or she may be developing asthma, such as wheezing, coughing, and trouble breathing.
Genes and Your Inhaler?
October 13, 2009
If your child has asthma, chances are, you are quite familiar with salmeterol and albuterol, two popular beta-agonist medications used for long- and short-term control of symptoms and exacerbations. But recently, British researchers discovered that these medications might not work effectively if your child carries two copies of a certain gene.
This asthma research, which was published in the October issue of the Journal of Allergy and Clinical Immunology, included more than 1,000 Scottish children and young adults with asthma ranging in age from three to 22.
At the start of the asthma study, researchers took a DNA sample to test for copies of the Arg16 allele—which, in previous research, has been linked to an increased risk of asthma exacerbations in kids. They also looked at lung function, frequency of asthma attacks, and asthma medication use over the previous six months.
Researchers found a 30% increase in asthma exacerbations among young people who had more than one copy of Arg16. This risk was strongest in kids who were using the short-acting reliever inhaler albuterol (i.e., Ventolin HFA) or the long-acting medication salmeterol (Serevent Diskus) more than once a day.
These results don't mean your child should stop taking his or her albuterol or salmeterol inhaler. Instead, if your child needs to use his or her inhaler frequently throughout the day to prevent asthma symptoms such as coughing, wheezing, and difficulty breathing, make an appointment with the doctor to discuss other asthma treatment options.
2009 Worst Cities for Fall Allergies
October 13, 2009
In many areas of the United States, October not only brings beautiful changing leaves and cooler weather, but also brings fall allergies. Each fall the Asthma and Allergy Foundation of America puts together a list of the top 100 most challenging places to live for people with seasonal allergies and allergy symptoms.
To determine the most difficult places to live for people with fall allergies, the Asthma and Allergy Foundation looks at the following factors: the city's pollen and mold levels; how long peak allergy season usually lasts; the number of allergy medications used by patients, such as antihistamines, nasal sprays, and oral drugs; and the number of allergy specialists in the area.
Here is a list of the top 10 worst cities in the United States for fall allergy sufferers:
- McAllen, Texas
- Wichita, Kansas
- Louisville, Kentucky
- Oklahoma City, Oklahoma
- Jackson, Mississippi
- Dayton, Ohio
- Augusta, Georgia
- Tulsa, Oklahoma
- Knoxville, Tennessee
- Little Rock, Arkansas
This list certainly won't give allergy sufferers much consolation, especially if they have been spending several days and nights coughing and sneezing. But what it does provide is incentive—especially if your city made the cut—to be especially diligent about controlling your allergies and allergy symptoms as best you can. For instance, keep your windows shut and limit your time outside during the early morning and evening when pollen counts are highest, take a shower after being outside for a long period of time, and wash your sheets and pillow case once a week.
Physician-developed and -monitored.
Original Date of Publication: 13 Oct 2009
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