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Purpose: Our aim was to evaluate the accuracy of a combined airway inflammatory biomarker assessment in diagnosing asthma in elite water sports athletes. Methods: Members of the Hungarian Olympic and Junior Swim Team and elite athletes from other aquatic disciplines were assessed for asthma by objective lung function measurements, and blood eosinophil count (BEC), serum total immunoglobulin E (IgE), fractional exhaled nitric oxide (FENO) measurements, and skin prick testing were performed. A scoring system from BEC, FENO, serum IgE, and skin test positivity was constructed by dichotomizing the variables and assigning a score of 1 if the variable is elevated. These scores were summed to produce a final composite score ranging from0 to 4. Results: A total of 48 participants were enrolled (age 21 ± 4 yr, 42% male), of which 22 were diagnosed with asthma. Serum total IgE and FENO levels were higher in asthmatic individuals (68 [27-176] vs 24 [1-43], P = 0.01; 20 [17-26] vs 15 [11-22], P = 0.02), and positive prick test was also more frequent (55% vs 8%, P < 0.01). Asthmatic participants had higher composite variable scores (2 [1-3] vs 1 [0-1], P = 0.02). Receiver operating characteristic analysis showed that total IgE, FENO, and composite variable were suitable for identifying asthmatic participants (area under the curve = 0.72, P = 0.01; 0.70, P = 0.02, and 0.69, P = 0.03). A composite score of >2 reached a specificity of 96.2%, a sensitivity of 36.4%, and a likelihood ratio of 9.5. Logistic regression model revealed a strong association between the composite variable and the asthma diagnosis (OR = 2.71, 95% confidence interval = 1.17-6.23, P = 0.02). Conclusions: Our data highlight the diagnostic value of combined assessment of Th2-type inflammation in elite water sports athletes. The proposed scoring system may be helpful in ruling in asthma in this population upon clinical suspicion. [ABSTRACT FROM AUTHOR]

The article discusses the draft guidance from the UK National Institute for Health and Care Excellence, and the Scottish Intercollegiate Guidelines Network on updated asthma management practices, focusing on eliminating short-acting beta2 agonist monotherapy in favor of a more integrated treatment approach that includes inhaled corticosteroids. It emphasizes the need for new diagnostic and management strategies, such as measuring blood eosinophil counts and FeNO levels.

The human voice has the potential to serve as a valuable biomarker for the early detection, diagnosis, and monitoring of pediatric conditions. This scoping review synthesizes the current knowledge on the application of artificial intelligence (AI) in analyzing pediatric voice as a biomarker for health. The included studies featured voice recordings from pediatric populations aged 0–17 years, utilized feature extraction methods, and analyzed pathological biomarkers using AI models. Data from 62 studies were extracted, encompassing study and participant characteristics, recording sources, feature extraction methods, and AI models. Data from 39 models across 35 studies were evaluated for accuracy, sensitivity, and specificity. The review showed a global representation of pediatric voice studies, with a focus on developmental, respiratory, speech, and language conditions. The most frequently studied conditions were autism spectrum disorder, intellectual disabilities, asphyxia, and asthma. Mel-Frequency Cepstral Coefficients were the most utilized feature extraction method, while Support Vector Machines were the predominant AI model. The analysis of pediatric voice using AI demonstrates promise as a non-invasive, cost-effective biomarker for a broad spectrum of pediatric conditions. Further research is necessary to standardize the feature extraction methods and AI models utilized for the evaluation of pediatric voice as a biomarker for health. Standardization has significant potential to enhance the accuracy and applicability of these tools in clinical settings across a variety of conditions and voice recording types. Further development of this field has enormous potential for the creation of innovative diagnostic tools and interventions for pediatric populations globally. [ABSTRACT FROM AUTHOR]

Asthma is a chronic lung disease characterized by reversible bronchoconstriction and inflammation of the bronchi. Its increasing prevalence in childhood as well as different triggers make asthma a challenging disease in several ways: defining its phenotype/endotype, the diagnostic approach (especially in younger children), therapeutic options, and systematic follow-up. Considering these problems, this review approaches the current status and limitations of guidelines used for asthma management in children. It also emphasizes the key points which could lead to a better understanding and the direction to take in future studies. [ABSTRACT FROM AUTHOR]

Excessive water consumption is an extremely rare and potential asthma risk factor with very few cases reported in the literature. Common triggers of asthma include genetic factors, smoking, allergens, and viral respiratory infections. The adult patient with asthma reportedly drank too much water and was unable to get relief from his asthma while hospitalized. The patient's asthma was better controlled with the use of diuretics and control of the patient's fluid intake and output. This case explores asthma induced by excessive drinking of water. [ABSTRACT FROM AUTHOR]

Background/Objective: Asthma is a common chronic medical condition among children and the most common diagnosis associated with interfacility transports for pediatric patients. As many as 40% of pediatric transfers may be unnecessary, resulting in potential delays in care and unnecessary costs. Our objective was to identify the patient-related factors associated with potentially unnecessary transfers for pediatric patients with asthma. Methods: We used patient care data from the California Department of Health Care Access and Information patient discharge and emergency department (ED) datasets to capture ED visits where a pediatric patient (age 2-17 years) presented with asthma and was transferred to another ED or acute care hospital. The outcome of interest was a potentially unnecessary transfer, defined as a visit where length of stay after transfer was <24 hours and no advanced services were used, such as respiratory therapy or critical care. Patient-related characteristics were extracted, including age, gender, race/ethnicity, primary language, insurance status, and clinical characteristics. First, we used descriptive statistics to compare necessary vs unnecessary transfers. Second, we used generalized estimating equations accounting for clustering by ED to estimate odds ratios (OR) and identify factors associated with potentially unnecessary transfers. Results: A total of 4,233 pediatric ED patients were transferred with a diagnosis of asthma, including 461 (11%) transfers that met criteria as potentially unnecessary. Median age was 12 years (interquartile range 7-15), and 46% were female. Factors associated with increased odds of potentially unnecessary transfer while controlling for key factors included younger age (eg, 2-5 years, OR 2.0, 95% confidence interval [CI] 1.4-2.9), male gender (OR 1.4, 95% CI 1.1-1.7), and Hispanic ethnicity (OR 1.6, 95% CI 1.2-2.1), while multiple hospitalizations for asthma per year was associated with decreased odds (OR 0.2, 95% CI 0.1-0.4). Conclusion: Several patient-related factors were associated with increased or decreased odds of potentially unnecessary transfers among pediatric patients presenting to the ED with asthma. These factors can be considered in future work to better understand, predict, and reduce unnecessary transfers and their negative consequences. [ABSTRACT FROM AUTHOR]

