Sharmilee Nyenhuis

University of Chicago | UC · Department of Pediatrics

Background Individuals are exposed to a variety of indoor residential toxins including volatile organic compounds and particulates. In adults with asthma, such exposures are associated with asthma symptoms, asthma exacerbations, and decreased lung function. However, data on these exposures and asthma-related outcomes are generally collected at diff...

Objective Olfactory dysfunction (OD) is a condition primarily affecting older adults. Several factors have been implicated in OD, such as age, socioeconomic status, and neurodegenerative disease; however, the effect of military service still requires additional investigation. Here, we aim to determine if there is an association between prior milita...

People with obesity and asthma often have severe, difficult to control disease. Obesity leads to distinct physiologic changes, alters inflammatory pathways, is associated with many comorbidities, alters response to infection and environmental exposures, and modifies response to some medications. These factors affect diagnosis and phenotyping as wel...

BACKGROUND Individuals are exposed to a variety of indoor residential toxins including volatile organic compounds and particulates. In adults with asthma, such exposures are associated with asthma symptoms, asthma exacerbations, and decreased lung function. However, data on these exposures and asthma-related outcomes are generally collected at diff...

Low-resource settings have a disproportionately higher burden of asthma due to factors that include environmental triggers, access to healthcare, availability of medications, and uncoordinated health systems. The application of guideline-based management can vary, which further impacts the treatment delivered. This chapter aims to outline the globa...

Background: Food insecurity has been associated with poorer asthma control in children but research lacks in adults. Objective: Assess the frequency of food insecurity and its association with asthma control in adults during the COVID-19 pandemic. Methods: An online cross-sectional survey study was conducted in US adults with asthma. Survey qu...

Background: Evidence-based strategies to improve outcomes in minority children with uncontrolled asthma discharged from the emergency department (ED) are needed. Objectives: This multicenter pragmatic clinical trial was designed to compare an ED-only intervention (decision support tool), an ED-only intervention and home visits by community healt...

Background: Exposure to particulate matter <2.5 μm in diameter (PM2.5) has been linked to increased sinusitis prevalence and morbidity. However, studies analyzing environmental exposures and sinusitis have not explored the effect of PM2.5 on healthcare presentation patterns. Objective: This study aims to characterize the relationship of communit...

Background It is estimated that over 60% of adults with asthma have uncontrolled symptoms, representing a substantial health and economic impact. The effects of the home environment and exposure to volatile organic compounds (VOCs) and fine particulate matter (PM2.5) on adults with asthma remain unknown. In addition, methods currently used to asses...

Background Social determinants of health (SDOH) and comorbid conditions (CMCs) influence the setting of presentation for care; however, few studies have explored this relationship in the context of sinus disease. Objective This study aims to characterize the relationship of SDOH and CMCs with acuity of health care presentation setting in adults wi...

Background National Heart, Lung, and Blood Institute guidelines recommend regular physical activity (PA) for patients with asthma. Health care provider (HCP) counseling represents an effective approach to optimizing patient PA. However, current exercise rates among asthma patients are suboptimal, which suggests that counseling may be improved. Obj...

The COVID-19 pandemic has placed increased demands on the ability to safely perform pulmonary procedures in keeping with Centers for Disease Control and Prevention (CDC), American Thoracic Society (ATS), and the Occupational Safety and Health Administration (OSHA) recommendations. Accordingly, the American Academy of Allergy, Asthma, and Immunology...

Background: During the COVID-19 pandemic, telehealth rapidly emerged as an essential health care service and became particularly important for patients with cancer and chronic conditions. However, the benefits of telehealth have not been fully realized for some of the most vulnerable populations due to inequitable access to telehealth capable tech...

Race is a social construct. It is used in medical diagnostic algorithms to adjust the readout for spirometry and other diagnostic tests. The authors review historic evidence about the origins of race adjustment in spirometry, and recent attention to the lack of scientific evidence for their continued use. Existing reference values imply that White...

Background: Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) rely on patient-reported symptoms and quality of life measures which are subject to bias. Ecological momentary assessment (EMA) captures data in real-time through repeated short surveys, thus reducing errors/biases. EMA's use in sinonasal conditions has not been well described, an...

There is strong evidence supporting the influence of social determinants of health (SDOH) on the development and progression of asthma. SDOH are defined as conditions in which people are born, grow up, live, work and age, that influence their opportunity to be healthy, risk of illness and life expectancy. The goal of this article is to describe two...

