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9. Can environment or allergy explain international variation in prevalence of wheeze in childhood?

Author

Weinmayr, G., Jaensch, A., Ruelius, A. -K., Forastiere, F., Strachan, D. P., Weiland, S. K., Buchele, G., Dentler, C., Rzehak, P., Priftanji, A., Shkurti, A., Simenati, J., Grabocka, E., Shyti, K., Agolli, S., Gurakuqi, A., Stein, R. T., de Pereira, M. U., Jones, M. H., Pitrez, P. M., Cooper, P. J., Chico, M., Chen, Y. Z., Zhong, N. S., Lai, C. K. W., Wong, G. W. K., Riikjarv, M. -A., Annus, T., Annesi-Maesano, I., Gotua, M., Rukhadze, M., Abramidze, T., Kvachadze, I., Karsanidze, L., Kiladze, M., Dolidze, N., Leupold, W., Keil, U., von Mutius, E., Arthur, P., Addo-Yobo, E., Gratziou, C., Priftis, K., Papadopoulou, A., Katsardis, C., Tsanakas, J., Hatziagorou, E., Kirvassilis, F., Clausen, M., Shah, J. R., Mathur, R. S., Khubchandani, R. P., Mantri, S., Di Domenicantonio, R., De Sario, M., Sammarro, S., Pistelli, Riccardo, Serra, M. G., Corbo, Giuseppe Maria, Perucci, C. A., Svabe, V., Sebre, D., Casno, G., Novikova, I., Bagrade, L., Brunekreef, B., Schram, D., Doekes, G., Jansen-van Vliet, P. H. N., Janssen, N. A. H., Aarts, F. J. H., de Meer, G., Crane, J., Wickens, K., Barry, D., Nystad, W., Bolle, R., Lund, E., Batlles Garrido, J., Rubi Ruiz, T., Bonillo Perales, A., Gonzalez Jimenez, Y., Aguirre Rodriguez, J., Momblan deCabo, J., Losilla Maldonado, A., Daza Torres, M., Garcia-Marcos, L., Martinez Torres, A., Guillen Perez, J. J., Pinana Lopez, A., Castejon Robles, S., Garcia Hernandez, G., Martinez Gimeno, A., Moro Rodriguez, A. L., Luna Paredes, C., Gonzalez Gil, I., Morales Suarez-Varela, M. M., Llopis Gonzalez, A., Escribano Montaner, A., Tallon Guerola, M., Braback, L., Kjellman, M., Nilsson, L., Mai, X. -M., Sandin, A., Saraclar, Y., Kuyucu, S., Tuncer, A., Sackesen, C., Sumbuloglu, V., Geyik, P., Kocabas, C., Kaur, B., El-Sharif, N., Nemery, B., Barghuthy, F., Abu Huij, S., Qlebo, M., van Hage, M., Ait-Khaled, N., Anderson, H. R., Flohr, C., Williams, John Harford, Asher, I., Ellwood, P., Stewart, A., Mitchell, E., Pearce, N., Beasley, R., Bjorksten, B., Foliaki, S., Mallol, J., Montefort, S., Odhiambo, J., and Robertson, C.

Subjects
International variation, medicine.medical_specialty, Allergy, Epidemiology, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, Environment, 030204 cardiovascular system & hematology, Global Health, medicine.disease_cause, Atopy, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Wheeze, Hypersensitivity, Prevalence, Humans, Medicine, Environmental risk factors, 030212 general & internal medicine, Risk factor, Child, Asthma, business.industry, Public health, Aeroallergen, medicine.disease, medicine.symptom, business, Demography
Abstract

Asthma prevalence in children varies substantially around the world, but the contribution of known risk factors to this international variation is uncertain. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two studied 8-12 year old children in 30 centres worldwide with parent-completed symptom and risk factor questionnaires and aeroallergen skin prick testing. We used multilevel logistic regression modelling to investigate the effect of adjustment for individual and ecological risk factors on the between-centre variation in prevalence of recent wheeze. Adjustment for single individual-level risk factors changed the centre-level variation from a reduction of up to 8.4% (and 8.5% for atopy) to an increase of up to 6.8%. Modelling the 11 most influential environmental factors among all children simultaneously, the centre-level variation changed little overall (2.4% increase). Modelling only factors that decreased the variance, the 6 most influential factors (synthetic and feather quilt, mother's smoking, heating stoves, dampness and foam pillows) in combination resulted in a 21% reduction in variance. Ecological (centre-level) risk factors generally explained higher proportions of the variation than did individual risk factors. Single environmental factors and aeroallergen sensitisation measured at the individual (child) level did not explain much of the between-centre variation in wheeze prevalence.

