Influence of atopy and asthma on exhaled nitric oxide in an unselected birth cohort study

Scott, Martha; Raza, Abid; Karmaus, Wilfried; Mitchell, Frances; Grundy, Jane; Kurukulaaratchy, Ramesh; Arshad, Syed Hasan; Roberts, Graham

doi:10.1136/thx.2009.125443

Cited by 120 publications

(125 citation statements)

References 32 publications

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“…Hence, eNO may be elevated in allergic rhinitis patients that do not have concomitant asthma, which suggests that physicians should see whether patients have allergic rhinitis when they use NO as diagnostic tools of asthma or monitoring tools of treatment efficacy. Scott et al [11] showed that atopy was significantly associated with higher levels of eNO. They reported that the level of eNO in non-atopic asthmatic participants was no different from that in the non-atopic non-asthmatic group and concluded that eNO behaves as a biomarker of atopy and of the "allergic asthma" phenotype, rather than of asthma itself.…”

Section: Discussionmentioning

confidence: 99%

Nasal and Exhaled Nitric Oxide in Allergic Rhinitis

Lee¹,

Yoo²,

Kim³

et al. 2010

Otolaryngol.--head neck surg.

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OBJECTIVE: 1) Establish current opinion from medico-legal sources based upon the following questions: Does the surgeon owe a duty of care to advise an x-ray for nasal fracture secondary to assault? Does a fracture demonstrated by x-ray result in the ability of the prosecution to establish a greater degree of harm against the victim? 2) Identify patients who underwent manipulation under anesthetic (MUA) of nasal fracture secondary to assault and investigate their legal outcomes. METHOD: A number of relevant medical and legal sources were contacted. The above questions were posed and advice sought. In this retrospective study, all adult patients who underwent MUA of a nasal fracture over a 1-year period (1st January 2007-1st January 2008) were contacted. If reported as a non-accidental fracture, further questions were asked; whether a facial x-ray was performed pre-operatively; did the patient proceed to press charges; if so, the outcome of the prosecution and court hearing. RESULTS: 97 patients underwent MUA of nasal fracture in the unit over the year. Information was available for 68 patients, non-accidental injury accounted for 26 cases (38%). Six patients within this group proceeded to press charges. The legal outcome of these patients is discussed. Literature review highlights controversy regarding the value of imaging but little is published giving guidance in cases of non-accidental nasal fractures where legal action is likely to proceed. CONCLUSION:We present an up-to-date review of medical and legal perspectives and the legal outcome of patients presenting with non-accidental nasal fractures managed in our department.

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Section: Discussionmentioning

confidence: 99%

Nasal and Exhaled Nitric Oxide in Allergic Rhinitis

Lee¹,

Yoo²,

Kim³

et al. 2010

Otolaryngol.--head neck surg.

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“…Participants attending in person also performed spirometry, bronchodilator reversibility (BDR) to 600 mg inhaled salbutamol, fractional exhaled nitric oxide (FeNO) measurement, methacholine challenge test and skin prick test (SPT). Identical methodology, published previously [30], was used for spirometry and challenge testing at 10 and 18 yrs. FeNO (Nioxmino1, Aerocrine AB, Solna, Sweden) and SPT to common food and aeroallergens (ALK-Abello, Horsholm, Denmark) were performed as reported previously [30].…”

Section: Methodsmentioning

confidence: 99%

“…Identical methodology, published previously [30], was used for spirometry and challenge testing at 10 and 18 yrs. FeNO (Nioxmino1, Aerocrine AB, Solna, Sweden) and SPT to common food and aeroallergens (ALK-Abello, Horsholm, Denmark) were performed as reported previously [30].…”

Section: Methodsmentioning

confidence: 99%

What does adolescent undiagnosed wheeze represent? Findings from the Isle of Wight Cohort

et al. 2012

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We sought to characterise adolescent wheeze in the absence of asthma, which we termed “undiagnosed wheeze”.The Isle of Wight Birth Cohort (n=1,456) was reviewed at 1, 2, 4, 10 and 18 yrs. Using questionnaire responses, “asthma” was defined as “ever had asthma” plus either “wheezing in the last 12 months” or “taking asthma treatment in the last 12 months”; “undiagnosed wheeze” as “wheeze in the last 12 months” but “no” to “ever had asthma”; and remaining subjects termed “non-wheezers”.Undiagnosed wheeze (prevalence 4.9%) accounted for 22% of wheezing at 18 yrs. This was largely adolescent-onset with similar symptom frequency and severity to diagnosed asthma. However, undiagnosed wheezers had significantly higher forced expiratory volume in 1 s to forced vital capacity ratio, less bronchodilator reversibility and bronchial hyperresponsiveness, and were less frequently atopic than asthmatics. Undiagnosed wheezers had earlier smoking onset, higher smoking rates and monthly paracetamol use than non-wheezers. Logistic regression identified paracetamol use (OR 1.11, 95% CI 1.01–1.23; p=0.03), smoking at 18 yrs (OR 2.54, 95% CI 1.19–5.41; p=0.02), rhinitis at 18 yrs (OR 2.82, 95% CI 1.38–5.73; p=0.004) and asthmatic family history (OR 2.26, 95% CI 1.10–4.63; p=0.03) as significant independent risk factors for undiagnosed wheeze.Undiagnosed wheeze is relatively common during adolescence, differs from diagnosed asthma and has strong associations with smoking and paracetamol use. Better recognition of undiagnosed wheeze and assessment of potential relevance to adult health is warranted.

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“…The authors found that low FeNO levels (<22.5 ppb), normal sputum eosinophils (<2.5%) and absence of atopy suggested a lower probability of CRC (19). Many studies reported the association between FeNO levels and atopy with increasing threshold for FeNO levels in atopic asthmatic subjects both in adults (22) and in children (23).…”

mentioning

confidence: 99%