Medicine and Health Sciences Commons^™

Indoor Tobacco Legislation Is Associated With Fewer Emergency Department Visits For Asthma Exacerbation In Children., Christina E. Ciaccio, Tami Gurley-Calvez, Theresa I. Shireman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: During the past 3 decades, numerous cities and states have adopted laws that ban smoking in public indoor spaces. The rationale for these policies has been to protect nonsmokers from the adverse health effects of secondhand smoke.

OBJECTIVE: To determine whether the implementation of indoor smoking legislation is associated with a decrease in emergency department visits for asthma in children.

METHODS: This retrospective analysis used a natural experiment to estimate the impact of clean indoor air legislation on the rate of emergency department admissions for asthma exacerbation in children. Data were obtained from the Pediatric Health Information System. A …

Airway Secretory Micrornaome Changes During Rhinovirus Infection In Early Childhood, Maria J. Gutierrez, Jose L. Gomez, Geovanny F. Perez, Krishna Pancham, Stephanie Val, Dinesh K. Pillai, Mamta Giri, Sarah Ferrante, Robert Freishtat, Mary C. Rose, Diego Preciado, Gustavo Nino

Pediatrics Faculty Publications

Background Innate immune responses are fine-tuned by small noncoding RNA molecules termed microRNAs (miRs) that modify gene expression in response to the environment. During acute infections, miRs can be secreted in extracellular vesicles (EV) to facilitate cell-to-cell genetic communication. The purpose of this study was to characterize the baseline population of miRs secreted in EVs in the airways of young children (airway secretory microRNAome) and examine the changes during rhinovirus (RV) infection, the most common cause of asthma exacerbations and the most important early risk factor for the development of asthma beyond childhood.

Methods Nasal airway secretions were obtained from …

Preterm Birth And Air Pollution: Critical Windows Of Exposure For Women With Asthma, Pauline Mendola, Maeve Wallace, Beom Seuk Hwang, Danping Liu, Candace Robledo, Tuija Männistö

School of Medicine Publications and Presentations

Background: Ambient air pollutants may increase preterm birth (PTB) risk, but critical exposure windows are uncertain. The interaction of asthma and pollutant exposure is rarely studied.

Objective: We sought to assess the interaction of maternal asthma and air pollutant exposures in relation to PTB risk.

Methods: Electronic medical records for 223,502 US deliveries were linked with modified Community Multiscale Air Quality model outputs. Logistic regression with generalized estimating equations estimated the odds ratio and 95% CIs for PTB on the basis of the interaction of maternal asthma and particulate matter with aerodynamic diameter of less than 2.5 microns and particulate …

Air Pollution Exposure And Preeclampsia Among Us Women With And Without Asthma, Pauline Mendola, Maeve Wallace, Danping Liu, Candace Robledo, Tuija Männistö, Katherine Grantz

School of Medicine Publications and Presentations

Maternal asthma and air pollutants have been independently associated with preeclampsia but rarely studied together. Our objective was to comprehensively evaluate preeclampsia risk based on the interaction of maternal asthma and air pollutants. Preeclampsia and asthma diagnoses, demographic and clinical data came from electronic medical records for 210,508 singleton deliveries. Modified Community Multiscale Air Quality models estimated preconception, first and second trimester and whole pregnancy exposure to: particulate matter (PM)<2.5 and <10µm, ozone, nitrogen oxides (NOx), sulfur dioxide (SO2) and carbon monoxide (CO); PM2.5 constituents; volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs). Asthma-pollutant interaction adjusted relative risks (RR) and 95% confidence intervals (CI) for preeclampsia were calculated by interquartile range for criteria pollutants and high exposure (≥75th percentile) for PAHs and VOCs. Asthmatics had higher risk associated with first trimester NOx and SO2 and whole pregnancy elemental carbon (EC) exposure than non-asthmatics, but only EC significantly increased risk (RR=1.11, CI:1.03-1.21). Asthmatics also had a 10% increased risk associated with second trimester CO. Significant interactions were observed for nearly all VOCs and asthmatics had higher risk during all time windows for benzene, ethylbenzene, m-xylene, o-xylene, p-xylene and toluene while most PAHs did not increase risk.

The Potentiating Effects Of Acetaminophen On Oxidant Air Pollutant Sensory Irritation And The Onset Of Asthma, Bennett J. Doughty

Honors Scholar Theses

Through its toxic metabolites, acetaminophen can cause oxidative injury in the liver. This damage has not yet been investigated in the respiratory tract. If acetaminophen also causes oxidative stress and injury here, this widely used antipyretic could potentiate the adverse effects of oxidant air pollutants. Thus, the primary goal of this project is to determine if low non-hepatotoxic doses of APAP is correlated with an increase of oxidative stress in the airways, possibly linking APAP to the onset of asthma. Using data that reflected murine breathing patterns, the addition of acetaminophen greatly increased the reflex irritant response to ETS through …

Hyperpolarized 3he Magnetic Resonance Imaging Ventilation Defects In Asthma: Relationship To Airway Mechanics, Del Leary, Sarah Svenningsen, Fumin Guo, Swati Bhatawadekar, Grace Parraga, Geoffrey N Maksym

Medical Biophysics Publications

In patients with asthma, magnetic resonance imaging (MRI) provides direct measurements of regional ventilation heterogeneity, the etiology of which is not well-understood, nor is the relationship of ventilation abnormalities with lung mechanics. In addition, respiratory resistance and reactance are often abnormal in asthmatics and the frequency dependence of respiratory resistance is thought to reflect ventilation heterogeneity. We acquiredMRIventilation defect maps, forced expiratory volume in one-second (FEV1), and airways resistance (Raw) measurements, and used a computational airway model to explore the relationship of ventilation defect percent (VDP) with simulated measurements of respiratory system resistance (Rrs) and reactance (Xrs).MRIventilation defect maps were …