Background While masks are recommended for those with asthma in the era of COVID-19, there is limited research exploring the extent of and problems related to mask use in adults with asthma. Objective We sought to describe in adults with asthma: 1) the extent masks are worn and attitudes and beliefs about wearing masks; (2) participant characteris...

Regular physical activity not only improves general health but also can positively impact asthma outcomes, such as control and quality of life. Despite this, many asthma patients do not engage in regular physical activity because they mistakenly believe that they should restrict exercise participation. Health care providers have an opportunity to i...

Background: African American (AA) women are disproportionately impacted by both physical inactivity and asthma. Lifestyle physical activity (PA) interventions targeted for AA women with asthma are lacking. Objective: Assess the feasibility/acceptability and preliminary effects of a lifestyle PA intervention culturally-tailored for AA women with...

Background: Asthma is a chronic respiratory disease that affects millions worldwide. Medication management is the current mainstay of treatment; however, there is evidence to suggest additional benefit with lifestyle changes, particularly with increased physical activity. Objective: Our systematic review aims to discover and evaluate the effects...

Consumer-based physical activity (PA) trackers, also known as wearables, are increasingly being used in research studies as intervention or measurement tools. One of the most popular and widely used brands of PA trackers is Fitbit. Since the release of the first Fitbit in 2009, hundreds of experimental studies have used Fitbit devices to facilitate...

Objective High rates of anxiety and depression exist among asthma patient populations. This scoping review will examine the existing interventional therapies that address depression and anxiety symptoms in patients with asthma. Data Sources PubMed, Cochrane, Psychinfo, CINAHL, Google Scholar and EMBASE databases were searched using the following s...

UNSTRUCTURED Consumer-based physical activity (PA) trackers are increasingly being used for research scientific purposes. One of the most widely used commercial PA trackers for research is Fitbit. Some interventional studies aim to improve participants’ PA levels and health outcomes through daily self-monitoring of PA measures, goal setting, and ot...

Peliosis hepatis is a rare condition characterized by blackish-blue blood-filled cavities in hepatic parenchyma caused by dilatation of hepatic sinusoids. Peliosis hepatis has been described in secondary immunodeficiencies and certain medications. We present the first case of peliosis hepatis in a patient with a primary immunodeficiency, common var...

Purpose of review: Our day-to-day life is saturated with health data that was previously out of reach. Over the last decade, new devices and fitness technology companies are attempting to tap into this data, uncovering a treasure trove of useful information that, when applied correctly, has the potential to revolutionize the way we approach health...

The prevalence of obesity and asthma are both increasing at alarming rates. The link between obesity and asthma suggests that obesity contributes to both risk of new onset asthma and increased asthma severity. The emerging evidence demonstrating the role of obesity and other lifestyle factors, such as diet and physical activity, on asthma outcomes...

Obstructive sleep apnea (OSA) and asthma are highly prevalent chronic respiratory disorders. Beyond frequent coexistence arising from their high prevalence and shared risk factors, these disorders feature a reciprocal interaction, whereby each disease impacts the severity of the other. Emerging evidence implicates airway and systemic inflammation,...

Background: Little is known about how patient-level factors and care settings relate to asthma outcomes in real-world settings. Objective: We therefore examined the rates and relative contributions of co-morbidities and care settings in terms of asthma severity and control among pediatric and adolescent/adult patients in a large national sample....

Background: Minority groups of African descent experience disproportionately greater asthma morbidity compared with other racial groups, suggesting that genetic variation from a common ancestry could influence exacerbation risk. Objective: We evaluated clinical trial measures in the context of self-reported race and genetic ancestry to identify...

Asthma is a prevalent condition in older adults, and the prevalence continues to rise. Asthma tends to be more severe in older adults, including higher morbidity and mortality, higher financial costs, and lower asthma-related quality of life. Diagnosis is confounded by poor recognition of symptoms, confusion with potential comorbid diseases, and gr...

Aim: Eosinophilic asthma is associated with more exacerbations and differential responses to treatment. The aim of this study was to assess if CLC/Gal-10 and MBP-1 are surrogate biomarkers of eosinophilic inflammation in asthma. Methods & results: Sputum induction was performed in patients with asthma and in healthy controls. Sputum analysis reveal...

BACKGROUND Asthma outcomes are worse among less physically active adults. African American women experience disparities in both physical inactivity and asthma relative to their Caucasian counterparts. We implemented a modified evidence-based walking intervention supplemented with mHealth technologies to help address barriers to physical activity....

Background Physical inactivity is associated with worse asthma outcomes. African American women experience disparities in both physical inactivity and asthma relative to their white counterparts. We conducted a modified evidence-based walking intervention supplemented with mobile health (mHealth) technologies to increase physical activity (PA). Ob...

