Asthma or Pneumonia?

Perhaps an association between both, according to a recent study investigating the role of a bacteria commonly associated with "walking pneumonia" in children. Dr. Susarla

M. pneumoniae IgM higher in children with asthma

Mycoplasma pneumoniae may play a key role in pediatric asthma, according to study data published online.

 Tamar A. Smith-Norowitz, PhD, of the department of pediatrics and the Center for Allergy and Asthma Research at SUNY Downstate Medical Center, Brooklyn, N.Y., and colleagues published data on specific anti-M. pneumoniae immunoglobulin M, IgG and IgE antibody responses in 23 patients with asthma and 13 control patients.

All patients were aged younger than 20 years, had a physician’s diagnosis of asthma or current clinically defined persistent asthma symptoms, or both, along with allergic rhinoconjunctivitis with elevated serum IgE levels (>100 IU/mL). Patients were recruited from the Pediatric Asthma Clinic at Kings County Hospital Center, and outpatient pediatric offices in Brooklyn.

The researchers said, “Asthmatic subjects had higher levels of specific IgM [anti-M. pneumoniae antibodies] levels compared with non-asthmatics. In addition, IgM positivity was significantly higher in asthmatic compared with non-asthmatic subjects.”

M. pneumoniae may be more common or persistent in children with asthma than other populations, they said. However, further data are needed because the sample size of this study was small.

“Atypical respiratory infection such as M. pneumoniae continues to be a significant concern in children with asthma. More research is needed to identify high risk groups and develop intervention strategies directed at children with asthma,” Smith-Norowitz told Infectious Diseases in Children.

Although the researchers assessed respiratory tract infection incidence, they said it was only assessed by patient recall, which could have limited the results.

Read article here.

Does IVF Increase Risk for Asthma?

The cause of this association is not clear, but premature infants especially under 30 weeks gestation seem to be more prone to develop asthma symptoms like recurrent wheezing.  Dr. Susarla

Fertility treatment 'asthma link'

Continue reading the main story

In a study of more than 13,000 UK children, five-years-olds were about twice as likely to have asthma if they were not conceived naturally.Children born after fertility treatments, such as IVF, may have a slightly higher chance of developing asthma, research suggests.

The children were also more likely to need medication, which could be an indication of more severe asthma.

The findings were published in the journal Human Reproduction.

The researchers, at the Universities of Oxford and Essex, analysed data from children born between 2000 and 2002.

Researcher Dr Claire Carson said 15% of all the children in the study had had asthma at the age of five, but this proportion had risen to 24% among the 104 of them born through assisted-reproduction technologies.

She said it was interesting that the pattern had emerged, but far too soon to say if IVF treatment resulted in higher rates of asthma. Other explanations, such as genetics, may explain the association.

Dr Carson told the BBC that parents should not be put off IVF.

"Assisted reproduction technologies offer a chance to become a parent when there isn't another option," she said.

"For the majority of children asthma is quite manageable."

Malayka Rahman, from the charity Asthma UK, said: "This study suggests that there might be an association between IVF treatment and asthma developing in children, but the sample size for this study is small and currently the research in this area generally is not conclusive.

"Those considering IVF should speak to their GP about the benefits and health risks in order to make an informed decision."

Read article here.

Hand Hygiene Cannot Stop Asthma, Study Shows

Although viruses are one of the main triggers of asthma exacerbations, aggressive hand hygiene did not appear to be enough to stop 'attacks'.  Dr. Susarla

School 'hand hygiene' plan shows no asthma benefit

An arsenal of hand sanitizers, hygiene education and good old-fashioned soap failed to prevent asthma attacks among school children in one Alabama county.

For children with asthma, the common cold is the top trigger of symptom attacks. So in theory, cleaner hands at school could mean fewer colds being passed around - and fewer asthma attacks.

But in a new clinical trial, researchers found that kids at schools with a "hand hygiene" plan, including alcohol-based hand sanitizers, suffered asthma attacks just often as their peers at other schools.