Is Dietary Intervention A Viable Method For Improving Outcomes In Adult Patients With Asthma?, Jennifer Grolimund

Senior Honors Theses

Asthma is a disease process characterized by episodic inflammation of the lower airway in response to various triggers. Those with asthma have trouble breathing effectively during an acute episode, making asthma a potentially life threatening condition. Standard medical treatment of asthma, including medications and environmental changes, can be effective at reducing or eliminating negative outcomes in patients with asthma. However, a holistic approach to patient care, including an examination of dietary influence, may also be useful for patients trying to manage the course of their illness. Variations in intake of individual nutrients or in total dietary patterns may play a …

Association Between High School Students’ Cigarette Smoking, Asthma And Related Beliefs: A Population-Based Study, Resa M. Jones, Kara P. Wiseman, Marina Kharitonova

Family Medicine and Population Health Publications

Background

Smoking has a detrimental effect on the symptoms and severity of asthma, a common chronic disease among adolescents. The purpose of this study was to examine the association between asthma and smoking among high school students and assess provider-patient communication with asthmatic adolescents regarding smoking and adolescents’ beliefs about the harms of smoking.

Methods

In fall 2014, data from high school students, ages 14–18 years, completing the 2009-2010 Virginia Youth Tobacco Survey (N = 1796) were used in descriptive analyses and multivariable logistic regression models adjusting for model-specific confounders as appropriate.

Results

Overall, an estimated 19 % of …

Association Between Personal Exposure To Ambient Metals And Respiratory Disease In Italian Adolescents: A Cross-Sectional Study, Maria José Rosa, Chiara Benedetti, Marco Peli, Filippo Donna, Marco Nazzaro, Chiara Fedrighi, Silvia Zoni, Alessandro Marcon, Neil Zimmerman, Rosalind Wright, Roberto Lucchini

School of Health Sciences Faculty Publications

Background

Release of ambient metals during ferroalloy production may be an important source of environmental exposure for nearby communities and exposure to these metals has been linked to adverse respiratory outcomes. We sought to characterize the association between personal air levels of metals and respiratory health in Italian adolescents living in communities with historic and current ferroalloy activity.

Methods

As part of a study in the industrial province of Brescia, Italy, 410 adolescents aged 11–14 years were recruited. Participants were enrolled from three different communities with varying manganese (Mn) levels: Bagnolo Mella which has current ferroalloy activity, Valcamonica, which has …

Trace Metal Exposure Is Associated With Increased Exhaled Nitric Oxide In Asthmatic Children, Krystal J. Godri Pollitt, Caitlin L. Maikawa, Amanda J. Wheeler, Scott Weichenthal, Nina A. Dobbin, Ling Liu, Mark S. Goldberg

Environmental Health Sciences Faculty Publication Series

Background

Children with asthma experience increased susceptibility to airborne pollutants. Exposure to traffic and industrial activity have been positively associated with exacerbation of symptoms as well as emergency room visits and hospitalisations. The effect of trace metals contained in fine particulate matter (aerodynamic diameter 2.5 μm and lower, PM2.5) on acute health effects amongst asthmatic children has not been well investigated. The objective of this panel study in asthmatic children was to determine the association between personal daily exposure to ambient trace metals and airway inflammation, as measured by fractional exhaled nitric oxide (FeNO).

Methods

Daily concentrations of trace metals …

Health Service Utilization And Poor Health Reporting In Asthma Patients, Joshua G. Behr, Rafael Diaz, Muge Akpinar-Elci

VMASC Publications

The management and treatment of adult asthma has been associated with utilization of health services. Objectives: First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data …

Comparison Of Secondhand Smoke Exposure In Minority And Non-Minority Children With Asthma, David A. Fedele, Erin M. Tooley

Arts & Sciences Faculty Publications

Objective—Determine if secondhand smoke exposure (SHSE) is related to asthma-related functional morbidity by examining racial/ethnic differences in Non-Latino White (NLW), African American, and Latino families and whether racial/ethnic SHSE differences across families persist when accounting for smoking factors.

Methods—Participants were 305 caregiver smokers of children with asthma. Two passive dosimeters measured SHS: one in the home and one worn by the child.

Results—Higher SHSE was related to greater asthma-related functional morbidity. African Americans had higher levels of home SHSE than Latinos (p = .003) or NLWs (p = .021). SHSE as assessed by the child …

Genetic Variation In The Histamine Production, Response, And Degradation Pathway Is Associated With Histamine Pharmacodynamic Response In Children With Asthma., Bridgette Jones, Catherine M T Sherwin, Xiaoxi Liu, Hongying Dai, Carrie A. Vyhlidal

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: There is growing knowledge of the wide ranging effects of histamine throughout the body therefore it is important to better understand the effects of this amine in patients with asthma. We aimed to explore the association between histamine pharmacodynamic (PD) response and genetic variation in the histamine pathway in children with asthma. Methods: Histamine Iontophoresis with Laser Doppler Monitoring (HILD) was performed in children with asthma and estimates for area under the effect curve (AUEC), maximal response over baseline (Emax), and time of Emax (Tmax) were calculated using non-compartmental analysis and non-linear mixed-effects model with a linked effect PK/PD …