P077 PERIPHERAL AIRWAY IMPAIRMENT AND DYSANAPSIS DEFINE RISK OF UNCONTROLLED ASTHMA IN OBESE ASTHMATIC CHILDREN

AbstractBackground and objectiveSpirometry, which is the most commonly used technique for asthma diagnosis, is often unsuitable for small children as it requires them to follow exact instructions and perform extreme inspiration and expiration maneuvers. In contrast, impulse oscillometry (IOS) is a child-friendly technique that could serve as an alternative pulmonary function test (PFT) for asthma diagnosis and control in children as it offers several advantages over spirometry. However, the complex test results of IOS may be difficult to be understood by practitioners due to its reliance on mechanical and electrical models of the human pulmonary system. Recognizing this reality, computer-aided decision systems could help to improve the utility of IOS. The main objective of this paper is to understand the current computer-aided classification research works on this topic.MethodsThis paper presents a methodological review of research works related to the computer-aided classification of peripheral airway obstruction using the IOS technique, which is focused on, but not limited to, asthmatic children. Publications that focused on computer-aided classification of asthma, peripheral dysfunction and/or small airway impairment (SAI) based on impulse oscillometric features were selected for this review.ResultsOut of the 34 articles that were identified using the selected scientific web databases and topic-related parameters, only eight met the eligibility criteria. The most relevant results of the articles reviewed are related to the performance of the different classifiers using static features which are solely based on the first pulmonary function testing measurements (IOS and spirometry). These results included an overall classifiers’ accuracy performance ranging from 42.24% to 98.61%.ConclusionThere is still a great opportunity to improve the utility of IOS by developing more computer-aided robust classifiers, specifically for the asthmatic children population as the classification studies performed to date (1) are limited in number, (2) include features derived from tests that are not optimally suitable for children, (3) are solely bi-class (mostly asthma and non-asthma) and therefore fail to include different degrees of peripheral obstruction for disease prevention and control and (4) lack of validation in cases that focus on multi-class classification of the different degrees of peripheral airway obstruction.

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Quantitative computed tomography detects peripheral airway disease in asthmatic children

Pediatric Pulmonology ◽

10.1002/ppul.20215 ◽

2005 ◽

Vol 40 (3) ◽

pp. 211-218 ◽

Cited By ~ 60

Author(s):

Neal Jain ◽

Ronina A. Covar ◽

Melanie C. Gleason ◽

John D. Newell ◽

Erwin W. Gelfand ◽

...

Keyword(s):

Computed Tomography ◽

Quantitative Computed Tomography ◽

Airway Disease ◽

Asthmatic Children ◽

Peripheral Airway

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Parent’s perceptions and concerns about inhaled asthma therapy

Gazeta Médica ◽

10.29315/gm.v6i1.211 ◽

2019 ◽

Author(s):

Rita Barreira ◽

Madalena Sales Luís ◽

Sara Marcos ◽

Vivian Gonçalves ◽

Rita Monteiro ◽

...

Keyword(s):

Disease Control ◽

Outpatient Clinic ◽

Inhalation Technique ◽

Asthma Therapy ◽

Uncontrolled Asthma ◽

Asthmatic Children ◽

Pediatric Allergy ◽

Parental Concerns ◽

Inhaled Therapy ◽

Regular Review

Aim: To determine parent´s perceptions and concerns about inhaled therapy and their relation to disease control. Methods: A questionnaire was applied by interviewing parents of 119 asthmatic children attending the Pediatric Allergy or Pneumology outpatient clinic. Results: Eighty-one (68%) parents expressed concerns and worries about the use of inhaled therapy in their children, either with controlled or partially/uncontrolled asthma (65% Vs 78% p=0.22). Regarding their beliefs about inhaled therapy, 11% (n=13) stated that they considered pMDI’s/DPI’s less effective than nebulizers. When questioned about the knowledge of their child's acute exacerbation therapy, 91.5% (n=109) reported knowing it, albeit only 40% (n=44) did answer it correctly. Nine parents said they were unaware of their children’s reliever treatment. Discussion: We expected to find parental concerns about inhaled therapy, but such a high percentage wasn´t expected. A substantial number of parents believe that their children can become addicted or dependent on the use of the inhaler. This finding reinforces the misconceptions parents do have regarding inhaled therapy. There is a higher proportion of parents with concerns in the group with partially/uncontrolled asthma, although it was not statistically significant. The majority of patients/parents reported knowing the reliever plan in an exacerbation, although most of them could not explain the plan correctly. These results are worrying, as they show parents have an inappropriate knowledge of reliever measures. Therefore, we suggest that improvements in education about inhaled therapy should be made, including the regular review of the inhalation technique and the reliever plan in every consultation.