Published
2018

24. Can environment or allergy explain international variation in prevalence of wheeze in childhood?

Author

Weinmayr G, Jaensch A, Ruelius A, Forastiere F, Strachan D, Weiland S, Buchele G, Dentler C, Rzehak P, Priftanji A, Shkurti A, Simenati J, Grabocka E, Shyti K, Agolli S, Gurakuqi A, Stein R, de Pereira M, Jones M, Pitrez P, Cooper P, Chico M, Chen Y, Zhong N, Lai C, Wong G, Riikjarv M, Annus T, Annesi-Maesano I, Gotua M, Rukhadze M, Abramidze T, Kvachadze I, Karsanidze L, Kiladze M, Dolidze N, Leupold W, Keil U, von Mutius E, Arthur P, Addo-Yobo E, Gratziou C, Priftis K, Papadopoulou A, Katsardis C, Tsanakas J, Hatziagorou E, Kirvassilis F, Clausen M, Shah J, Mathur R, Khubchandani R, Mantri S, Di Domenicantonio R, De Sario M, Sammarro S, Pistelli R, Serra M, Corbo G, Perucci C, Svabe V, Sebre D, Casno G, Novikova I, Bagrade L, Brunekreef B, Schram D, Doekes G, Jansen-van Vliet P, Janssen N, Aarts F, de Meer G, Crane J, Wickens K, Barry D, Nystad W, Bolle R, Lund E, Garrido J, Ruiz T, Perales A, Jimenez Y, Rodriguez J, de Cabo J, Maldonado A, Torres M, Garcia-Marcos L, Torres A, Perez J, Lopez A, Robles S, Hernandez G, Gimeno A, Rodriguez A, Paredes C, Gil I, Suarez-Varela M, Gonzalez A, Montaner A, Guerola M, Braback L, Kjellman M, Nilsson L, Mai X, Sandin A, Saraclar Y, Kuyucu S, Tuncer A, Sackesen C, Sumbuloglu V, Geyik P, Kocabas C, Kaur B, El-Sharif N, Nemery B, Barghuthy F, Abu Huij S, Qlebo M, van Hage M, Ait-Khaled N, Anderson H, Flohr C, Williams H, Asher I, Ellwood P, Stewart A, Mitchell E, Pearce N, Beasley R, Bjorksten B, Foliaki S, Mallol J, Montefort S, Odhiambo J, Robertson C, and ISAAC Phase Two Study Grp

Published
2019

35. Use of lung clearance index to assess the response to intravenous treatment in cystic fibrosis

Author

Elpis Hatziagorou, Avramidou, V., Kirvassilis, F., and Tsanakas, J.

Subjects
Original Article
Abstract

Progressive lung disease is the main cause of clinical deterioration and mortality in cystic fibrosis (CF) patients. Being able to assess the effectiveness of interventions is very significant.To assess the response to intravenous (IV) treatment among CF patients, using forced expired volume in 1(st) second (FEV1) and Lung Clearance Index (LCI) as outcome measures and to compare the effect of IV treatment on lung function and LCI between CF children being treated on a regular basis, or in case of a pulmonary exacerbation.Thirty-two CF patients (15 males) with mean age 9.90 (range: 2-23) years, performed spirometry and multiple breath washout (MBW) before and one month after IV antibiotic treatment. Nineteen patients received a course of elective treatment (group A) and 13 received IV antibiotic regimens for an acute exacerbation (group B).Statistically significant differences after treatment were seen in LCI (p≤0.001), and Forced Expiratory Flow (FEF) z-scores (p0.05). FEV1 did not change significantly after drug intervention. Dividing patients into two groups, only LCI showed significant change (p0.05), when treatment was administered on a regular basis. Patients being treated for an acute pulmonary exacerbation showed significant improvement in most of the lung function parameters: LCI (p=0.0001), FEV1% (p=0.05), FEV1 z-score (p=0.033) and FEF25-75 (p=0.046). The mean LCI difference was significantly greater in group B compared to group A (p=0.001).LCI is more sensitive marker than FEV1 to assess the effect of IV antibiotic treatment among CF children. IV antibiotics are more effective on lung function parameters, when they are administered for an acute exacerbation, than when they are given on a regular basis. Hippokratia 2015, 19 (1): 47-52.

Published
2015

36. Characterization of Asthma, Atopy and Associated Phenotypes in Families Identified Through Child Probands with Physician Diagnosed Asthma

Author

Helms, P.J, Anderson, W., Barnes, K., Berg, A., Brewster, S., Carlsen, K., Gerritsen, J., Haynes, C., Lenney, W., Manasco, P., Roses, A., Pericak-Vance, M., Silverman, M., Sly, P., Speer, M., Sundy, J., Tsanakas, J., Vance, J., and Whyte, M.

