Journal of Asthma最新文献

Background: Integrating Artificial Intelligence (AI) into public health education represents a pivotal advancement in medical knowledge dissemination, particularly for chronic diseases such as asthma. This study assesses the accuracy and comprehensiveness of ChatGPT, a conversational AI model, in providing asthma-related information.

Methods: Employing a rigorous mixed-methods approach, healthcare professionals evaluated ChatGPT's responses to the Asthma General Knowledge Questionnaire for Adults (AGKQA), a standardized instrument covering various asthma-related topics. Responses were graded for accuracy and completeness and analyzed using statistical tests to assess reproducibility and consistency.

Results: ChatGPT showed notable proficiency in conveying asthma knowledge, with flawless success in the etiology and pathophysiology categories and substantial accuracy in medication information (70%). However, limitations were noted in medication-related responses, where mixed accuracy (30%) highlights the need for further refinement of ChatGPT's capabilities to ensure reliability in critical areas of asthma education. Reproducibility analysis demonstrated a consistent 100% rate across all categories, affirming ChatGPT's reliability in delivering uniform information. Statistical analyses further underscored ChatGPT's stability and reliability.

Conclusion: These findings underscore ChatGPT's promise as a valuable educational tool for asthma while emphasizing the necessity of ongoing improvements to address observed limitations, particularly regarding medication-related information.

Introduction: Pediatric asthma is a common respiratory disease that burdens affected patients, their caregivers, and the entire healthcare system. Uncontrolled asthma ultimately impacts patients' quality of life. There are limited studies examining the factors associated with asthma control and quality of life. Thus, this study aimed to explore factors associated with asthma control and examine the relationship between asthma control and quality of life in children with asthma.

Methods: A cross-sectional study was conducted from October 2023 to January 2024 at the Jordan University Hospital, including 136 children aged 7-17 diagnosed with asthma. Asthma control was assessed using the Asthma Control Test (ACT) or Childhood Asthma Control Test (C-ACT). Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS), and quality of life was evaluated using the Pediatric Asthma Quality of Life Questionnaire (PAQLQ).

Results: Only 43.4% of patients had proper asthma control. The average quality of life and MMAS scores were 4.9 ± 1.5 and 4.2 ± 1.9, respectively. Uncontrolled asthma was associated with increased hospital admissions (p = 0.008), sensitivity to cold (p = 0.002), spring weather (p = 0.031), and infections (p = 0.001). Patients with controlled asthma had significantly higher quality of life (p < 0.001), but no significant differences in MMAS scores (p = 0.743). On multivariate analysis, QoL score was a positive predictor of control (p < 0.001), while sensitivity to infections were a negative predictor (p < 0.05).

Conclusion: Most pediatric patients with asthma at the Jordan University Hospital had poor asthma control. Quality of life remained a positive predictor of control irrespective of adherence to asthma treatment. This highlights the need for caregivers and physicians to focus greater attention on these cases, given the substantial clinical and social challanages they poses for affected children.

Rationale: Asthma attacks (AA) are potentially life-threatening complications of asthma associated with high levels of morbidity, mortality and rising healthcare costs. Patient experience, impact and understanding of AA is poorly described in the literature. Enhanced understanding will identify unmet needs in asthma care and support the development of improved personalized strategies for managing and preventing attacks.

Objective: To explore patients' experiences and understanding of AAs, the impact of AAs on their lives and self-management strategies during attacks.

Methods: Single center (UK) qualitative semi-structured interview study with 30 patients who recently had asthma attacks (≤4 wk). Data were analyzed using the framework approach.

Results: The patient experience and impact of AA varied, including recognizing an impending attack. Variation in patients' self-management behaviors during AAs was observed and was influenced by prior experience of attacks and care received for these and other life priorities. Several behaviors previously recognized as contributory to asthma deaths, including short-acting β-agonist (SABA) overuse, poor recognition of the risk of adverse outcomes, and delay in seeking medical help were identified and reported. Most patients had a poor understanding of AAs and their management.

Conclusions: This study describes the differing impact of AA on patient experiences and understanding of asthma attacks. These differences, combined with healthcare factors and attack characteristics, affect patient self-management approaches. These findings highlight unmet needs in asthma attack care.

Clinical trial registration: ClinicalTrials.gov ID NCT04410120.