Objective: African American Women (AAW) are disproportionately impacted by both physical inactivity and asthma. The aims of this study were to: 1) understand barriers to physical activity among AAW with asthma; 2) obtain feedback from AAW on an evidence-based walking intervention; and 3) modify the intervention using input from AAW with asthma. M...

Objective: The older adult population is increasing worldwide, and a significant percentage has asthma. This review will discuss the challenges to diagnosis and management of asthma in older adults. Data Sources: PubMed was searched for multiple terms in various combinations, including asthma, older adult, elderly, comorbid conditions, asthma diagn...

This comprehensive book presents an evidence-based approach to treating asthma in adults aged 65 and older, a vulnerable subset of patients who are more likely to experience higher morbidity and mortality rates, and often enduring higher financial burdens related to treatment. Treatment of Asthma in Older Adults: A Comprehensive, Evidence-Based Gui...

Background: Evidence on the association between residential surrounding greenness (RSG) in urban areas with asthma and asthma symptoms is inconsistent. Objective: To examine the association of RSG with respiratory outcomes in a sample of Mexican American children living in inner-city Chicago, Illinois. Methods: This study is based on parent-re...

Background: Timing and stability of the sleep-wake cycle are potential modifiable risk factors for cardiometabolic disease. The aim of this study was to evaluate the relationship between objective measures of sleep-wake timing and stability with cardiometabolic disease risk. Methods: In this multicenter, cross-sectional, population-based study,...

As the aging population in the USA grows, it will be increasingly important for healthcare providers to effectively diagnose and manage rhinitis. Nasal symptoms such as rhinorrhea, congestion, sneezing, nasal/ocular pruritus, and postnasal drainage affect up to one-third of older adults, and significantly impact their quality of life. Several under...

Obesity and asthma are two significant public health issues worldwide. Accumulating evidence has related high body mass index (BMI) and obesity with asthma (1), although a causal role of obesity in the development of asthma remains uncertain. A recent study reported a significant association between genetic predisposition to obesity, estimated by a...

Unhealthy lifestyle factors such as poor diet quality, sedentary lifestyle, and obesity are associated with negative health consequences in asthma including poor asthma control, impaired quality of life, and greater health care utilization. Lifestyle modification is the cornerstone of behavioral treatments and has been effective in chronic diseases...

Objective: Comprehensive, rapid, and accurate identification of patients with asthma for clinical care and engagement in research efforts is needed. The original development and validation of a computable phenotype for asthma case identification occurred at a single institution in Chicago and demonstrated excellent test characteristics. However, it...

Purpose of review: Comparative efficacy trials are designed to evaluate the harms and benefits of health care in a research environment. There is increasing interest in the results of comparative effectiveness trials, which are intended to fill gaps in evidence to inform decision-making in real-life clinical environments. The objective of this rep...

Background: Socioeconomic status (SES) is associated with asthma morbidity in observational studies but the factors underlying this association are uncertain. Objective: We investigated whether three SES correlates-low income, low education, and high perceived stress- were independent risk factors for treatment failure and asthma exacerbations i...

Introduction In addition to sleep duration there is growing evidence that the timing and variability of the sleep-wake cycle may also be important modifiable cardiometabolic disease risk factors. We aim to evaluate the relationship between objective actigraphy-based measures of sleep-wake timing and stability with cardiometabolic disease risk. Met...

Among children with asthma, black children are two to four times as likely to have an emergency department (ED) visit and die from asthma, respectively, compared to white children in the United States. Despite the availability of evidence-based asthma management guidelines, minority children are less likely than white children to receive or use eff...

Chronic lower respiratory diseases, including asthma and chronic obstructive pulmonary disease, are a significant public health burden owing to their high incidence and prevalence. Nurse practitioners in primary care routinely see patients with these diagnoses. Although inhaled pharmacotherapy is the mainstay of treatment for individuals with these...

Background: African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. Objective: We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled c...

The emergency department (ED) is a critical point of identification and treatment for some of the most high-risk children with asthma. This review summarizes the evidence regarding care transition interventions originating in the ED for children with uncontrolled asthma, with a focus on care coordination and self-management education. Although many...

By 2050, the US aging population will nearly double. It will be increasingly important for health care providers to diagnose and manage rhinitis. Nasal symptoms of rhinorrhea, congestion, sneezing, nasal/ocular pruritus, and postnasal drainage affect up to 32% of older adults, and can impact quality of life. Several underlying factors associated wi...