No abstract

Asthma is now one of the most common chronic diseases affecting an estimated 300 million people worldwide (1). The prevalence of asthma (and other local allergic conditions) increased very markedly over the second half of the last century, especially in westernized societies, where it now poses a considerable disease burden on individuals and economic disease burden on healthcare systems and society (2, 3). There have, however, been recent reports that its prevalence may now be declining (or has at least plateaued) (4-7), and these are, if true, important for future national and international healthcare planning (6,8,9).To inform these deliberations, we aimed to search systematically for, and appraise, published reports on the epidemiology of asthma. We endeavoured to include studies using appropriate study designs and validated instruments [such as the International Study of Asthma and Allergies in Childhood (ISAAC) (10) and the European Community Respiratory Health Survey (ECRHS)] (11) to assess recent international trends in asthma prevalence and more specifically to assess if asthma prevalence is declining. MethodsWe searched EMBASE (from 1990), Medline (from 1990), ISI Web of Science (from 1990) and Google Scholar for reports describing trends in asthma prevalence using appropriate Medical Subject Heading (MeSH) and free text searches embracing the following concepts/terms: asthma$ AND epidemiology OR prevalence OR time trends OR cohort OR repeat questionnaire OR repeat survey OR ISAAC OR ECRHS from 1990 onwards, in English and in all age groups. In addition, we drew on our personal databases of literature on the epidemiology of asthma and our own sources of routine data. Bibliographies of papers found were scanned for additional papers of interest.We only included full reports of studies that presented data on estimates of asthma prevalence for at least two time points during the period 1990-2008. We stipulated that these studies needed to employ appropriate designs to assess disease trends (i.e. cohort studies, repeat cross-sectional surveys and analysis of routine healthcare data), validated instru- AbstractAsthma prevalence has increased very considerably in recent decades such that it is now one of the commonest chronic disorders in the world. Recent evidence from epidemiological studies, however, suggests that the prevalence of asthma may now be declining in many parts of the world, which, if true is important for health service planning and also because this offers the possibility of generating and testing new aetiological hypotheses. Our objective was to determine whether the prevalence of asthma is declining worldwide. We undertook a systematic search of EMBASE, Medline, Web of Science and Google Scholar, for high quality reports of cohort studies, repeat cross-sectional studies and analyses of routine healthcare datasets to examine international trends in asthma prevalence in children and adults for the period 1990-2008. There were 48 full reports of studies that satisfied our inclusion criteria....

There is growing evidence supporting the relationship between pain-related fear and functional disability in chronic musculoskeletal pain conditions. In osteoarthritis (OA) patients the role of pain-related fear and avoidance has received little research attention so far. The present study investigates the degree to which pain-related fear, measured with the Tampa Scale for Kinesiophobia (TSK), influences daily functioning in OA patients. The purpose of the present paper was twofold: (1) to investigate the factor structure of the TSK in a sample of OA patients by means of confirmatory factor analysis; and (2) to investigate the role of pain-related fear in OA compared to other factors, such as radiological findings and level of pain intensity. The results show that TSK consists of two factors, called 'activity avoidance' and 'somatic focus', which is in line with other studies in low back pain and fibromyalgia. Furthermore, pain-related fear occurred to a considerable extent in this sample of osteoarthritis patients and was negatively associated with daily functioning. Level of pain and level of pain-related fear were significantly associated with functional limitations. Radiological findings were not significant predictors and when compared to pain-related fear they were not significant. These findings underscore the importance of pain-related fear in daily functioning of OA patients. Therefore, treatment strategies aiming at reduction of pain-related fear in OA patients need to be developed and investigated.

There is an increasing interest in the potential of exhaled biomarkers, such as volatile organic compounds (VOCs), to improve accurate diagnoses and management decisions in pulmonary diseases. The objective of this manuscript is to systematically review the current knowledge on exhaled VOCs with respect to their potential clinical use in asthma, lung cancer, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and respiratory tract infections. A systematic literature search was performed in PubMed, EMBASE, Cochrane database, and reference lists of retrieved studies. Controlled, clinical, English-language studies exploring the diagnostic and monitoring value of VOCs in asthma, COPD, CF, lung cancer and respiratory tract infections were included. Data on study design, setting, participant characteristics, VOCs techniques, and outcome measures were extracted. Seventy-three studies were included, counting in total 3,952 patients and 2,973 healthy controls. The collection and analysis of exhaled VOCs is non-invasive and could be easily applied in the broad range of patients, including subjects with severe disease and children. Various research groups demonstrated that VOCs profiles could accurately distinguish patients with a pulmonary disease from healthy controls. Pulmonary diseases seem to be characterized by a disease specific breath-print, as distinct profiles were found in patients with dissimilar diseases. The heterogeneity of studies challenged the inter-laboratory comparability. In conclusion, profiles of VOCs are potentially able to accurately diagnose various pulmonary diseases. Despite these promising findings, multiple challenges such as further standardization and validation of the diverse techniques need to be mastered before VOCs can be applied into clinical practice.