Earth's climate is changing at an unprecedented pace, primarily due to anthropogenic causes including greenhouse gas emissions. Evidence shows a strong link between climate change and its effects on asthma. Healthcare professionals must be educated to advocate for and lead effective strategies to reduce the health risks of climate change. [ABSTRACT FROM AUTHOR]

The article focuses on a spirometry service established by the Northwest Surrey Integrated Care Service (NICS). During the COVID-19 pandemic, spirometry testing was halted, leading to missed diagnoses of respiratory conditions and highlighting funding issues in general practice. NICS addressed this by establishing a spirometry service for 37 practices. The service adapted infection control measures and used trained staff. This model serves as an exemplar for post-pandemic healthcare innovation.

Asthma, a serious global health problem, has been an area of interest due to its increasing prevalence, expanding treatment costs, and rising burden on patients and the community. Since asthma cannot be cured, clinical episodes can be prevented and controlled by adequate management and sufficient knowledge of the disease. Appropriate treatment may relieve asthma symptoms and improve quality of life. However, poor knowledge of asthma disease and medication use, misdiagnoses, misuse of inhalers and inadequate self-management of disease symptoms may have a greater impact on the disease process. Therefore, assessment of the population's knowledge and attitude toward asthma is essential. To the best of our knowledge, no previous studies has assessed the population's knowledge and attitude regarding asthma in Beirut, thus this study was conducted to assess the knowledge and attitude of Lebanese adults regarding asthma in Beirut, Lebanon. Additionally, the goal of this study was to determine the incidence from the studied sample of participants with physician-diagnosed and physicianundiagnosed asthma treated by bronchodilators/inhaled corticosteroids (BD/ICS). Furthermore, to identify from the sample studied the participants having the likelihood of asthma disease and to highlight the natural products used by the participants in managing asthma-related symptoms. Four hundred participants were enrolled in a cross-sectional study that was carried out using web-based anonymous questionnaires about asthma disease evaluating their knowledge towards the disease and attitude in Beirut, Lebanon. The study revealed that Lebanese adults had an inadequate level of knowledge regarding asthma, its medications, and asthma triggers. This lack of knowledge was reflected in their attitude towards the disease. Moreover, our study showed that 9.1% of the asthmatic participants who were questioned were undiagnosed yet by the physician and 33.3% of those were using BD/ICS to relieve their asthma symptoms. Furthermore, it is noteworthy that 18.75% of the questioned participants had recurrent respiratory symptoms and had features that associated with asthma, thus increasing the risk of developing chronic airway disease and asthma. However, only 8.25% of questioned participants were asthmatic. In conclusion, there is a need to improve the Lebanese community's knowledge and attitude by increasing the level of awareness about the disease. Several recommendations were suggested to advance the knowledge of asthma in order to improve future health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Asthma is a heterogeneous chronic inflammatory disease of the airways. Chronic inflammation leads to changes in the structure and stiffening of the bronchial wall, and irreversible disruption of airflow through the airways. One of the factors researchers consider important in the process of inflammation and fibrosis is the transforming growth factor β (TGF-β). Overexpression of TGF-β in the structural cells of the bronchial tree is thought to translate into excessive secretion of type I and III collagen, fibronectin, tenascin and proteoglycans, as well as inhibition of matrix metalloproteinases and collagenases, promoting the phenomenon of remodeling. Aim: To evaluate serum levels of all the TGF-β (TGF-β 1-3) isoforms in asthmatic patients, compare the obtained results with those of non-asthmatic subjects, and analyze potential correlations between particular isoforms. Material and methods: The study included 69 individuals, 41 asthmatic patients and 28 non-asthmatic volunteers recruited from the Department of Allergology and the Allergy and Pulmonology Outpatient Clinic of N. Barlicki University Teaching Hospital No. 1 in Lodz. The participants underwent a full medical examination and spirometry, and blood samples were collected from them for serum TGF-β levels. Individual isoforms, i.e., TGF-β1, TGF-β2 and TGF-β3, were determined by ELISA. The data obtained were then subjected to statistical analysis using Student's t-test, the Mann-Whitney U-test, Fisher's t-test and Pearson's correlation method. Results: The obtained results show a significant increase in TGF-β1 and TGF-β2 levels, as well as a slight increase in TGF-β3 concentration among asthmatic patients compared to the general population. Additionally, there occurred a significant association between TGF-β1 and TGF-β2. TGF-β1 and TGF-β2 isoforms were found to be associated with the pathogenesis of asthma. Among the patients, serum TGF-β levels were significantly higher compared to the control group. Conclusions: The TGF-β1 and TGF-β2 isoforms appear to have a cumulative effect on remodeling processes in the airways. [ABSTRACT FROM AUTHOR]

BACKGROUND Asthma imposes a heavy morbidity burden during childhood. Severe persistent asthma significantly increases patients' risk of exacerbations, hospital admissions, and mortality and often substantially impairs their quality of life. This study aimed to identify high-risk patients for exacerbation recurrence using spirometric parameters. METHODS A prospective cohort study involving patients with asthma aged 6-15 years was conducted at the principal children's hospital in Mekong Delta, Vietnam, from June 2020 to June 2022. Demographic, clinical, and lung function characteristics of the patients were collected. Spirometry measurement parameters were utilized as predictive factors for the short-term asthma exacerbation recurrence. RESULTS Among all patients (mean age of 9.5 years old), 10.4% experienced recurrent exacerbations. FEV1, FVC, FEV1/FVC, FEF25-75, FEF25-75/FVC, and PEF, gradually decreased with increasing exacerbation severity (p<0.01). All patients showed a positive bronchodilator responsiveness (BDR), with a mean value of 16.85 (3.00)%, which was significantly different between the severe and non-severe asthma groups (20.53 [2.83] versus 16.00 [2.35], p<0.001). After adjusting in multivariable logistic regression, a BDR ≥20% was identified as the sole independent factor associated with an increased risk of asthma exacerbation recurrence (aOR 6.95, 95% CI 1.08-44.75, p = 0.041). CONCLUSIONS A high BDR can serve as a predictor of acute asthma exacerbation recurrence. [ABSTRACT FROM AUTHOR]