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Evaluation of association between airway hyperresponsiveness, asthma control test, and asthma therapy assessment questionnaire in asthmatic children

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2013.546 ◽

2013 ◽

Vol 8 ◽

Author(s):

Daniele Rapino ◽

Marina Attanasi ◽

Nicola P. Consilvio ◽

Alessandra Scaparrotta ◽

Anna Cingolani ◽

...

Keyword(s):

Logistic Regression ◽

Asthma Control ◽

Asthma Therapy ◽

Control Test ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Therapy Assessment ◽

Asthmatic Children ◽

Exercise Induced ◽

Assessment Questionnaire

Background: Achieving asthma control is a major challenge in children, otherwise symptoms perception remain poor especially at this age. The aim of this study is to evaluate the relationship between Asthma Control Test (ACTTM), Asthma Therapy Assessment Questionnaire (ATAQTM) and exercise-induced bronchospasm (EIB). Methods: We studied 80 asthmatic children. Airways hyperresponsiveness (AHR) was assessed by exercise-induced bronchospasm (Balke Protocol). Asthma control was evaluated using two questionnaires in all subjects: ACT (composed by Childhood-ACT and ACT) and ATAQ. In addition the use of short acting beta 2 agonist agents (SABAs) was assessed for each patient. Non-parametric variables were compared by Chi Square Test. Binomial logistic regression was performed to estimate the two questionnaires Odds Ratio (OR) in finding AHR. Results: We have found that ATAQ has a sensitivity and a specificity of 0.72 and 0.45 respectively; instead, ACT has a sensitivity and a specificity of 0.5 and 0.39 respectively in evaluating AHR. Patients with uncontrolled asthma according to ATAQ revealed a significant higher percentage of AHR compared with ACT (72% vs 50%, p < 0.01). Confirming this finding, patients declaring uncontrolled asthma to ATAQ have a significantly higher percentage (34%) of frequent SABAs use than the group with uncontrolled asthma to ACT (21%) (p <0.01). Binomial logistic regression shows how a test revealing uncontrolled asthma is associated with the increasing odds of having AHR according to ATAQ (OR = 3.8, p = 0.05), not to ACT (OR = 0.2, p = 0.1). Conclusions: Our results show that ATAQ reflects AHR and asthma control better than ACT. Children with uncontrolled asthma according to ATAQ have higher odds of having AHR and use of rescue medications (SABAs) compared to patients declaring uncontrolled asthma according to ACT. However both questionnaires are not sufficient alone to fully evaluate asthma control in children and it is always necessary to perform functional tests and investigate patients lifestyle, drug use and other important data that a simple questionnaire is not able to point out

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Quantitative high resolution CT demonstrates evidence for peripheral airway disease in asthmatic children with normal FEV1*1

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2004.01.478 ◽

2004 ◽

Vol 113 (2) ◽

pp. S279 ◽

Cited By ~ 1

Author(s):

N JAIN

Keyword(s):

High Resolution ◽

Airway Disease ◽

Asthmatic Children ◽

High Resolution Ct ◽

Peripheral Airway

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Assessing the quality of life of asthmatic children using the PedQL™

Paediatrica Indonesiana ◽

10.14238/pi51.5.2011.245-51 ◽

2011 ◽

Vol 51 (5) ◽

pp. 245

Author(s):

Yulia Wigoeno ◽

Rini Sekartini ◽

Darmawan Budi Setyanto ◽

Sri Rezeki Hadinegoro

Keyword(s):

Quality Of Life ◽

Protective Factor ◽

Male Gender ◽

Self Report ◽

Uncontrolled Asthma ◽

Proxy Report ◽

Female Ratio ◽

Asthmatic Children ◽

Parental Assessment

Background Asthma is the most common chronic respiratory illness in childhood. Its prevalence in Indonesia is 6.7 - 10%. Asthma influences growth, development and quality of life in affected children. Studies abroad have shown that children with asthma have a decreased quality of life (QoL), yet such data is limited in Indonesia.Objective To assess quality of life of asthmatic children in Indonesia, the influence of sociodemographic and medical characteristics on QoL, and to compare child self-reporting to their parents’ proxy-reporting.Methods This descriptive analysis, cross-sectional study was conducted from May to July 2010. We assessed the quality of life of asthmatic children aged 2-18 years using the PedsQLTM 4.0 generic scale.Results A total of 100 asthmatic children and their parents were included, with 43% of the subjects aged 8-12 years and a male to female ratio of 1.7:1. We observed that 26.8% of children who self-reported had impaired QoL, while 35% of children who reported by proxy had impaired QoL. In a multivariate analysis, we found the following characteristics to independently influence QoL: male gender (P 0.018 OR 0.26 95% CI 0.08 to 0.9) based on child self-report, and having partly controlled/uncontrolled asthma based on self-report and proxy-report (P 0.013 OR 6.24 95% CI 1.48 to 26.37 and P 0.018 OR 3.43 95% CI 1.24 to 10.05, respectively). There was good correlation between the self-report and the proxy-report on emotional and social functioning (r > 0.5), yet we found physical and school functioning to be weakly correlated (r < 0.5).Conclusions We observed a relatively high (26.8-35%) impaired QoL in asthmatic patients. Parental assessment of their child’s QoL was generally lower than the child’s self-assessment. Male gender is a protective factor against impaired QoL, but having partly controlled/uncontrolled asthma is a risk factor for lower QoL. [Paediatr Indones. 2011;51:245-51].

