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Severe asthma features in children: a case–control online survey
BACKGROUND: Very few studies have explored the distinguishing features of severe asthma in childhood in Europe, and only one study was conducted in Southern Europe. The aim of this study was to provide a detailed characterization of children with severe asthma treated in specialized pediatric asthma...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722711/ https://www.ncbi.nlm.nih.gov/pubmed/26796331 http://dx.doi.org/10.1186/s13052-016-0217-z |
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author | Montella, Silvia Baraldi, Eugenio Cazzato, Salvatore Aralla, Raffaele Berardi, Mariangela Brunetti, Luigia Maria Cardinale, Fabio Cutrera, Renato de Benedictis, Fernando Maria di Palmo, Emanuela Di Pillo, Sabrina Fenu, Grazia La Grutta, Stefania Lombardi, Enrico Piacentini, Giorgio Santamaria, Francesca Ullmann, Nicola Rusconi, Franca |
author_facet | Montella, Silvia Baraldi, Eugenio Cazzato, Salvatore Aralla, Raffaele Berardi, Mariangela Brunetti, Luigia Maria Cardinale, Fabio Cutrera, Renato de Benedictis, Fernando Maria di Palmo, Emanuela Di Pillo, Sabrina Fenu, Grazia La Grutta, Stefania Lombardi, Enrico Piacentini, Giorgio Santamaria, Francesca Ullmann, Nicola Rusconi, Franca |
author_sort | Montella, Silvia |
collection | PubMed |
description | BACKGROUND: Very few studies have explored the distinguishing features of severe asthma in childhood in Europe, and only one study was conducted in Southern Europe. The aim of this study was to provide a detailed characterization of children with severe asthma treated in specialized pediatric asthma centers across Italy. METHODS: We conducted a web-based data collection of family, environmental, clinical and laboratory characteristics of 41 patients aged 6–17 years with severe asthma, defined according to the recent guidelines of the European Respiratory Society and the American Thoracic Society, and 78 age-matched peers with non-severe persistent asthma. The patients have been enrolled from 16 hospital-based pediatric pulmonology and allergy centers in Northern, Central, and Southern Italy. Logistic regression analysis assessed the relationship between patients’ characteristics and severe asthma or non-severe persistent asthma. RESULTS: Features independently and significantly associated with severe asthma included lifetime sensitization to food allergens [Odds ratio (OR), 4.73; 95 % Confidence Interval (CI), 1.21–18.53; p = 0.03], lifetime hospitalization for asthma (OR, 3.71; 95 % CI, 1.11–12.33; p = 0.03), emergency-department visits for asthma during the past year (OR = 11.98; 95 % CI, 2.70–53.11; p = 0.001), and symptoms triggered by physical activity (OR = 12.78; 95 % CI, 2.66–61.40; p = 0.001). Quality-of-life score was worse in patients with severe asthma than in subjects with non-severe persistent asthma (5.9 versus 6.6, p = 0.005). Self-perception of wellbeing was compromised in more than 40 % of patients in both groups. Children with severe asthma had lower spirometric z scores than non-severe asthmatic peers (all p < 0.001), although 56 % of them had a normal forced expiratory volume in 1 s. No differences were found between the two groups for parental education, home environment, patients’ comorbidities, adherence to therapy, exhaled nitric oxide values, and serum eosinophils and IgE . CONCLUSIONS: As expected, children with severe asthma had more severe clinical course and worse lung function than peers with non-severe persistent asthma. Unlike previous reports, we found greater sensitization to food allergens and similar environmental and personal characteristics in patients with severe asthma compared to those with non-severe persistent asthma. Psychological aspects are compromised in a large number of cases and deserve further investigation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13052-016-0217-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4722711 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47227112016-01-23 Severe asthma features in children: a case–control online survey Montella, Silvia Baraldi, Eugenio Cazzato, Salvatore Aralla, Raffaele