American Thoracic Society Journal news tips for January (second issue)

January 24, 2002

Children who begin to wheeze at ages 2 to 5 likely to continue into adulthood

In a study lasting from birth to age 22 for a group of 63 young persons who were at high risk for atopic disease and wheezy disorders, British researchers found that participants younger than 2 years who wheezed were no more likely to become adults with asthma than were those without wheeze. But children who started wheezing from ages 2 to 5 and who had many wheezing episodes were highly likely to wheeze in adulthood. (Atopic diseases are inherited immunoglobulin E (IgE)-mediated illnesses such as allergic rhinitis and allergic asthma.) The investigators found that there was a steady increase in the annual prevalence of wheeze in participants who were older than 3 years. The 100 starting participants, all of whom were born in 1976, were selected on the basis that at least one of their parents was atopic. The entire research cohort was studied every 3 months for their first year, annually through age 5, and again at 11 and 22 years. There were 63 subjects left at age 22, although data from every test was available for only 58. Of that group, 20 (34 percent) never wheezed over the entire 22-year period; 12 (21 percent) wheezed only when younger than 5 years; and 26 (45 percent) wheezed when older than 5 years. The research appears in the second issue for January of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

Simple asthma control test can determine future health care needs

After querying 4,795 adults to determine when their asthma was under control, researchers developed a brief, simple, self-administered five-item questionnaire that can predict both acute and routine health care utilization associated with the disease over the next 12 months. The investigators indicated that asthma patients (those under age 65) with three to four control problems consistently exhibited the highest rates of health care utilization. With their study, the researchers performed a 12-month prospective evaluation of their questionnaire to determine its ability to predict future health care utilization (both acute and routine) by the asthmatics. They note that many patients are undertreated and are at greater risk for acute exacerbations. More than 50 percent of the study population had at least one control problem, and 13.5 percent had three or four. After adjusting for age and sex, data from the study showed that risk for acute asthma episodes increased by a factor of approximately 49 percent for each additional control problem uncovered. The research is published in the second issue for January of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

Sleep disordered breathing associated with obesity and craniofacial abnormalities

Obesity and craniofacial abnormalities work synergistically to increase the collapsibility of the passive pharyngeal airway in patients with sleep disordered breathing (SDB). Japanese investigators evaluated 54 patients with SDB and 23 normal subjects to show the effect of certain physical characteristics and craniofacial abnormalities on haryngeal collapse during sleep. They believe that both obesity and craniofacial abnormalities work together to increase tissue pressure surrounding the pharynx (throat), leading to an increase in closing pressure of the passive pharyngeal airway. They said that SDB patients, as compared with normal subjects, had receding lower jaws (mandibles) and long lower faces with downward mandible development. They believe the position and size of the maxilla (upper jaw structure) and mandible have physiologic importance in determining the collapsibility of the pharyngeal airway. Their study appears in the second issue for January of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.
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For the complete text of these articles, please see the American Thoracic Society Online Web Site at http://www.atsjournals.org. For contact information or to request a complimentary journalist subscription to ATS journals online, or if you would like to add your name to the Society's twice monthly journal news mailing list (please select either postal or electronic delivery), contact Cathy Carlomagno at 212-315-6442, or by e-mail at ccarlomagno@thoracic.org

American Thoracic Society

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