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Study of the role of exhaled nitric oxide (NO) in predicting controlled or uncontrolled asthma in asthmatic children

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2020.656 ◽

2020 ◽

Vol 15 ◽

Author(s):

Xuan Ngo-Minh ◽

Tram Tang-Thi-Thao ◽

Nhu Doan-Thi-Quynh ◽

Timothy J. Craig ◽

Sy Duong-Quy

Keyword(s):

Nitric Oxide ◽

Asthma Control ◽

Exhaled Nitric Oxide ◽

Blood Eosinophil ◽

Inhaled Corticosteroid ◽

Uncontrolled Asthma ◽

Cross Sectional ◽

Total Ige ◽

Asthmatic Children ◽

Exhaled No

Background: Exhaled nitric oxide (NO), especially fractional concentration of exhaled NO (FENO) has been used to predict the responsiveness of inhaled corticosteroid (ICS) in children with asthma. However, the use of exhaled NO for predicting asthma control in children is still controversial.Methods: This was a randomized and cross-sectional study. Asthmatic children who were naïve to inhaled corticosteroid (ICS) were included in the present study. The measurements of FENO and CANO (concentration of NO in the gas phase of the alveolar), spirometry, blood eosinophil counts (BEC), and total IgE levels were done for each asthmatic child.Results: Ninety three asthmatic children (9±3 years) with moderate (63.4%) to severe (36.6%) asthma were included and finished the 3 month study. The levels of FENO and CANO at inclusion were 37±11 ppb and 5.8±1.4 ppb, respectively; the mean of BEC was 617±258 cells/µL; the level of total IgE was 1563±576 UI/mL; 89% of subjects were positive for at least one respiratory allergen. The percentage of severe asthma was reduced significantly after 3 months (P<0.001). Well controlled asthma subjects at 3 months had higher levels of FENO and lower levels of CANO at inclusion (P<0.05 and P<0.05). FENO <20 ppb or CANO >5 ppb had a risk of uncontrolled asthma at 3 months (OR: 1.7, CI 95% [(0.8) – (3.3)], P<0.05; OR: 1.9, CI 95% [(0.9) – (2.7)], p<0.05; respectively). FENO >35 ppb at inclusion had a positive predictive value for asthma control at 3 months (OR: 3.5, CI 95% [2.2 – 5.9], P<0.01).Conclusions: Exhaled NO is a biomarker of asthma which may have a potential role to predict the control of asthma in short-term follow-up in asthmatic children.

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The Relation between Asthma Control and Quality of Life in Children

International Journal of Pediatrics ◽

10.1155/2018/6517329 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

M. Banjari ◽

Y. Kano ◽

S. Almadani ◽

A. Basakran ◽

M. Al-Hindi ◽

...

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Holistic Approach ◽

Well Being ◽

Life Questionnaire ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Cross Sectional ◽

Asthmatic Children

Background. Asthma is a common chronic illness worldwide. Asthmatic children are forced to alter their way of living to avoid its complications or exacerbations, which negatively affects their psychological and social well-being. High prevalence of behavioral and emotional difficulties was noticed among children with asthma. Methods. Cross-sectional study that was conducted over 8 months involving asthmatic children within the ages of 7-17 years presenting to two governmental hospitals in Jeddah, Saudi Arabia. Three questionnaires were used: asthma control test, the strengths and difficulties questionnaire, and the pediatrics asthma quality of life questionnaire. Using SPSS, Pearson’s chi-square and independent sample t-tests were used to find associations. Results. Among the 106 respondents, 84% of the sample had poor asthma control. Significantly poorer quality of life was observed in children with uncontrolled asthma (p = <0.001). Children with controlled and uncontrolled asthma were equally affected psychosocially with no relation between asthma control and their psychosocial well-being (p = 0.58). Conclusion. The majority of asthmatic children were uncontrolled with poor quality of life. This study recommends that the psychosocial well-being should be assessed during clinic visits for a better holistic approach and effective improvement of outcome. Further researches are needed to study the psychological effect of asthma.

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