Using the sub-sample of First Nations adults from the 2017 Aboriginal Peoples Survey and non-Indigenous adults from the 2017 Canadian Community Health Survey (N = 35,390), we examined inequalities in self-reported general and mental health, diagnosed asthma, and diagnosed diabetes between non-Indigenous people and First Nations adults living off-reserve in Canada. The Blinder–Oaxaca approach was used to decompose the inequalities of each health outcome into the differences in characteristics and differences in returns. We found that First Nations adults experienced health outcomes 5–10 percent worse than those of non-Indigenous populations, with non–Status First Nations adults reporting poorer health than Status First Nations adults, with the exception of diabetes. Our findings also revealed that observable characteristics accounted for 20–45 percent of the inequalities in general health, mental health, and diabetes. Socio-economic factors, such as employment status, income, and educational attainment, explained 10–25 percent of the differences in self-rated general health, mental health, and diagnosed diabetes for both Status and non–Status First Nations peoples compared with the non-Indigenous population. Although we were unable to assess other critical pathways through which various aspects of colonialism continue to affect First Nations peoples, our findings suggest that improving the socio-economic status of off-reserve First Nations peoples could potentially narrow the health inequalities between them and the non-Indigenous population in Canada. [ABSTRACT FROM AUTHOR]

Introduction: Targeting the parasympathetic nervous system innervating the airway with pharmacologic products has been proved to improve the clinical outcomes of severe asthma. Bronchial cryo-denervation (BCD) is a novel non-pharmacologic treatment for severe asthma using an endobronchial cryo-balloon administered via bronchoscopy to denervate parasympathetic pulmonary nerves. Preclinical studies have demonstrated that BCD significantly disrupted vagal innervation in the lung. Methods: A total of 15 patients with severe asthma were enrolled in this prospective, single-center pilot study. Patients underwent bifurcated BCD treatment at a 30-day interval after baseline assessment. Follow-up through 12 months included assessment of adverse events, technical feasibility, and changes in pulmonary function; asthma control questionnaire-7 (ACQ-7); and asthma control test (ACT). Results: BCD was performed on all 15 severe asthma patients, with technical feasibility of 96.7%. There were no device-related and 2 procedure-related serious adverse events through 12 months, which resolved without sequelae. The most frequent nonserious procedure-related adverse event was increased cough in 60% (9 of 15) patients. Pulmonary function remained unchanged, and significant improvements from baseline ACQ-7 (mean, −1.19, p = 0.0032) and ACT (mean, 3.18, p = 0.0011) scores were observed since the first month's follow-up after a single lung airway treatment, with similar trends till the end of the 12-month follow-up. Conclusion: This study provides the first clinical evidence of the safety, feasibility, and initial efficacy of BCD in patients with severe asthma. [ABSTRACT FROM AUTHOR]

Peak expiratory flow rate (PEFR) is the volume of air forcefully exhaled at maximum speed. This can be measured using a peak flow meter or a spirometry device. Peak flow meters are portable, inexpensive and widely available. The technique is non-invasive, carries no risk to the person, can be taught and learned quickly, and can easily be mastered by the patient. Published evidence for the use of peak expiratory flow rate (PEFR) and peak flow monitoring in asthma is limited, despite the use of the peak flow meter being documented in national and international guidelines for many years. National and international guidelines recommend the use of easily calibrated spirometers, which can provide accurate results with good technique, along with fractional exhaled nitrous oxide (FeNO) testing, which requires a greater analysis and interpretation of the results. Is the use therefore of the peak flow meter redundant? This article discusses the indications for use of peak flow meters, technique and clinical context. [ABSTRACT FROM AUTHOR]

Background: The recognition of comorbidities is relevant for asthma management, especially if these conditions/diseases are treatable traits such as anxiety. This study aimed to explore the associations between asthma severity and child and parent asthma-related anxiety and to recognize the most common specific fears. Methods: This cross-sectional study consisted of 150 parents and their children diagnosed with asthma, and was conducted at the Pediatric Clinic of the University Hospital Center Split in Croatia. All children, from ages 3 to 17 years, underwent a thorough clinical examination. A total of 150 parents and 108 children filled out an asthma-related anxiety questionnaire in paper form. Results: Parents of children with moderate and severe asthma had higher asthma-related anxiety due to restrictions related to asthma symptoms (p = 0.032), and children diagnosed with moderate and severe asthma had greater anxiety due to restrictions related to asthma symptoms than children diagnosed with mild asthma (p = 0.004). Children's anxiety was the highest when they experienced an asthmatic attack during physical activity (PA), and they fear that they will not be successful in sports or dancing due to asthma. Parents commonly reported the fear of an asthma attack without warning signs (p < 0.001), fear of drug side effects (p < 0.001), fear of absence from school (p = 0.006), and fear of an asthma attack during PA (p < 0.001). Conclusions: The current study reports findings of increased parental levels of anxiety when compared to their children, related to fear of an asthma attack occurring without warning signs, fear of side effects and fear of absence from school, as well as the fear of an asthma attack occurring during sports activities. When assessing individual items on anxiety associated with asthma, children most commonly reported concern related to physical activity. [ABSTRACT FROM AUTHOR]

The Saudi Initiative for Asthma 2024 (SINA-2024) is the sixth version of asthma guidelines for the diagnosis and management of asthma for adults and children that was developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up-to-date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA Panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5–12 years, and children aged <5 years. SINA guidelines have focused more on personalized approaches reflecting a better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. The medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan. [ABSTRACT FROM AUTHOR]

Objective Study objectives are to detect small airways disease in asthma and to study T2 inflammatory markers (eosinophil count, IgE, phenotyping) in association with small airways disease. Methods and patients The retrospective study at OPC at Al Qassimi Hospital of EHS included 83 patients with confirmed asthma diagnosis. Based on their ACT scores, patients were divided into two groups. An assessment of demographic data, blood eosinophils, fractional exhaled nitric oxide, IgE, PFE25-75, FEV1%, R5-20, X5 and AX was carried out. Analyzing and collecting data. Results In this study, a significant correlation was found between the R5-20, X5, and AX values of the small airway and the asthma control test. Uncontrolled asthmatics had a higher fractional exhaled nitric oxide level and blood eosinophilic count. Conclusion In asthma management, small airways clinical impact should be investigated actively. Impulse oscillometry is an excellent marker for asthma control. [ABSTRACT FROM AUTHOR]

