American Thoracic Society journal news tips for September

September 20, 2000

Urban living biggest risk for asthma in children

The disturbingly high prevalence of asthma among black children in the United States is not attributable to race, but to urban living. After examining a nationally representative sample of 17,110 children from birth to age 17 for parent-reported asthma, investigators found 4.2 percent (747 children) who had the disease during the preceding 12 months. To uncover a cause, the researchers examined the database of variables including race, poverty status, and urban residence. They discovered that all urban children had a heightened risk of asthma regardless of race or family income. The research appears in the September issue of the American Journal of Respiratory and Critical Care Medicine.

TB now most common opportunistic infection in HIV patients

Marked decreases in the incidence of TB and Mycobacterium avium complex (MAC), common opportunistic infections among HIV patients, took place among 7,000 individuals studied from 1994 to 1999. The authors say the decrease in TB and part of the reduction in MAC was due to the impact of highly active antiretroviral therapy, which dramatically changed the clinical prognosis for HIV-infected patients in terms of disease mortality, less severity of illness, and reduced need for hospitalization. The research team said that after March 1997 TB became the most common mycobacterial disease among those infected with HIV. This conclusion was in stark contrast to the pre-antiretroviral era in which MAC was twice as common as TB. The study involved a large cohort of patients from 51 clinical centers in 17 European countries. The research appears in the September issue of the American Journal of Respiratory and Critical Care Medicine.

Effect of prenatal steroids on respiratory distress syndrome (RDS)

A study by Dutch investigators shows, for the first time, that prenatal corticosteroid treatment increases surfactant phosphatidylcholine (PC) production from the precursor glucose in preterm infants who have RDS. After very premature delivery, many infants develop RDS caused by primary surfactant deficiency. (Surfactants are lipoproteins that alter surface tension of fluids in the lungs and facilitate gaseous exchange in the tiny air sacs of the lungs by preventing their collapse.) Prenatal corticosteroid administration in women at risk for very premature delivery reduces the incidence and severity of RDS in their babies after birth. The researchers found significantly increased surfactant PC synthesis with glucose in a study which involved 27 preterm infants with RDS. Their data showed an increase of 40 percent per dose of prenatal corticosteroid in the 16 infants who received the steroids. The research appears in the September issue of the American Journal of Respiratory and Critical Care Medicine.
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American Thoracic Society

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