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Background It is unclear if predictors of asthma attacks are the same as those of asthma symptom control in children. We evaluated predictors for these two outcomes in a clinical cohort study. Methods The Swiss Paediatric Airway Cohort (SPAC) is a multicentre prospective clinical cohort of children referred to paediatric pulmonologists. This analysis included 516 children diagnosed with asthma. At baseline, we collected sociodemographic information, symptoms, personal and family history and environmental exposures from a parental baseline questionnaire, and treatment and test results from hospital records. Outcomes were assessed 1 year later by parental questionnaire: asthma control in the last 4 weeks as defined by GINA guidelines, and asthma attacks defined as any unscheduled visit for asthma in the past year. We used logistic regression to identify and compare predictors for suboptimal asthma control and asthma attacks. Results At follow-up, 114/516 children (22%), reported suboptimal asthma control, and 114 (22%) an incident asthma attack. Only 37 (7%) reported both. Suboptimal asthma control was associated with poor symptom control at baseline, wheeze triggered by allergens, colds and exercise, a more intense treatment at baseline, history of preschool and persistent wheeze, and exposure to tobacco smoke. Incident asthma attacks were associated with previous episodes of severe wheeze and asthma attacks, younger age and non-Swiss origin. Lung function, exhaled nitric oxide (FeNO) and allergic sensitization at baseline were not associated with control or attacks. Conclusion Predictors of suboptimal control differ from those of attacks. Prediction tools and preventive efforts should differentiate these two asthma outcomes.

BACKGROUND Cardiovascular disease is the leading nonmalignant cause of late deaths in childhood cancer survivors. Cardiovascular disease and cardiac dysfunction can remain asymptomatic for many years, but eventually lead to progressive disease with high morbidity and mortality. Early detection and intervention are therefore crucial to improve outcomes. OBJECTIVE In our study, we aim to assess the prevalence of preclinical cardiac dysfunction in adult childhood cancer survivors using conventional and speckle tracking echocardiography; determine the association between cardiac dysfunction and treatment-related risk factors (anthracyclines, alkylating agents, steroids, cardiac radiation) and modifiable cardiovascular risk factors (abdominal obesity, hypertension); investigate the development of cardiac dysfunction longitudinally in a defined cohort; study the association between cardiac dysfunction and other health outcomes like pulmonary disease, endocrine disease, renal disease, quality of life, fatigue, strength and endurance, and physical activity; and gain experience conducting a clinical study of childhood cancer survivors that will be extended to a national, multicenter study of cardiac complications. METHODS For this retrospective cohort study, we will invite ≥5-year childhood cancer survivors who were treated at the University Children's Hospital Bern, Switzerland with any chemotherapy or cardiac radiation since 1976 and who are ≥18 years of age at the time of the study for a cardiac assessment at the University Hospital Bern. This includes 544 childhood cancer survivors, of whom about half were treated with anthracyclines and/or cardiac radiation and half with any other chemotherapy. The standardized cardiac assessment includes a medical history focusing on signs of cardiovascular disease and its risk factors, a physical examination, anthropometry, vital parameters, the 1-minute sit-to-stand test, and echocardiography including 2-dimensional speckle tracking. RESULTS We will invite 544 eligible childhood cancer survivors (median age at the time of the study, 32.5 years; median length of time since diagnosis, 25.0 years) for a cardiac assessment. Of these survivors, 300 (55%) are at high risk, and 244 (45%) are at standard risk of cardiac dysfunction. CONCLUSIONS This study will determine the prevalence of preclinical cardiac dysfunction in Swiss childhood cancer survivors, inform whether speckle tracking echocardiography is more sensitive to cardiac dysfunction than conventional echocardiography, and give a detailed picture of risk factors for cardiac dysfunction. The results will help improve primary treatment and follow-up care of children with cancer. CLINICALTRIAL ClinicalTrials.gov NCT03790943; https://clinicaltrials.gov/ct2/show/NCT03790943 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17724

BACKGROUND Childhood cancer survivors (CCSs) are at high risk of developing adverse late health effects. Poor nutritional intake may contribute to this risk, but information about dietary intake is limited. OBJECTIVE This study will assess dietary intake of CCSs and compare two dietary assessment tools: a self-reported food frequency questionnaire (FFQ), and dietary measurements from urine spot samples. METHODS In the Swiss Childhood Cancer Survivor Study, we assessed dietary intake of CCSs via a validated FFQ. To a subset of CCSs from the French-speaking region of Switzerland, we sent a urine spot collection kit to analyse urinary sodium, potassium, urea, urate, creatinine, and phosphate content. We will compare the FFQ with the urine spot analyses to quantify the intake of different nutrients in CCSs. Data collection took place between March 2016 and March 2018. RESULTS We contacted 1599 CCSs of whom 919 (57%) returned an FFQ. We excluded 11 CCSs who were pregnant or were breastfeeding, 35 CCSs with missing dietary data, and 71 CCSs who had unreliable FFQ data, resulting in 802 CCSs available for FFQ analyses. To a subset of 197 CCSs in French-speaking Switzerland we sent a urine spot collection kit, and 111 (56%) returned a urine sample. We expect to have the results from analyses of these samples in mid-2019. CONCLUSIONS The SCCSS-Nutrition study has collected in-depth dietary data that will allow us to assess dietary intake and quality and compare two dietary assessment tools. This study will contribute to the current knowledge of nutrition among CCSs and is a step towards surveillance guidelines and targeted nutritional recommendations for CCSs in Switzerland. CLINICALTRIAL ClinicalTrials.gov identifier SCCSS: NCT03297034