Subjects
Genetic research -- Analysis, Human genetics -- Research, Asthma -- Genetic aspects, Biological sciences
Published
2000

37. Overweight/obesity and respiratory and allergic disease in children: International study of asthma and allergies in childhood (ISAAC) phase two

Author

Weinmayr, G. Forastiere, F. Büchele, G. Jaensch, A. Strachan, D.P. Nagel, G. Weiland, S.K. Dentler, C. Rzehak, P. Priftanji, A. Shkurti, A. Simenati, J. Grabocka, E. Shyti, K. Agolli, S. Gurakuqi, A. Stein, R.T. De Pereira, M.U. Jones, M.H. Pitrez, P.M. Cooper, P.J. Chico, M. Chen, Y.Z. Zhong, N.S. Lai, C.K.W. Wong, G.W.K. Riikjärv, M.-A. Annus, T. Annesi-Maesano, I. Gotua, M. Rukhadze, M. Abramidze, T. Kvachadze, I. Karsanidze, L. Kiladze, M. Dolidze, N. Leupold, W. Keil, U. Von Mutius, E. Arthur, P. Addo-Yobo, E. Gratziou, C. Priftis, K. Papadopoulou, A. Katsardis, C. Tsanakas, J. Hatziagorou, E. Kirvassilis, F. Clausen, M. Shah, J.R. Mathur, R.S. Khubchandani, R.P. Mantri, S. Di Domenicantonio, R. De Sario, M. Sammarro, S. Pistelli, R. Serra, M.G. Corbo, G. Perucci, C.A. Svabe, V. Sebre, D. Casno, G. Novikova, I. Bagrade, L. Brunekreef, B. Schram, D. Doekes, G. Jansen-Van Vliet, P.H.N. Janssen, N.A.H. Aarts, F.J.H. De Meer, G. Crane, J. Wickens, K. Barry, D. Nystad, W. Bolle, R. Lund, E. Garrido, J.B. Ruiz, T.R. Perales, A.B. Jiménez, Y.G. Rodriguez, J.A. De Cabo, J.M. Maldonado, A.L. Torres, M.D. García-Marcos, L. Torres, A.M. Pérez, J.J.G. López, A.P. Robles, S.C. Hernandez, G.G. Gimeno, A.M. Rodríguez, A.L.M. Paredes, C.L. Gil, I.G. Suarez-Varela, M.M.M. González, A.L. Montaner, A.E. Guerola, M.T. Bråbäck, L. Sandin, A. Kjellman, M. Nilsson, L. Mai, X.-M. Saraçlar, Y. Tuncer, A. Saçkesen, C. Sumbulglu, V. Geyik, P. Kocabas, C. Kuyucu, S. Kaur, B. El-Sharif, N. Barghuthy, F. Abu Huij, S. Qlebo, M. Nemery, B. Aït-Khaled, N. Anderson, H.R. Pearce, N. Strachan, D.P. Flohr, C. Williams, H. Asher, M.I. Ellwood, P. Stewart, A. Mitchell, E. Beasley, R. Björkstén, B. Foliaki, S. Mallol, J. Montefort, S. Odhiambo, J. Robertson, C. ISAAC Phase Two Steering Group

Abstract

Background: Childhood obesity and asthma are increasing worldwide. A possible link between the two conditions has been postulated. Methods: Cross-sectional studies of stratified random samples of 8-12-year-old children (n=10 652) (16 centres in affluent and 8 centres in non-affluent countries) used the standardized methodology of ISAAC Phase Two. Respiratory and allergic symptoms were ascertained by parental questionnaires. Tests for allergic disease were performed. Height and weight were measured, and overweight and obesity were defined according to international definitions. Prevalence rates and prevalence odds ratios were calculated. Results: Overweight (odds ratio=1.14, 95%-confidence interval: 0.98; 1.33) and obesity (odds ratio=1.67, 95%-confidence interval: 1.25; 2.21) were related to wheeze. The relationship was stronger in affluent than in non-affluent centres. Similar results were found for cough and phlegm, rhinitis and eczema but the associations were mostly driven by children with wheeze. There was a clear association of overweight and obesity with airways obstruction (change in FEV1/FVC, 20.90, 95%-confidence interval: 21.33%; 20.47%, for overweight and 22.46%, 95%-confidence interval: 23.84%; 21.07%, for obesity) whereas the results for the other objective markers, including atopy, were null. Conclusions: Our data from a large international child population confirm that there is a strong relation of body mass index with wheeze especially in affluent countries. Moreover, body mass index is associated with an objective marker of airways obstruction (FEV1/FVC) but no other objective markers of respiratory and allergic disorders. © 2014 Weinmayr et al.

Published
2014

47. Results of active cycle of breathing techniques and conventional physiotherapy in mucociliary clearance in children with cystic fibrosis

Author

Hristara-Papadopoulou, A and Tsanakas, J

Subjects
Original Article
Abstract

The aim of the present study is the comparison of the results of the appliance of two methods of respiratory physiotherapy; the active cycle of breathing techniques in drainage positions and the conventional physiotherapy, regarding their effects on mucociliary clearance in patients with cystic fibrosis.Thirty-five children teenagers and adults with cystic fibrosis, 8-20 years of age, with mean Schwachman score 78,49 took part in the research. All patients had regular physiotherapeutic control and applied systematically physiotherapy. The same children received two methods of respiratory physiotherapy in a 3-month random order, when they came at the outpatients' department of the hospital for their regular check-up.The comparison of the results of the two methods did not show statistical significant difference in sputum quantity, whereas statistical significant difference was noticed in sputum quality after the application of active cycle of breathing techniques.The application of the active cycle of breathing techniques contributes effectively in the sputum expectoration from the peripheral bronchopulmonary segments and enhances the mucociliary clearance in children with cystic fibrosis.

Published
2007

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