No abstract

RATIONALE: Smoking is one of the most significant triggers for asthma patients. The aim of this study was to evaluate the differences between smoker asthma (S) patients with non-smoker (NS) and ex-smoking (ES) patients in terms of symptoms, risk factors and comorbidities. METHODS: A web-based data entry of 500 patients living in the urban area of Istanbul/Turkey who were followed for at least one year after asthma diagnosis was made via Microsoft Access 2013. The registered respiratory symptoms, habits, risk factors, comorbidities of NS, ES, and S patients were compared statistically. RESULTS: Number and percentage of the NS, ES and S groups and their mean age were respectively 353 (70.6%) 39.9 6 15.4; 88 (17.6) 44.8 6 12.7; and 59 (11.8%) 38.0 6 15.4. No group difference was found between cough, wheeze, chest tightness and dyspnea symptoms; asthma ratios in parents; body mass index; non-steroid anti-inflammatory hypersensitivity; pollen, mite, mold, pet sensitivity; heating methods in both home and workplace; allergic conjunctivitis, rhinitis and or sinusitis comorbidities (p>0.05). Percentage of allergic dermatitis and hypertension was lower in NS group (3.4%, 3.4% respectively) compared to ES and S groups (12.7% 17% and 13.9%, 10.2% respectively with p<0.02, p<0.03) and reflux was lower in S group (41.6%) compared to other groups (59.1%; 57.6% with p<0.003). CONCLUSIONS: Smoker and ex-smoker asthma patients of the urban area had similar asthma symptoms and risk factors but they had higher hypertension and allergic dermatitis comorbidities than non-smoker asthma patients.

Background Topical mast cell stabilizers were previously shown to treat the signs and symptoms of seasonal and perennial allergic conjunctivitis safely and effectively in active and placebo‐controlled trials. However, mast cell stabilizers have not been compared to topical corticosteroids for efficacy. We tested the non‐inferiority of a topical mast cell stabilizer, N‐acetyl aspartyl glutamic acid (4.9%, NAAGA), compared to fluorometholone (0.1%, FM) during controlled exposures to the airborne birch pollen allergen, Bet v 1, in an environmental exposure chamber (EEC). Methods This randomized, cross‐over, investigator‐blinded study included 24 patients with a history of birch pollen allergic conjunctivitis. Patients were randomized to 5 days of treatment with NAAGA, then FM (n = 12) or FM, then NAAGA (n = 12). After each treatment, patients were exposed to a fixed airborne concentration of Bet v 1 in ALYATEC EEC. The primary endpoint was the amount of allergen required to trigger a conjunctival response (Abelson score ≥5). Groups were compared with a linear model for cross‐over studies. Non‐inferiority was assumed, when the lower bound of the risk ratio confidence interval (CI) was >0.5. Results At screening, the mean time‐to‐conjunctival response was 72.5 ± 35.9 min. NAAGA and FM extended the response time to 114.8 ± 55.0 and 116.6 ± 51.5 min respectively. The mean amounts of allergen required to trigger a conjunctival response were 1.165 ng after NAAGA and 1.193 ng after FM treatment. The risk ratio for the conjunctival response was 0.977 (95% CI: 0.812; 1.174), which indicated non‐inferiority. Adverse events occurred less frequently with NAAGA (29.2%) than with FM (58.3%). Conclusion In patients with allergic conjunctivitis to birch pollen, NAAGA was non‐inferior to FM in exposures to airborne Bet v 1. The EEC was a good model for simulating real‐life airborne allergen exposure and for demonstrating the efficacy and safety of eye drops for treating allergic conjunctivitis. Trial registration Not registered.

RATIONALE: Although asthma self-management mobile apps are readily available, there is a lack of published literature regarding how a patient's educational level may influence the response to these mobile interventions. This study correlates the educational levels of asthma patients using the ASTHMA-Educator mobile application with asthma emergency department (ED) visits. METHODS: We developed the ASTHMA-Educator program to provide guideline-based asthma education for patients at our institution in the Bronx. 25 adult asthma patients received a tablet-based version of the program, and were included in this study. We collected baseline data for each subject including self-reported highest educational level. At baseline, 2 months, and 4 months, we queried patients regarding the number of asthma ED visits in the prior 2 months. We performed statistical analyses through the paired t-test. RESULTS: Of the 25 subjects, 6 did not finish high school, 3 finished high school, 10 finished college, 3 completed a higher degree, and 3 reported 'other'. Among patients that finished college, we observed a statistically significant decrease in mean asthma ED visits from baseline to 2 months and 4 months (p 5 0.01 and p 5 0.04, respectively). Among patients that did not finish high school, finished high school, or completed a higher degree, there was no significant reduction in asthma ED visits from baseline to follow-up. CONCLUSIONS: The study showed that patients who finished college showed the most benefit from the ASTHMA-Educator. Larger sample sizes are needed to further validate these results and target the mobile software program to patients from other educational backgrounds.

No abstract