Background: Serum albumin (Alb) is an essential indicator of human physiological function, which can reflect the functionality of multiple organs, including the liver and kidneys. Presently, numerous studies have indicated that levels of blood albumin serve as important biomarkers for a range of respiratory illnesses. These findings can better guide clinical practice and disease prevention. However, there have been few investigations into the correlation between serum albumin and asthma. Therefore, this study aims to explore the relationship between serum albumin and the onset of asthma.

Methods: Data from the 2003 to 2018 National Health and Nutrition Examination Survey (NHANES) were used in this observational study. Alb was measured using the bichromatic digital endpoint method. Univariate and multivariate logistic regression analyses of the potential correlation between Alb and asthma were performed. The non-linear relationship was characterized by restricted cubic spline (RCS) curve. We also conducted subgroup and interaction analyses.

Result: In this study, we included 29,336 individuals with a mean age of 38.13 ± 17.98 years. Both univariate and multivariate logistic regression analyses show a significant association between serum albumin levels and asthma and higher Alb levels were associated with a lower risk of asthma (OR = 0.64, 95%CI: 0.43-0.96, p = 0.032). RCS curve validated that serum albumin and asthma showed a biphasic correlation. The results of the subgroup analysis showed that a significant interaction between serum albumin and alcohol consumption, Alb was associated with reduced asthma risk only in the subgroup of non-alcohol drinkers (OR = 0.8, 95% CI: 0.7-0.93, p < 0.001).

Conclusions: In the general population in the United States, asthma is associated with Alb, with asthma patients exhibiting lower albumin concentrations. This provides new insights into the management of asthma patients, suggesting that greater attention should be paid to their nutritional status, and further exploration of the causal relationship between the two may be warranted.

Objective: Dietary flavonoids in various green plants have anti-inflammatory, antioxidant, and immune-modulating properties. While numerous studies have confirmed that flavonoid substances benefit asthma, evidence remains limited in epidemiological research and human experiments. This study aimed to explore the relationship between childhood asthma and dietary flavonoids.

Methods: Dietary flavonoids comprise isoflavones, anthocyanins, flavan-3-ols, flavanones, flavones, and flavonols. This study used data from the United States National Health and Nutrition Examination Survey, collected during interviews from 2007 to 2010 and 2017 to 2018. Asthma data were obtained from the survey questionnaire. The analysis included 7,913 participants under 20 years old. A multivariable logistic regression model was performed to investigate the correlation between flavonoids (as constant or category variables) and asthma frequency among children in the United States, with stratified analyses performed for each group.

Results: After adjusting for potential confounding variables, a significant negative correlation was observed between asthma incidence and the highest intake group of anthocyanins compared to the lowest intake group (odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.72-0.97, and p = 0.0182). Similarly, asthma incidence indicated a significant negative association with the median flavonol intake group compared to the lowest intake group (OR = 0.83, 95% CI: 0.72-0.97, and p = 0.0165). In the stratified analysis, anthocyanin content demonstrated a significant negative correlation with asthma prevalence among males, non-Hispanic whites, nonsmoking families, and middle-income families (p < 0.05).

Conclusion: The intake of dietary flavonoids, including anthocyanins and flavonols, is correlated with asthma prevalence in children.

Objective: ASTHMAXcel Perception is an expansion of prior ASTHMAXcel mobile health applications for children with asthma. ASTHMAXcel Perception was evaluated for its ability to improve asthma control and perception of airflow limitation.

Methods: Patients with asthma ages 15-21 were randomized to receive ASTHMAXcel Perception with peak expiratory flow (PEF) feedback or usual care (UC). A baseline visit was followed by 3 intervention sessions across 6 wk in the intervention group. Assessments in both groups were designed to occur at baseline, 6-week (primary time point), and 3-month follow-up. Self-reported asthma control (primary outcome), asthma quality of life, asthma knowledge, medication adherence, healthcare utilization, app usage, and perception of airflow limitation (measured by comparing self-reported PEF guess to actual PEF) were assessed.

Results: 45 patients were enrolled (PEF n = 22, UC n = 23). At 6 wk, the PEF group reported better asthma control than the UC group (18.7 vs 16.7, p < .05). In the PEF group, accurate perception increased from baseline to 6 wk (48% vs 77%, p = 0.01) and from baseline to 3 months (48% vs 74%, p = 0.009). Over-perception decreased from baseline to 6 wk (26% vs 5%, p = 0.041). The number of logins was associated with greater accuracy in perception of airflow limitation from baseline to 2 wk (r = 0.91, p = 0.002) and 2 wk to 4 wk (r = 0.77, p < .05). No significant differences were found in asthma quality of life, asthma knowledge, medication adherence, or healthcare utilization between the two groups.

