| 1. |
- Medsker, Brock H, et al.
(författare)
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Maternal depressive symptoms, maternal asthma, and asthma in school-aged children
- 2017
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Ingår i: Annals of Allergy, Asthma & Immunology. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 1081-1206. ; 118:1, s. 55-U146
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is known about the joint effects of maternal asthma and maternal depression on childhood asthma. OBJECTIVE: To examine whether maternal depression and maternal asthma lead to greater risk of childhood asthma than maternal asthma alone. METHODS: Cross-sectional studies of children (6-14 years old) in San Juan, Puerto Rico (n = 655) and Sweden (n = 6,887) were conducted. In Puerto Rico, maternal depressive symptoms were defined using the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire. In Sweden, maternal physician-diagnosed depression was derived from national registries, and maternal depressive symptoms were defined using an abbreviated CES-D questionnaire. Childhood asthma was defined as physician-diagnosed asthma plus current wheeze (in Puerto Rico) or plus medication use (in Sweden). Logistic regression was used for multivariable analysis. RESULTS: Compared with Puerto Rican children whose mothers had neither asthma nor depressive symptoms, those whose mothers had asthma but no depressive symptoms had 3.2 times increased odds of asthma (95% confidence interval [CI] = 2.1-4.8) and those whose mothers had asthma and depressive symptoms had 6.5 times increased odds of asthma (95% CI = 3.3-13.0). Similar results were obtained for maternal depression and maternal asthma in the Swedish cohort (odds ratio for maternal asthma without maternal depression = 2.8, 95% CI = 2.1-3.7; odds ratio for maternal asthma and maternal depression = 4.0, 95% CI = 1.7-9.6). Although the estimated effect of maternal asthma on childhood asthma was increased when maternal depressive symptoms (Puerto Rico) or maternal depression (Sweden) was present, there were no statistically significant additive interactions. CONCLUSION: Maternal depression can further increase the risk of asthma in children whose mothers have a history of asthma.
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| 2. |
- Protudjer, Jennifer, et al.
(författare)
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Puberty and asthma in a cohort of Swedish children
- 2014
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Ingår i: Annals of Allergy, Asthma & Immunology. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 1534-4436 .- 1081-1206.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Blumenschein, Karen, et al.
(författare)
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Relationship Between Quality of Life Instruments, Health State Utilities, and Willingness to Pay in Patients with Asthma
- 1998
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Ingår i: Annals of allergy, asthma, & immunology. - : Elsevier Inc. - 1534-4436 .- 1081-1206. ; 80:2, s. 189-194
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Tidskriftsartikel (refereegranskat)abstract
- In asthma, a substantial impact of disease is on quality of life rather than survival. To date, the quality of life effects of asthma have not been quantitated. The purpose of this study was to quantitate the quality of life effects of asthma via measurement of the health utility of asthmatic patients, and the willingness to pay for an asthma cure. A second goal was to analyze how these measures are related to the different dimensions of quality of life as measured by general and disease specific quality of life instruments. Health utilities were measured on a scale between 0 and 1 using the rating scale, time trade off, and standard gamble methods. Willingness to pay was elicited using both the dichotomous choice and the bidding game approach. Quality of life was assessed using both a generic instrument (the SF-36) and a disease-specific instrument (the Asthma TyPE). Sixty-nine patients with asthma were surveyed. The mean health utility was 0.68 with the rating scale method, 0.89 with the time trade off, and 0.91 with the standard gamble. On average, patients were willing to pay between $200 to $350 dollars more per month for an asthma cure. Nearly all correlations between dimensions of quality of life, health state utilities, and willingness to pay were in the expected direction. The two quality of life instruments performed about equally well in terms of being correlated with and being able to explain the responses to the health state utility questions and the willingness to pay questions. Correlations between the dimensions of the Asthma TyPE and the SF-36 were also fairly high. Further work should focus on validating and refining the different methods of quantitating quality of life for asthma patients.
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| 4. |
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| 5. |
- Abrams, EM, et al.
(författare)
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The need for patient voices in food allergy research
- 2020
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Ingår i: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. - : Elsevier BV. - 1534-4436. ; 125:3, s. 346-347
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Ahlbeck, Lars, 1964-, et al.
(författare)
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Intralymphatic allergen immunotherapy against pollen allergy. A 3-year open follow-up study of 10 patients
- 2018
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Ingår i: Annals of Allergy, Asthma & Immunology. - : Elsevier. - 1081-1206 .- 1534-4436. ; 121:5, s. 626-627
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Tidskriftsartikel (refereegranskat)abstract
- To date, allergen immunotherapy (AIT) is the only treatment that affects the long-term development of allergic rhinoconjunctivitis and induces clinical tolerance primarily by stimulating regulatory T (Treg) cells, attenuating T helper 2 (Th2) responses and synthesis of blocking antibodies1. Conventional AIT with subcutaneous injections, sublingual tablets or drops is effective, but consumes time and resources 2.
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| 7. |
- Andersson, F, et al.