We studied associations between fractional exhaled nitric oxide (FeNO), health and household exposure among school children (N = 348) in Penang, Malaysia. Multiple logistic regression and linear mixed models were applied. Overall, 46.0% had elevated FeNO (>20 ppb) and 10.6% diagnosed asthma. Male gender (p = 0.002), parental asthma or allergy (p = 0.047), cat allergy (p = 0.009) and seafood allergy (p < 0.001), diagnosed asthma (p = 0.001), wheeze (p = 0.001), ocular symptoms (p = 0.001), rhinitis (p = 0.002) and respiratory infections (p = 0.004) were all associated with FeNO. Students exposed to ETS had lower FeNO (p = 0.05). Dampness and mould was associated with wheeze (p = 0.038), especially in wooden homes (interaction p = 0.042) and among students with elevated FeNO (interaction p = 0.024). Cat keeping increased rhinitis (p = 0.041) and respiratory infections (p = 0.008) and modified the dampness associations. In conclusion, FeNO can be associated with ocular and respiratory symptoms. Elevated FeNO, cat keeping and a wooden house can enhance the risk of wheeze when exposed to dampness and mould. [ABSTRACT FROM AUTHOR]

Bronchial asthma, which is the most common chronic disease of the respiratory system, causes significant diagnostic problems in younger children due to the difficulty of performing typical respiratory function tests, including spirometry. This problem is especially important for paediatricians, allergists, and pulmonologists. A new, promising method of objectifying allergic inflammation in the respiratory tract is the measurement of volatile organic compounds (VOCs) in exhaled air. They are formed during the metabolic processes of the body's cells and the microorganisms that inhabit it. Clinical benefits of the VOC profile have been proven in differentiating asthma phenotypes, monitoring its course, predicting exacerbations, and responding to treatment. However, further studies are needed to standardise this process and establish reference standards. The aim of this study is to review the latest literature on the usefulness of VOC profiles in exhaled air and the composition of the microbiome in children with bronchial asthma. [ABSTRACT FROM AUTHOR]

Background: To study whether the four locus gene model consisting of ADRB2 rs1042713, IL4 rs2243250, FCER1B rs569108 and L13 rs20541 can predict asthma of the Kazak children in Xinjiang, China. Methods: Four single nucleotide polymorphisms about the 4 genes were genotyped in asthma group and control group of Han children and Kazak children respectively. The frequencies of different genotypes and alleles were compared between the asthma group and the control group in the two nationalities. Different risk genotypes for asthma were evaluated in the two nationalities. Results: The differences about frequencies of genotypes in ADRB2 rs1042713 and IL4 rs2243250 and IL13 rs20541 between asthma group and control group were statistically significant in Han children, as were the frequencies of alleles in the 3 single nucleotide polymorphisms, but there were no statistical differences in FCER1B rs569108(P > 0.05). For the Kazak children, no differences were existed among all the genotypes and alleles in asthma group and control group. For the Han children, more children were asthma high risk genotype in the asthma group than those in the control group and no difference was found in the Kazak children. Conclusions: The four locus gene model consisting of ADRB2 rs1042713, IL4 rs2243250, FCER1B rs569108 and L13 rs20541 can predict asthma of Han children but not for the Kazak children in Xinjiang, which illustrating that the difference of asthma prevalence between different races is closely related to the genetic background. [ABSTRACT FROM AUTHOR]

Introduction of inhaled corticosteroids (ICS) has been the cornerstone of the long-term management of asthma. ICSs either alone or in combination with long-acting beta-2 agonists have been shown to be associated with favorable asthma outcomes. However, asthma control is still reported to be below expectations all around the world. Research in the last decades focusing on the use of ICS/formoterol both as maintenance and as needed (maintenance and reliever therapy approach) showed improved asthma outcomes. As a result of recent developments, Turkish Asthma Guidelines group aimed to revise asthma treatment recommendations. In general, we recommend physicians to consider the risk factors for poor asthma outcomes, patients' compliance and expectations and then to determine "a personalized treatment plan." Importantly, the use of short-acting beta-2 agonists alone as a symptom reliever in asthma patients not using regular ICS is no longer recommended. In stepwise treatment approach, we primarily recommend to use ICS-based controllers and initiate ICS as soon as possible. We define 2 different treatment tracks in stepwise approaches as maintenance and reliever therapy or fixed-dose therapy and equally recommend each track depending on the patient's risks as well as decision of physicians in a personalized manner. For both tracks, a strong recommendation was made in favor of using add-on treatments before initiating phenotype-specific treatment in step 5. A strong recommendation was also made in favor of using biologic agents and/or aspirin treatment after desensitization in severe asthma when indicated. [ABSTRACT FROM AUTHOR]