The findings are not, however, the final word, according to Lynn B. Gerald, a professor of health promotion sciences at the University of Arizona in Tucson who led the study.

That's because the trial hit an obstacle when the H1N1 "swine" flu epidemic broke out right at the study's outset: All of the schools in the trial became a lot more vigilant about clean hands, Gerald said.

Schools that weren't part of the hand-hygiene program started putting hand sanitizer on the list of school supplies given to parents.

"Hand sanitizer became ubiquitous in schools," Gerald said.

So, she told Reuters Health, it's hard to draw conclusions about whether hand sanitizers, added to old-fashioned hand washing, might prevent some asthma attacks.

The sanitizers and soap used in the trial were provided to schools for free by Akron, Ohio-based GOJO, which makes the Purell brand hand sanitizers.

GOJO "believes there is great benefit in establishing the effectiveness of hand hygiene interventions under real-world conditions and supports scientific studies that take that approach," the company told Reuters Health.

"We agree with the conclusion that the results of this study were highly confounded by increased overall hand hygiene practices, even in the usual-care schools, as a result of the H1N1 pandemic," they said in an emailed statement.

The findings appear in the Journal of Allergy and Clinical Immunology.

Read full article here.

Asthma attack led to teen's death

The rule is asthma-related deaths are avoidable, which makes stories like this shocking.  Even mild asthma requires routine evaluation.  Dr. Susarla

Asthma attack led to teen's death

Family and friends remember JheVontae Davis

CHESAPEAKE, Va. (WAVY) - Family members of a Chesapeake teen who died after football practice say the teen complained of chest pain before he collapsed earlier this week.

According to family members, 14-year-old JheVontae Davis, who played JV football at Oscar Smith High School, complained of a cough and chest pain before he collapsed at practice. Davis was diagnosed with severe asthma when he was a baby. 

"Early on, it was more intense, and he had to frequent the hospital multiple times," said Jamal Vaughn, Davis' cousin. "But as he grew older, the asthma became more controllable, to the point where he was able to just have his inhaler."

Davis used a breathing machine to sleep at night, but the asthma never crippled his competitive nature or his love for sports, especially football.

At Friday's varsity football game, Oscar Smith's team took a knee and prayed over Davis' jersey. The announcer called for a moment of silence and, in the fence, students used cups to draw a heart around the number Davis wore when he played.

"The moment of silence and the player that wore his jersey, it was just like, man, it was a very touching moment for myself, because he touched so many hearts," said Vaughn, who was a father figure in Davis' life.

He remembers Davis' plans to go to college. He says the teen had so much living left to do.

"We had our whole life planned out and what we wanted to do," said Zyuanya Laguerre, Davis' younger cousin. "I never thought that was the last time I was going to say goodbye to my cousin." 

Read article here.

Discovery May Lead to New Asthma Treatment

This promising research focuses on a unique step in the pathway that leads to asthma exacerbations. Dr. Susarla

Scientists Focus on Factors Behind Asthma Attacks

Findings could pave way to reducing 2 major airway symptoms, researchers say

THURSDAY, Sept. 20 (HealthDay News) -- Blocking two particular biological processes might help provide relief to people with asthma, according to a new study.

The University of California, San Francisco-led team found that a specific calcium-activated chloride channel called TMEM16A plays a role in the severity of asthma. The channel regulates airway secretions and smooth-muscle contraction: the major factors that lead to an asthma attack.

"Maybe if we could inhibit both of these processes by blocking this one channel, then we could affect the two symptoms of asthma," study senior author Jason Rock, an assistant professor at the UCSF anatomy department, said in a university news release.

People with asthma have a higher-than-normal number of mucus-producing cells in the lining of the airway tubes that lead to the lungs, and they also have an abnormal amount of smooth muscle surrounding the airway tubes. The slightest stimulus can cause the tubes to contract.

"The overabundance of mucus plugging the airways combined with hyper-contractility of the smooth muscle -- when the tubes get really small -- make it difficult to move air in or out," Rock explained. "A lot of people equate that with breathing through a straw."