Conclusion: ASTHMAXcel Perception improved asthma control and was associated with greater accuracy in perception of airflow limitation.

Background: Thunderstorm Asthma (TA) events are observed worldwide, but the precise triggering mechanisms remain elusive.

Objective: This study aims to outline the environmental patterns associated with TA events in China.

Methods: Environmental data was collected from Chinese cities that have experienced TA events, focusing on meteorological conditions in the seven days preceding the thunderstorms. This allowed for the identification of common environmental precursors to TA.

Results: In China, TA events are primarily concentrated in the northwest plateau region. These locations have a temperate continental monsoon climate with infrequent rainfall, leading to a generally arid environment. The four cities that have reported TA incidents are situated predominantly in the vicinity of desert areas. The extensive cultivation of Artemisia arenaria exists in these areas, which are primarily used for windbreaks and sand stabilization. In early September, prior to the occurrence of thunderstorms, these cities typically experience higher temperatures, gentle breezes, and minimal rainfall. Under such environmental conditions, the concentration of Artemisia pollen in the urban areas is extremely high. Upon the arrival of thunderstorms, these allergens can trigger widespread asthma outbreaks among individuals sensitized to them.

Conclusion: The cities in China that experience TA events are primarily situated in the vicinity of deserts located on the plateau. Prior to the occurrence of TA, these cities are exposed to an environment characterized by elevated temperatures, gentle breezes, minimal rainfall, and exceptionally high concentrations of Artemisia pollen.

Introduction and objective: Response to biologics in severe uncontrolled asthma (SUA) can be classified as super-responders, good responders, non-responders, and those achieving clinical remission. The aim of this study is to evaluate the long-term response to mepolizumab in patients with severe eosinophilic asthma and assesses the rate of asthma clinical remission over four years in a real-life setting.

Methods: This is a single-center, observational, retrospective study was conducted at La Paz University Hospital (Madrid, Spain) from 2017 to 2022. Patients with SUA treated with mepolizumab 100mg every four weeks for at least three years were included. Response to mepolizumab was classified into good responders, super-responders, non-responders, and patients achieving clinical remission after three and four years of treatment.

Results: 27 patients (67% women; mean age 37.7 years) were included. 58% of patients achieved remission after three years of treatment, increasing to 63% after four years. Similar trends were observed in super-responders and good responders. We found that a significant number of patients treated with mepolizumab in a real-life setting can achieve asthma remission, particularly when compared to other similar studies.

Conclusions: By distinguishing these different degrees of response, clinicians can better understand the patient's condition and make more informed decisions about whether to continue with the current biologic therapy or consider switching to a different treatment.

Objectives: Cardiometabolic Index (CMI) is a surrogate marker for metabolic disorders. It is associated with various chronic diseases. This study aims to investigate the relationship between CMI and asthma.

Methods: Data from seven consecutive National Health and Nutrition Examination Survey cycles between 2005 and 2018 were used. The study included adults with self-reported asthma diagnoses and complete information for CMI calculation. The formula for CMI is CMI = [WC (cm)/height (cm)] × [TG (mg/dL)/HDL-C (mg/dL)]. A multivariate logistic regression model was employed to examine the linear relationship between CMI and asthma. Subgroup analyses were conducted to explore potential influencing factors. Additionally, smooth curve fitting and threshold effect analysis were used to describe the non-linear relationship.

Results: A higher CMI was possibly associated with an increased prevalence of asthma. After adjusting for various covariates including marital status, Poverty Income Ratio, Body Mass Index, hypertension, diabetes, smoking, alcohol consumption, heart attack, and stroke, the results remained significant (OR = 1.03; 95%CI, 1.00-1.05, p = 0.0178, R² = 0.52). Participants with the highest CMI had a 38% increased risk of asthma prevalence compared to those with the lowest CMI (OR = 1.38; 95%CI, 1.19-1.60, p < 0.0001).

Conclusion: The findings reveal that elevated CMI levels correlate with an increased risk of asthma, highlighting CMI's potential as a predictive marker for asthma, particularly in populations with a CMI below 1.97. These results suggest that interventions aimed at improving metabolic health may prove effective in managing or preventing asthma.