Cystic fibrosis is the most common autosomal recessive hereditary disease in white populations. It is characterized by the formation of abnormal secretions in the exocrine glands located in the sweat and salivary glands, tracheobronchial tree, large intestine, and pancreas. The severity of the clinic depends on the type of "cystic fibrosis transmembrane regulatory protein" gene mutation. Although most cases are diagnosed in infancy or childhood, some patients are also diagnosed during adolescence and adulthood. We report a case a 19-yearold patient who was followed up with a diagnosis of asthma and bronchiectasis since childhood and diagnosed with cystic fibrosis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Genome-length association studies have shown that Gasdermin B (GSDMB) and Orosomucoid-like 3 (ORMDL3) genes located on the long arm of chromosome 17 are associated with asthma. In this study, it was aimed to determine the possible relationship between asthma control test (ACT), exercise provocation test (ECT), and fractional nitric oxide (FENO) levels and GSDMB and ORMDL3 gene expressions. METHODS: 59 asthmatic and 38 non-asthmatic children were included in the study. We divided the patient group into two subgroups as mild persistent asthma (29 patients) and moderate persistent asthma (30 patients). ORMDL3, GSDMB gene expression levels, ECT, total IgE levels, and eosinophil counts were measured in all cases. In addition, ACT and FeNO levels were measured in children with asthma. Afterward, the relationship of ORMDL3 and GSDMB gene expression coefficient changes with ECT, ACT, and FeNO was examined. RESULTS: When patients with ACT =15 were compared with patients with ACT =20, ORMDL3 and GSDMB gene expressions were increased 6.74 and 11.74 times, respectively. Comparing patients with ACT =20 and ACT =15 in terms of coefficient changes (ΔCq), higher change values were observed for ΔCq ORMDL3 in patients with ACT =15 (p=0.015). Similarly, when patients with FENO =25 ppb were compared with patients with FENO >25 ppb, ORMDL3 and GSDMB gene expressions were increased by 2.93 and 3.56 times, respectively. When the coefficient changes were compared, no significant difference was found between FENO=25 and FENO >25 patients. There was a slight negative correlation between ΔCq values and ACT score (p=0.003, r=-0.418 for ORMDL3, and p=0.016, r=-0.345 for GSDMB). In addition, we observed a statistically significant positive correlation between ORMDL3 and GSDMB gene expressions (r=0.80, p<0.001). CONCLUSION: We showed that increased ORMDL3 and GSDMB gene expression levels may be associated with ACT scores, FeNO and ECT in asthma. These findings may encourage future studies with larger numbers of subjects that can use gene expression levels in various asthma phenotypes for prognostic prediction. [ABSTRACT FROM AUTHOR]

Aim: It is aimed to contribute to preventive measures by determining the distribution of allergens in patients with allergic rhinitis and asthma in Kırıkkale and to contribute to the creation of the allergy map of our country. Materials and Methods: The files of patients who underwent skin prick test at Kırıkkale Yüksek İhtisas Hospital between 2018 and 2022 were retrospectively analyzed. Results: A total of 6,056 people, 4,464 (73.7%) women and 1,592 (26.3%) men, were applied skin prick test within 5 years. Of the test results, 3,454 (57%) were positive and 2,602 (43%) were negative. While 622 (10.3%) of 3,454 positive patients were sensitive to a single allergen, 2,832 (46.8%) were sensitive to multiple allergens. The most common positivity rate in the skin prick test is Blattella germanica (cockroach) (24.2%), Dermatophagoides (D.) Farinae (house dust mite) (21.9%), herb mixture (plant grass, wormwood, buckwheat, sticky grass) (weed pollen) (19%) and D. Pteronyssinus (house dust mite) (18.4%) was found. When the pollens were examined collectively rather than individually (test 5 willow pollen 10.7%, test 6 cereal pollen 17.8%, test 7 poplar pollen 14.0%), it was determined as 42.5%. House dust mites D. Farinae and D. Pteronyssinus together were determined to be 40.3% allergen positive. Conclusion: It was determined that the most common allergens in Kırıkkale province were cockroaches, pollen and house dust mites. [ABSTRACT FROM AUTHOR]

Oesophageal achalasia is a disease characterized by the inability of the lower oesophageal sphincter (LOS) to relax, which results in persistent contraction and the lack of peristaltic movement in the oesophageal body. It is a rare condition in children; therefore, its identification may be challenging. In this paper, we present a case of an 11-year-old patient with persistent cough and post-exercise tachypnoea, consulted due to uncontrolled asthma. After thorough diagnostic work-up, the patient was given the final diagnosis of oesophageal achalasia and was referred for surgical treatment. Uncontrolled asthma always requires the supervision of inhalation technique, consideration of treatment modification, and confirmation of the diagnosis. In this case, in-depth anamnesis and adequate interpretation of lung function tests allowed a correct diagnosis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Best practice guidelines for asthma management recommend education and spirometry at specific intervals. A written asthma action plan with education and spirometry is ordered at the discretion of physicians at our institution. An initial chart review revealed that asthma education and spirometry were not consistently ordered in the pediatric primary care clinics. This quality improvement study aimed to increase frequency of spirometry and asthma education in children with asthma seen in pediatric primary care through use of a respiratory therapist (RT)--driven protocol. METHODS: The protocol established that spirometry and education would be done annually for children ≥ 6 y of age with intermittent asthma and every 6 months for persistent asthma. RTs identified eligible subjects and placed the electronic medical record orders before the clinic visit. Physicians were invited to complete a questionnaire before and after protocol implementation to assess barriers and protocol satisfaction. RESULTS: Nine hundred and thirty-two children were included. Prior to protocol implementation, spirometry and education were completed in 64.9% and 62.6% of eligible children, respectively. Following protocol implementation, spirometry and education were significantly increased to 92.7% (P < .001) and 88.5% (P < .001), respectively. Physicians identified interruption in clinic flow as the primary barrier for ordering spirometry and were satisfied with the protocol. Physicians stated that communication with RT improved through use of this protocol. CONCLUSIONS: Implementation of an RT-driven protocol in an out-patient pediatric primary care setting significantly increased utilization of spirometry and education for children with asthma. RTs working in the pediatric outpatient primary care setting played a vital role in achieving best practices for asthma management. The implementation of the protocol enhanced interdisciplinary communication. [ABSTRACT FROM AUTHOR]

Background: Asthma is the most common chronic condition in children. It is a complex non-communicable disease resulting from the interaction of genetic and environmental factors and characterized by heterogeneous underlying molecular mechanisms. Metabolomics, as with the other omic sciences, thanks to the joint use of high-throughput technologies and sophisticated multivariate statistical methods, provides an unbiased approach to study the biochemical–metabolic processes underlying asthma. The aim of this narrative review is the analysis of the metabolomic studies in pediatric asthma published in the past 10 years, focusing on the prediction of asthma development, endotype characterization and pharmaco-metabolomics. Methods: A total of 43 relevant published studies were identified searching the MEDLINE/Pubmed database, using the following terms: "asthma" AND "metabolomics". The following filters were applied: language (English), age of study subjects (0–18 years), and publication date (last 10 years). Results and Conclusions: Several studies were identified within the three areas of interest described in the aim, and some of them likely have the potential to influence our clinical approach in the future. Nonetheless, further studies are needed to validate the findings and to assess the role of the proposed biomarkers as possible diagnostic or prognostic tools to be used in clinical practice. [ABSTRACT FROM AUTHOR]