(författare)
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Comparison of the cost-effectiveness of budesonide and sodium cromoglycate in the management of childhood asthma in everyday clinical practice
- 2001
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Ingår i: Annals of Allergy, Asthma & Immunology. - 1081-1206 .- 1534-4436. ; 86:5, s. 537-544
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Tidskriftsartikel (refereegranskat)abstract
- Background: Budesonide and sodium cromoglycate are both recommended as maintenance therapy for childhood asthma. Objective: To compare the cost-effectiveness of these two treatment strategies in clinical practice, in an open-label, pharmacoeconomic clinical trial. Methods: Health economics were evaluated in 138 children. ages 5 to 11 years, with unstable asthma not previously treated with corticosteroids or cromones. The asthma was stabilized during 4 to 6 weeks with budesonide 200 to 400 mug twice daily. The children were then randomly allocated to one of the two treatment strategies aiming at maintaining asthma control for 12 months, budesonide 400 mug/day (N = 69) or sodium cromoglycate 60 mg/day (N = 69). If asthma control was judged unsatisfactory, the doses were increased or the children were switched to the alternate treatment. Results: In children continuing on the same treatment, the degree of asthma control was similar in the two groups at study end. To maintain asthma control, 42% of cromoglycate children switched to budesonide, and then experienced a 14% increase in symptom-free days. No budesonide patient had to switch therapy because of lack of asthma control. Although not statistically significant, total annual cost per patient was 24% (Swedish kronor 4195, US $487, Euro 485) lower in the budesonide than the cromoglycate group, mainly due to a lower cost for asthma medication. Conclusions: A budesonide strategy for continued maintenance treatment, after an initial period of stabilizing treatment with budesonide, resulted in lower costs and less drug switches than did a strategy with sodium cromoglycate.
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| 8. |
- Dreborg, Sten, 1933-, et al.
(författare)
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Epinephrine auto-injector needle lengths : Can both subcutaneous and periosteal/intraosseous injection be avoided?
- 2018
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Ingår i: Annals of Allergy, Asthma & Immunology. - : ELSEVIER SCIENCE INC. - 1081-1206 .- 1534-4436. ; 120:6, s. 648-653
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Tidskriftsartikel (refereegranskat)abstract
- Background: Epinephrine should be administered intramuscularly in the anterolateral aspect of the thigh. The length of the epinephrine auto-injector (EAI) needle should ensure intramuscular injection.Objective: To discuss suitable EAI needle lengths based on ultrasound measurements related to weight. Methods: The skin-to-muscle distance (STMD) and skin-to-bone distance (STBD) were measured by ultrasound in the mid-third of the anterolateral area of the right thigh when applying high pressure (8 lb; high-pressure EAI [HPEAI]) or low pressure (low-pressure EAI [LPEAI]) on the ultrasound probe. The study included 302 children and adolescents and 99 adults. The maximum and minimum STMD and the maximum and minimum STBD were estimated.Results: Using HPEAIs, the risk of periosteal or intraosseous penetration was 32% in children weighing less than 15 kg. The risk of subcutaneous injection was 12% in adolescents and 33% in adults. With LPEAIs, there was no risk of periosteal or intraosseous injection and the risk of subcutaneous injections in adolescents and adults was lower at 2% and 10%, respectively. A new EAI for injection in small children would have no risk of periosteal or intraosseous injection but would have 71% chance of subcutaneous deposit of epinephrine.Conclusion: Common HPEAIs have a high risk of periosteal or intraosseous penetration in children and subcutaneous injections in overweight and obese adults. LPEAIs have some risk of subcutaneous injection in adults. HPEAIs with 0.1 mg of epinephrine and shorter needles have no risk of periosteal or intraosseous injection but have a high risk of subcutaneous deposit. For adult or overweight or obese patients, HPEAIs and LPEAIs should have longer needles. Future studies should focus on triggering pressures and variations in needle length.
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| 9. |
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| 10. |
- Dreborg, Sten, 1933-, et al.
(författare)
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Implications of variation of epinephrine auto-injector needle length
- 2019
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Ingår i: Annals of Allergy, Asthma & Immunology. - : ELSEVIER SCIENCE INC. - 1081-1206 .- 1534-4436. ; 123:1, s. 89-94
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Tidskriftsartikel (refereegranskat)abstract
- Background: The variation of needle lengths of epinephrine auto-injectors (EAIs) has not been investigated. Objective: To investigate the impact of the variation of the needle length of EAIs. Methods: Skin-to-muscle (STMD) and skin-to-bone distances (STBD) were measured for 303 children and adolescents and 99 adults. Distance was determined by ultrasound, applying high or low pressure on the probe. The risk of subcutaneous and periosteal/intraosseous injection was calculated using the lower and upper acceptance limits for length of EAI needles as provided for 3 high-pressure EAIs (HPEAI) and 1 low-pressure EAI (LPEAI). Results: The variation in needle length of the HPEAIs are for Epipen Jr/Epipen 5 mm, for Jext 2 mm, for Auvi-Q 2.5 mm, and for the LPEAI, Emerade, 1.5 mm. When using the longest acceptable needles for Epipen Jr, the risk of intraosseous/periosteal penetration was highest in children weighing less than 15 kg at 60% and for Jext at 43%. The risk was low for Auvi-Q and Emerade. The risk of subcutaneous injection was greatest with the shortest needles of the Auvi-Q 0.1 mg at 94% in children weighing less than 15 kg. In adults, the risk of subcutaneous injection using the shortest needles was for Epi-Pen at 41%, Jext at 36%, Auvi-Q at 38%, and Emerade at 12%. Conclusion: The variation in needle length of EAIs influences the risk of subcutaneous and intraosseous/periosteal injections. Compared with Epipen Jr, the Auvi-Q 0.1 mg for children weighing less than 15 kg had a low risk of intraosseous/periosteal injection but a very high risk of subcutaneous injection. For adults, there is a significant risk of subcutaneous injection. (C) 2019 Published by Elsevier Inc. on behalf of American College of Allergy, Asthma & Immunology.
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