In laboratory tests, the researchers identified three chemicals that inhibited the activity of TMEM16A and led to reduced mucus production and smooth muscle contraction.

The study was published Sept. 17 in the journal Proceedings of the National Academy of Sciences.

The next step is to test the safety and effectiveness of these chemical blockers in animals, the researchers say. If that goes well, human clinical trials could follow.

Read article here.

iSonea's AsthmaSense Smartphone App Now Free

Here's a chance to check out this free app if you or your child has asthma.  It's quite handy for those that follow a schedule, and hard to beat at this price.  Dr. Susarla

Most intelligent asthma app available to everyone through September as allergy and back-to-school season nears

SEVERNA PARK, MD., SEPT. 4, 2012 — /PRNewswire/ -- Medical technology company iSonea Ltd. (ASX: ISN; OTCQX: ISOAD) today announced that its asthma management smartphone app,AsthmaSense™ v.1.0.1, is  available for free for iPhone, iPad and Android users through September 30.  According to the American Lung Association, more than seven million children suffer from asthma, making it one of the most chronic childhood disorders in the United States.  Asthma is a leading cause of school absenteeism, accounting for more than 14 million lost school days.

With AsthmaSense, parents and children have the most intelligent asthma management app at their fingertips. Unlike most health apps which act as passive journals, AsthmaSense v.1.0.1 analyzes user symptoms, medication usage and lung function measurements against the National Institute of Health (NIH) asthma guidelines, alerting the user if it senses that their asthma is not well controlled.

With AsthmaSense, users can input their medication, symptoms and peak flow results, and set alerts for medication and lung function testing. In addition to using this information to determine the status of a user's asthma, the AsthmaSense app stores this data, giving the user and their doctor a better picture of their lung health.

"Autumn is a tough time for asthmatics, especially children. By offering AsthmaSense for free through September, we are increasing access to the most intelligent, easy-to-use asthma management app on the market during this troublesome season," said Michael Thomas, CEO of iSonea Ltd. "At iSonea, we are committed to helping asthmatics breathe easier and we are continuing to develop tools to help people control this disease."

AsthmaSense is the first of iSonea's family of asthma management apps. Future iSonea apps will incorporate the Company's proprietary Acoustic Respiratory Monitoring (ARM™) technology and diagnostic algorithms. The company is also developing the AsthmaSense Cloud™ for data sharing and enhanced capabilities for detecting asthma risk based on changes in environmental conditions such as air quality and weather.

AsthmaSense is available for free on the Apple App Store (for iPhone and iPad users), Google Play and Amazon App Stores (for Android users).

To see how one mother uses iSonea's technology to keep her son's asthma under control, please follow this link.

Read article here.

Read more here: http://www.heraldonline.com/2012/09/04/4234072/isoneas-asthmasense-smartphone.html#storylink=cpy

Exercise-Induced Bronchospasm (Asthma) : What you need to know (Part 2)

Exercise Related Asthma - Don’t let untreated asthma impact your child or adolescent’s sports training this season.

Asthma affects 5 million children and adolescents in the United States.  It is estimated that about half of children with asthma will experience exercise-related symptoms.  Breathing difficulty with sports and exercise is one of the consequences of asthma that is poorly controlled, and it may be the first or only warning sign that there is a problem.  

The National Heart, Lung, and Blood Institute (NHLBI) has published guidelines for the management of exercise-induced asthma.  The same organization has also published guidelines for teachers and coaches which you can read here. But how do you know if your child has breathing difficulty in sports due to asthma?  Exercise problems can be attributed to other medical problems or simply deconditioning.  

The gold standard test is exercise challenge spirometry.   Usually, the child will be asked to perform a treadmill run with a lung function test known as spirometry before and after exercise. This is the only test that can replicate the conditions that can trigger an asthmatic reaction (bronchospasm) which can be measured in the office.  

We are proud to offer this service at our Memorial City location.  Ask your pediatrician today about testing if your child has problems with exercise.

Dr. Susarla