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Purpose: This study investigated the effects of body mass index (BMI), waist circumference (WC), and depression on asthma in older adults Koreans. Methods: Data for 1,388 individuals (> 65 years) were extracted from the Korea National Health and Nutrition Examination Survey (KNHANES w-2, 2020). Complex sampling design data were analyzed using stratification, clustering, and weights. Data were analyzed using unweighted frequencies, weighted percentages, estimated means and standard errors, the Rao-Scott χ² test, and multiple logistic regression analysis, which was performed to identify variables that influenced asthma after adjusting for confounding factors. Results: The factors influencing asthma in the older adults were a depression diagnosis, age at the onset of depression, current depression status, and gender. In contrast, BMI and WC did not affect asthma. A diagnosis of depression had an odds ratio of 3.07 for asthma in the older adults. Furthermore, the odds ratios for asthma in the older adults were 5.08 for depression onset at <49 years and 3.37 for current depression compared to no depression diagnosis. The odds ratio for asthma in female older adults was 1.35. Conclusion: The results of this study suggest that asthma in the older adults could be detected early through depression symptoms. This study also provides evidence that depression-related interventions should be included in asthma prevention and management programs for the older adults in Korea. [ABSTRACT FROM AUTHOR]

Respiratory disease is ubiquitous in hospitals and community healthcare settings in the UK. Nurses, therefore, must be able to understand the physiology and pathophysiology that underpins the care they provide for people living with a respiratory disorder. This article summarises the fundamental anatomy and physiology of the respiratory system and respiration. It also explores the pathophysiological changes that occur in the four most common respiratory conditions, namely pneumonia, lung cancer, asthma and chronic obstructive pulmonary disease. Key elements of a comprehensive respiratory assessment and how nurses can determine acute deterioration are explored. The case study and reflective questions aim to enhance the reader’s understanding of respiratory assessment and nursing care. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of the signs and symptoms of asthma, as well as how it is treated • To be aware of various frameworks and tools that can be used when assessing, managing and prescribing medicines for patients • To recognise the legal, ethical and professional considerations when prescribing medicines for children Asthma is a chronic condition of varying intensity that is characterised by symptoms including coughing, wheezing, chest tightness and breathlessness. The article details a case study outlining the consultation and prescribing practice for a five-year-old girl who presented with a cough and breathlessness, and who was subsequently diagnosed with asthma. The author assessed and treated this patient while undertaking her non-medical prescribing qualification, and she outlines the diagnostic and prescribing decision-making process. The author also examines the potential drug interactions and adverse drug reactions relevant to the patient's age and comorbidities. [ABSTRACT FROM AUTHOR]

Introduction: Exercise‐induced bronchoconstriction (EIB) is not only highly prevalent in people with asthma, but can also occur independently, particularly in athletes. Fractional exhaled nitric oxide (FeNO) is an indirect biomarker of type 2 airway inflammation that has an established role in the assessment and management of asthma. The aim was to evaluate the value of FeNO in the assessment of EIB in athletes. Method: Multicenter retrospective analysis. In total, 488 athletes (male: 76%) performed baseline FeNO, and spirometry pre‐ and post‐indirect bronchial provocation via eucapnic voluntary hyperpnea (EVH). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for established FeNO thresholds—that is, intermediate (≥25 ppb) and high FeNO (≥40 ppb and ≥ 50 ppb)—and were evaluated against objective evidence of EIB (≥10% fall in FEV1). The diagnostic accuracy of FeNO was calculated using receiver operating characteristics area under the curve (ROC‐AUC). Results: Thirty‐nine percent of the athletes had a post‐EVH fall in FEV1 consistent with EIB. FeNO values ≥25 ppb, ≥40 ppb, and ≥ 50 ppb were observed in 42%, 23%, and 17% of the cohort, respectively. The sensitivity of FeNO ≥25 ppb was 55%, which decreased to 37% and 27% at ≥40 ppb and ≥ 50 ppb, respectively. The specificity of FeNO ≥25 ppb, ≥40 ppb, and ≥ 50 ppb was 66%, 86%, and 89%, respectively. The ROC‐AUC for FeNO was 0.656. Conclusions: FeNO ≥40 ppb provides good specificity, that is, the ability to rule‐in a diagnosis of EIB. However, due to the poor sensitivity and predictive values, FeNO should not be employed as a replacement for indirect bronchial provocation in athletes. [ABSTRACT FROM AUTHOR]

Asthma management consists of a cyclical process based on clinical assessment of the patient, the implementation of therapeutic adjustments, and evaluation of the patient's response. Self-efficacy is the person's confidence in his or her ability to successfully perform a behaviour and guides the patient's decisions for producing healthy behaviours. Studies have shown that asthma management is related to self-efficacy, which in turn can be influenced by various psychosocial factors. A literature search on the relationship between asthma and self-efficacy in paediatric age, has allowed us to hypothesize that adequate levels of self-efficacy might be achieved through a cyclical process, 'the self-efficacy cycle', taking into account assessment, identification of modifiable risk factors and patient's response. This would make it easier to identify the personal and social aspects on which to intervene to promote a proper management of the disease. [ABSTRACT FROM AUTHOR]

Background Smoking influences the nature of airway inflammation in patients with bronchial asthma though synthesis of certain cytokines. Patterns of bronchial asthma are differentiated clinically, functionally, and regarding inflammatory biomarkers. Aim The research aimed to study the clinical, functional, sputum cytological differences, and serum eotaxin-2 and periostin levels in asthmatic patients regarding smoking status. Patients and methods The research was a cross-sectional study. The collection of cases began in August 2018 and ended in January 2020 at the Chest Department, Assiut University Hospital. We studied 117 asthmatic patients who were classified regarding their smoking status (45 nonsmokers, 42 smokers, and 30 former smokers) for serum eotaxin-2 and periostin by enzyme-linked immunosorbent assay. The effects of smoking were analyzed on inflammatory cells including eosinophilic and neutrophilic percentages in sputum and serum eotaxin-2 and periostin levels. Results Smokers with asthma had worse clinical and functional outcomes. Asthmatic smokers had mainly neutrophilic phenotype. Serum eotaxin-2 level was higher in smokers compared with nonsmokers and former smokers. However, serum periostin level was higher in nonsmokers compared with smokers and former smokers. Serum eotaxin-2 had a positive correlation with smoking index and eosinophilic and neutrophilic count in sputum, whereas serum periostin was correlated negatively with smoking index and positively with eosinophilic count. Conclusion Asthmatic smokers had worse clinical and functional outcomes with increased neutrophils in the sputum. The inflammatory biomarkers seen in smokers with asthma showed low serum periostin and increased serum eotaxin-2 levels. [ABSTRACT FROM AUTHOR]

