Advancing asthma care: The glass is only half full!

Department of Pediatrics, National Jewish Health, University of Colorado School of Medicine, Denver, CO 80206, USA.
The Journal of allergy and clinical immunology (Impact Factor: 11.48). 07/2011; 128(3):485-94. DOI: 10.1016/j.jaci.2011.07.010
Source: PubMed


Over the past 20 years, there has been a concerted effort in the United States to reduce morbidity related to chronic disease, including asthma. Attention was initially directed toward asthma in response to the recognition that asthma mortality was increasing and that the burden of disease was significant. These efforts to address asthma mortality led to many new initiatives to develop clinical practice guidelines, implement the asthma guidelines into clinical practice, conduct research to fill the gaps in the guidelines, and continuously revise the asthma guidelines as more information became available. An assessment of our progress shows significant accomplishments in relation to reducing asthma mortality and hospitalizations. Consequently, we are now at a crossroads in asthma care. Although we have recognized some remarkable accomplishments in reducing asthma mortality and morbidity, the availability of new tools to monitor disease activity, including biomarkers and epigenetic markers, along with information technology systems to monitor asthma control hold some promise in identifying gaps in disease management. These advances should prompt the evolution of new strategies and new treatments to further reduce disease burden. It now becomes imperative to continue a focus on ways to further reduce the burden of asthma and prevent its onset.

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Available from: Stanley Szefler, Mar 14, 2014
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    • "Atopic asthma is the most common chronic inflammatory disease, resulting in high morbidity and important economic impact for families and health systems worldwide. Glucocorticoid is the most efficient anti-inflammatory treatment in persistent asthma so far (Szefler, 2011). However, its efficacy is restricted to established clinical disease and chronic use is necessary for disease control. "
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    • "Gender differences in asthma prevalence and outcomes are commonly noted in the literature. Studies have shown that boys have higher odds of asthma incidence than girls (de Marco et al., 2000); girls are more likely to have late-onset asthma (de Marco et al., 2004); and females have higher asthma hospitalizations than males (Szefler, 2011). "
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    ABSTRACT: Studies have demonstrated the negative impact of environmental tobacco smoke (ETS) or parental cigarette smoking on pediatric asthma. Little is known, however, regarding whether there is a gender difference in the effect of household ETS on pediatric asthma. Using a nationwide survey in Taiwan, we examined the relationship between asthma prevalence in the past year and household ETS among children below 12 years of age (N = 3761). We used multivariate regression models to assess odds ratios (ORs) and 95% confidence intervals (CIs) for the association of household ETS and asthma attacks by gender. In about 3% of the sample, parents reported that their children had an asthma attack in the past year, confirmed by physicians. Multivariate logistic regression revealed that household ETS predicted asthma attacks for girls (OR = 3.11, 95%CI = 1.24-7.76) but not for boys. Father's education was significantly associated with asthma attack for both girls (OR = 1.24, 95%CI = 1.04-1.47) and boys (OR = 1.15, 95%CI = 1.05-1.26). Girls with lower family income were more likely to have had an asthma attack in the last year (OR = .48, 95%CI = .27-.87). The impact of household ETS and family socioeconomic status on asthma attacks differs by gender among children below 12 years.
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