The Journal of asthma : official journal of the Association for the Care of Asthma
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To examine the effect of ambulatory health care processes on asthma hospitalizations. ⋯ In children with asthma, more frequent primary care visits are associated with reduced asthma hospitalizations.
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Hospital-based data reveal that children who have secondhand smoke exposure (SHSe) experience severe respiratory illnesses and greater resource utilization. Our objective was to assess the relationship between SHSe and illness severity/resource utilization among children presenting to the pediatric emergency department (PED) with three common respiratory conditions-asthma, bronchiolitis, and pneumonia. ⋯ SHS-exposed children with asthma or bronchiolitis have greater illness severity/resource utilization. Our findings highlight the importance of SHSe assessment, cessation, and research efforts in the PED setting.
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We investigated patterns of multimorbidities among asthma, allergies, and respiratory illnesses in preschool children. We investigated multimorbidities of lifetime asthma, allergic rhinitis, eczema, food allergy, pneumonia, and ear infections; and multimorbidities of current (in the last year before the survey) wheeze, dry cough, rhinitis, eczema, and common cold during childhood. We further analyzed whether prevalences of these multimorbidities were due to chance. ⋯ Our findings suggest that multimorbidities among childhood asthma, allergies, and respiratory illnesses are likely not random, but rather share etiology. Specific patterns of childhood asthma multimorbidities perhaps differ between boys and girls and between children with and without FHA.
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The currently available treatments for severe asthma are insufficient. Infiltration of neutrophils rather than eosinophils into the airways is an important inflammatory characteristic of severe asthma. However, the mechanism of the phenotypic change from eosinophilic to neutrophilic inflammation has not yet been fully elucidated. ⋯ These findings suggest that the eosinophilic inflammatory phenotype of asthmatic lungs switches to the neutrophilic phenotype following exposure to LPS. The change in the inflammatory phenotype is strongly correlated with the increases in IL-17A and Th17 cells.
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Although pediatric asthma continues to be a highly studied disease, data to suggest clear strategies to decrease asthma related revisits or readmissions is lacking. The purpose of our study was to assess the effect of emergency department (ED) direct dispensing of beta-agonist metered dose inhalers on pediatric asthma ED revisit and readmission rates. ⋯ In our study, ED direct dispensing of beta-agonist MDIs resulted in a reduction in 28-day revisit and readmission to the hospital. Further studies should be performed to evaluate the economic impact of reducing these revisits and readmissions against the costs of maintaining a dispensing program. Our findings may support modification of asthma programs to include dispensing MDIs from the emergency department.