While autism spectrum disorder (ASD) has traditionally been diagnosed in specialty care, rising prevalence rates have strained specialist capacity and created significant diagnostic bottlenecks. With long wait times for specialist evaluations, pediatricians are increasingly being asked to play a greater role in identifying, diagnosing, and managing ASD within the medical home. In this commentary we draw parallels between the challenges pediatricians faced two decades ago learning how to manage pediatric asthma in the medical home, to those faced today in the field of primary care ASD management. Reflecting on the lessons learnt in primary care asthma management may help us construct a roadmap towards a higher and more consistent standard of ASD primary care for patients and their families. [ABSTRACT FROM AUTHOR]

Abstract Introduction Making a diagnosis of asthma can be challenging for clinicians and patients. A clinical decision support system (CDSS) for use in primary care including a patient‐facing mode, could change how information is shared between patients and healthcare professionals and improve the diagnostic process. Methods Participants diagnosed with asthma within the last 5 years were recruited from general practices across four UK regions. In‐depth interviews were used to explore patient experiences relating to their asthma diagnosis and to understand how a CDSS could be used to improve the diagnostic process for patients. Interviews were audio recorded, transcribed verbatim and analysed using a thematic approach. Results Seventeen participants (12 female) undertook interviews, including 14 individuals and 3 parents of children with asthma. Being diagnosed with asthma was generally considered an uncertain process. Participants felt a lack of consultation time and poor communication affected their understanding of asthma and what to expect. Had the nature of asthma and the steps required to make a diagnosis been explained more clearly, patients felt their understanding and engagement in asthma self‐management could have been improved. Participants considered that a CDSS could provide resources to support the diagnostic process, prompt dialogue, aid understanding and support shared decision‐making. Conclusion Undergoing an asthma diagnosis was uncertain for patients if their ideas and concerns were not addressed by clinicians and were influenced by a lack of consultation time and limitations in communication. An asthma diagnosis CDSS could provide structure and an interface to prompt dialogue, provide visuals about asthma to aid understanding and encourage patient involvement. Patient and Public Contribution Prespecified semistructured interview topic guides (young person and adult versions) were developed by the research team and piloted with members of the Asthma UK Centre for Applied Research Patient and Public Involvement (PPI) group. Findings were regularly discussed within the research group and with PPI colleagues to aid the interpretation of data.

Cockroaches are one of the most important causes of asthma and allergies in residential areas. Sensitization to cockroach allergens is an established risk factor for asthma among populations. In this study, cockroach bodies and feces from the two species were separately dried, homogenized, and centrifuged after one day in phosphate-buffered saline (PBS). The protein concentration of the samples was then determined using the Bradford method. The supernatant was prepared for injection into 20 mice, and after four weeks of subcutaneous injection, an ELISA test was used to determine the antibody titer against the injected antigen. After the overdoes (OD) samples were detected, an SDS-PAGE test was performed to determine the peptides' molecular band and molecular weight. Lastly, a Western blot test with anti-mouse IgE conjugated HRP (Horseradish Peroxidase) for IgE in mouse serum was prepared. A comparison of the cockroach OD with the rest showed that more antibodies, both for feces and for the body, were produced in the mouse serum than in other cockroaches. A Western blot test also showed that the body of this cockroach produced IgE antibodies in the serum of mice. The molecular weights of body and feces samples of German cockroaches by SDSPAGE were 85, 75, and 100 kDa, respectively, and 75, 35, 60, and 60 kDa, respectively, for the body and feces of the brown-banded cockroach. The weight of IgE protein bands (antibody) produced in mouse serum by western blot varied from 60 to 220 kDa. The upper titer of the whole body and the cockroach feces of Supella longipalpa were observed in comparison with the other cockroaches, as well as the IgE antibody band of the Supella whole body was observed, which indicated the risk of allergy to this cockroach. [ABSTRACT FROM AUTHOR]

Background: Outdoor air pollution, including ozone (O3) pollution, and childhood family environments may interact and impact asthma exacerbations in children. Previous epidemiology studies have primarily focused on stress in the home, rather than support, and whether psychosocial factors modify the association between pollution and health outcomes, rather than whether pollution exposure modifies associations between psychosocial factors and health outcomes. Methods: Data from the cross-sectional 2003 representative, population-based California Health Interview Survey were linked with air quality monitoring data on O3 pollution from the California Air Resources Board. Adolescents (N = 209) ages 12–17 who reported an asthma diagnosis and lived within 5 mi of the nearest air monitoring station had linked O3 data for a 12-month period preceding the survey interview date. Adolescents reported perceived available support from an adult at home and frequency of asthma symptoms. Results: In unadjusted models, for adolescents living in high O3 pollution regions, greater perceived support was related to lower asthma symptom frequency. Follow-up analyses suggested that the most plausible interpretation of the interaction was that O3 exposure modified the association between perceived support and symptom frequency. O3 × perceived support interactions were not statistically significant after adjusting for covariates. Conclusions: These data provide preliminary evidence that the association between the lack of support in the home environment and worse asthma symptoms may be stronger in areas with higher O3 exposure. Future work may benefit from incorporating personal pollution exposure assessments, comprehensive family environment assessments, and longitudinal follow-up of asthma exacerbations over time. [ABSTRACT FROM AUTHOR]