Berardi, Mariangela Brunetti, Luigia Maria Cardinale, Fabio Cutrera, Renato de Benedictis, Fernando Maria di Palmo, Emanuela Di Pillo, Sabrina Fenu, Grazia La Grutta, Stefania Lombardi, Enrico Piacentini, Giorgio Santamaria, Francesca Ullmann, Nicola Rusconi, Franca Ital J Pediatr Research BACKGROUND: Very few studies have explored the distinguishing features of severe asthma in childhood in Europe, and only one study was conducted in Southern Europe. The aim of this study was to provide a detailed characterization of children with severe asthma treated in specialized pediatric asthma centers across Italy. METHODS: We conducted a web-based data collection of family, environmental, clinical and laboratory characteristics of 41 patients aged 6–17 years with severe asthma, defined according to the recent guidelines of the European Respiratory Society and the American Thoracic Society, and 78 age-matched peers with non-severe persistent asthma. The patients have been enrolled from 16 hospital-based pediatric pulmonology and allergy centers in Northern, Central, and Southern Italy. Logistic regression analysis assessed the relationship between patients’ characteristics and severe asthma or non-severe persistent asthma. RESULTS: Features independently and significantly associated with severe asthma included lifetime sensitization to food allergens [Odds ratio (OR), 4.73; 95 % Confidence Interval (CI), 1.21–18.53; p = 0.03], lifetime hospitalization for asthma (OR, 3.71; 95 % CI, 1.11–12.33; p = 0.03), emergency-department visits for asthma during the past year (OR = 11.98; 95 % CI, 2.70–53.11; p = 0.001), and symptoms triggered by physical activity (OR = 12.78; 95 % CI, 2.66–61.40; p = 0.001). Quality-of-life score was worse in patients with severe asthma than in subjects with non-severe persistent asthma (5.9 versus 6.6, p = 0.005). Self-perception of wellbeing was compromised in more than 40 % of patients in both groups. Children with severe asthma had lower spirometric z scores than non-severe asthmatic peers (all p < 0.001), although 56 % of them had a normal forced expiratory volume in 1 s. No differences were found between the two groups for parental education, home environment, patients’ comorbidities, adherence to therapy, exhaled nitric oxide values, and serum eosinophils and IgE . CONCLUSIONS: As expected, children with severe asthma had more severe clinical course and worse lung function than peers with non-severe persistent asthma. Unlike previous reports, we found greater sensitization to food allergens and similar environmental and personal characteristics in patients with severe asthma compared to those with non-severe persistent asthma. Psychological aspects are compromised in a large number of cases and deserve further investigation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13052-016-0217-z) contains supplementary material, which is available to authorized users. BioMed Central 2016-01-22 /pmc/articles/PMC4722711/ /pubmed/26796331 http://dx.doi.org/10.1186/s13052-016-0217-z Text en © Montella et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Montella, Silvia Baraldi, Eugenio Cazzato, Salvatore Aralla, Raffaele Berardi, Mariangela Brunetti, Luigia Maria Cardinale, Fabio Cutrera, Renato de Benedictis, Fernando Maria di Palmo, Emanuela Di Pillo, Sabrina Fenu, Grazia La Grutta, Stefania Lombardi, Enrico Piacentini, Giorgio Santamaria, Francesca Ullmann, Nicola Rusconi, Franca Severe asthma features in children: a case–control online survey |
title | Severe asthma features in children: a case–control online survey |
title_full | Severe asthma features in children: a case–control online survey |
title_fullStr | Severe asthma features in children: a case–control online survey |
title_full_unstemmed | Severe asthma features in children: a case–control online survey |
title_short | Severe asthma features in children: a case–control online survey |
title_sort | severe asthma features in children: a case–control online survey |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722711/ https://www.ncbi.nlm.nih.gov/pubmed/26796331 http://dx.doi.org/10.1186/s13052-016-0217-z |
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