Aim: To examine differences in the prevalence of self-reported diagnosed asthma by socioeconomic status and the contribution of lifestyle factors to these differences. Methods: The study was based on 28,531 persons aged 18 years or older who answered a survey questionnaire sent to a random population sample in mid-Sweden in 2017. The overall response rate was 44%. Socioeconomic status was measured with educational level and economic difficulties, and lifestyle factors with physical activity, smoking, snuff use, risk-drinking of alcohol and obesity. The associations between socioeconomic status and asthma were analysed using multivariate logistic regression. Results: The overall asthma prevalence was 9% among women and 7% in men and decreased with increasing age. Educational level was not independently associated with asthma, but a statistically significant odds ratio (with 95% confidence intervals) for the prevalence of asthma was observed for economic difficulties 1.5 (1.3–1.7). Also, physical inactivity 1.2 (1.1–1.3) and obesity 1.6 (1.4–1.8) were associated with increased asthma prevalence. Smoking and risk-drinking were not statistically significantly associated with asthma whereas snuff users had a higher prevalence of asthma among women. Adjusting for lifestyle factors did not affect the association between socioeconomic status and asthma. Conclusions: In this population-based study, self-reported diagnosed asthma was independently associated with economic difficulties but not with educational level. Lifestyle factors did not explain the association between economic difficulties and asthma prevalence. This applies to both men and women as well as younger and older age groups. [ABSTRACT FROM AUTHOR]

Asthma is a chronic disease of the airways of the lungs caused by inflammation and narrowing of the airways. Asthma patients are sometimes misdiagnosed because of the similarity of asthma symptoms to other respiratory diseases. This leads to administering inappropriate medications, and thus the patient's condition worsens. In this search, we propose a new approach based on ontology, the aiming this method is that to develop a system that can diagnose asthma and suggest the appropriate treatment for each patient. The proposed approach consists of three steps: the knowledge base, four modules that act as mediators between the user interface and ontology, and the web application that act as an interface to the approach. Semantic Web Rule Language (SWRL) was used for asthma diagnosis. The proposed system was tested using several patients previously diagnosed with asthma. The obtained results showed that the approach could diagnose the disease and recommend treatments. It diagnosed 56 out of 59 (accuracy rate of 94.91%) and correctly recommended treatment for 20 out of 22 patients (accuracy rate of 90.9%). The approach also showed good speed in the previous two procedures, as it took 3.6 seconds to diagnose and 15.4 seconds to recommend the appropriate treatment. [ABSTRACT FROM AUTHOR]

Bronchial asthmais a chronic inflammatory disorder of the airways in which several cells and cellular elements play an important role, the hallmark of which is airway hyperresponsiveness, or an exaggerated response (bronchoconstriction) on exposure to certain triggers such as allergens and/or respiratory infections and others. The airway inflammation and obstruction are usually reversible but manifest clinically as acute episodes of wheezing, breathlessness, cough, or chest tightness, that occur particularly at night or early in the morning. Exacerbations and comorbidities affect disease severity as well as impact treatment success in many patients. Therapies are directed toward controlling airway inflammation and relieving airway obstruction. [ABSTRACT FROM AUTHOR]

Asthma, and chronic obstructive pulmonary disease (COPD) are significant health problems that have disparate effects on many Americans. Misdiagnosis and underdiagnosis are common and lead to ineffective treatment and management. This study assessed the feasibility of applying a two-step case-finding technique to identify both COPD and adult asthma cases in urban African American churches. We established a community-based partnership, administered a cross-sectional survey in step one of the case-finding technique and performed spirometry testing in step two. A total of 219 surveys were completed. Provider-diagnosed asthma and COPD were reported in 26% (50/193) and 9.6% (18/187) of the sample. Probable asthma (13.9%), probable COPD (23.1%), and COPD high-risk groups (31.9%) were reported. It is feasible to establish active case-finding within the African American church community using a two-step approach to successfully identify adult asthma and COPD probable cases for early detection and treatment to reduce disparate respiratory health outcomes. [ABSTRACT FROM AUTHOR]

This study examined associations among perceived stress, religiosity, and substance use in African American and Latinx college students with asthma. Participants included 194 college students with asthma (18–20 years, 63.4% African American, 21.1% Latinx). Eligible students completed an online questionnaire that included measures of asthma control, perceived stress, religiosity, alcohol misuse, and last 30-day tobacco use and marijuana use. Over one-quarter (25.3%) of participants reported using tobacco and 31.9% reported using marijuana in the past 30 days. Perceived stress and religiosity were each independently associated with multiple indicators of substance use. Asthma control moderated associations between religiosity and tobacco use in the past 30 days (b = −.014, p =.002), such that the association between religiosity and tobacco use was stronger among those with better asthma control. Participant gender significantly moderated the association between perceived stress and alcohol misuse (b = −.099, p =.029); a stronger, positive association between stress and alcohol misuse was found among men. Students' perceived stress levels were associated with marijuana use in the past 30 days and high alcohol misuse. Religiosity was inversely linked to substance use. There is a need for healthcare providers to recognize and focus on substance use prevention specifically among African American and Latinx college students with asthma. [ABSTRACT FROM AUTHOR]

BACKGROUND: Spirometry tests with a bronchodilator response (BDR) in FEV1, a methacholine concentration that produces a 20% drop in FEV1 (PC20) ≤ 2 mg/mL, and a positive exercise test have high specificity for the diagnosis of asthma in children. However, the value of forced expiratory flow during the middle half of the FVC maneuver (FEF25-75) in spirometry has been questioned. The objective of this study was to relate the BDR in FEF25-75 of spirometry tests with normal FEV1 and FEV1/FVC to airway hyper-responsiveness (AHR) to methacholine or exercise in children age 5-15 y with clinical suspicion of asthma. METHODS: This was a cross-sectional study of spirometry tests performed between January 2017-December 2019 in children age 5-15 y with diagnostic suspicion of asthma who had a methacholine and/or exercise testing within a period not exceeding 60 d between exams. RESULTS: The mean (± SD) age of the children was 9.04 ± 2.67 y, with a range of 5-15 y, and 56.17% were male. Of the 324 spirometry tests with normal FEV1 and FEV1/FVC, 66 (20.4%) tests showed BDR in FEF25-75. A total of 46.9% and 33.3% of the children with and without BDR in FEF25-75, respectively, had a PC20 value ≤ 2 mg/mL and/or a positive exercise testing (P = .039). CONCLUSIONS: Children with suspected asthma and normal spirometry, other than BDR in FEF25-75, had greater AHR than those without BDR in FEF25-75. BDR in FEF25-75 was not always accompanied by AHR to confirm the diagnosis of asthma, so this study suggests that assessment of FEF25-75 alone is not always reliable for ruling in or ruling out AHR in the setting of otherwise normal spirometry results in children with suspected asthma. [ABSTRACT FROM AUTHOR]

Copyright of Polish Journal of Allergology / Alergologia Polska is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)