A researcher from the University of Southern California (USC) Medical Center in Los Angeles says telemedicine had a positive impact on inner city children with asthma at the start of the Covid-19 pandemic. According to Kenny Kwong, MD, making the switch to telemedicine for routine asthma visits early on in the pandemic resulted in positive disease control and an increase in appointment "show rates" among Los Angeles inner city children. Prior to taking advantage of telemedicine, in-person appointment show rates between March and June 2019 averaged 70%-80%. After the switch to telemedicine, this increased to 90%-95% between March and June 2020. Furthermore, delivering routine asthma care via telemedicine did not appear to negatively impact asthma control among the children in the study, Wong said in a presentation at the American College of Allergy, Asthma & Immunology virtual meeting. There was also a notable increase in the amount of time healthcare providers spent with patients after switching to telemedicine, with appointments conducted over the telephone lasting as much as 62% longer than pre-pandemic in-person visits. “This system has worked very well. We have been able to treat many asthmatic children until the debacle of COVID-19. All our face-to-face visits on the mobile asthma units came to a grinding halt, and we had to switch almost overnight to telephone visits,” Wong said.
Experts in the UK say a cost effective and widely available drug can help save the lives of seriously ill COVID-19 patients. The drug, dexamethasone, a steroid, has been around since the early 1960s, and is usually given in low doses to patients with severe asthma, allergies and painful/swollen joints. It is also used to treat autoimmune conditions, such as systemic lupus erythematosus and rheumatoid arthritis. Dexamethasone’s effect on inflammation and our immune systems is what is believed to make it useful in treating patients with severe COVID-19 infections. The drug is part of the RECOVERY Trial, the largest clinical trial to date aiming to identify treatments that may be beneficial for COVID-19 patients. As part of the trial, researchers studied the effect of dexamethasone in 2,000 patients and compared that to the outcomes in 4,000 patients who did not receive it. Dexamethasone was found to cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth. This equates to one life saved for every eight on ventilators and every 20-25 treated with oxygen. One of the biggest benefits of dexamethasone is that it is not cost prohibitive, meaning it could be pivotal for treating COVID-19 in poorer countries. [Related reading: What does it mean for a vaccine if the new coronavirus mutates?]
Researchers have found fat in overweight and obese people’s lungs. It’s the first time such a discovery has been made and could provide important clues as to why overweight and obese people have an increased risk of asthma. For the research, a team from Australia analysed lung samples from 52 deceased individuals. They found the amount of fat present increased in line with Body Mass Index (BMI). Being overweight/obese is already linked to having asthma, but it was previously thought that excess weight pressing on the lungs was the main reason for this. However, the Australian researchers say fatty tissue in the walls of airways takes up space and causes inflammation, which can lead to wheezing and asthma. Speaking about the findings of the research, which are published in the European Respiratory Journal, Dr Peter Noble from the University of Western Australia said: “We’ve found that excess fat accumulates in the airway walls where it takes up space and seems to increase inflammation within the lungs. “We think this is causing a thickening of the airways that limits the flow of air in and out of the lungs, and that could at least partly explain an increase in asthma symptoms.” Experts say that more research is now needed to find out whether the build-up of fatty tissue could be reversed through weight loss. In the meantime, asthma patients should be supported to achieve a healthy weight.
The method via which a baby is born has a dramatic impact on its gut bacteria and could explain why babies born by Caesarean section are more likely to experience health problems later in life, a new study has found. The study by Wellcome Sanger Institute, UCL, and the University of Birmingham – the largest of its kind – looked at babies’ microbiomes (the bacteria, viruses and fungi that live in our guts) to see if they formed differently depending on how a baby was born. For the research, samples were taken on a regular basis from the nappies of 600 babies in their first month of life. The results showed that vaginally born babies got most of their first bacteria from their mothers. However, babies born via Caesarean section showed high levels of hospital bugs, with some having as much as 30% of their total microbiomes made up by such bugs. It’s a reality that could explain why babies born by Caesarean section are more susceptible to certain conditions when they are older, like allergies, asthma and type 1 diabetes. Speaking about the findings of the research, Dr Trevor Lawley, from the Wellcome Sanger Institute, said: “What surprised me and scared me was the amount of healthcare bugs showing up in these children. “But what excites me is we have an amazing body of data now that we can build on, to think about how to properly establish the human ecosystem, starting at birth.”
New research shows that some drugs commonly prescribed for treating depression, epilepsy and other conditions may increase a person’s risk of dementia. The drugs, which belong to a family of medicines called anticholinergics, have previously been lined to short-term problems with thinking. According to the new study of patients in the UK, the findings of which are published in Jama Internal Medicine, using such drugs could lead to possible long-term brain side effects. However, experts are stressing that the study findings do not prove there is a direct risk and that patients already taking these drugs – literally millions of people in the UK - should not stop doing so. Anticholinergic drugs block the action of a neurotransmitter (chemical messenger) in the brain which controls signals around the body. They are used to treat a variety of conditions, including depression, epilepsy, psychosis, overactive bladder, Parkinson’s disease, chronic obstructive pulmonary disease and some allergies. For the study, researchers looked at nearly 300,000 patients (58,000 with dementia) and their use of medication going back more than 20 years. They found a strong link between the use of certain anticholinergic drugs – namely ones used to treat depression, Parkinson’s, psychosis, bladder conditions and epilepsy - and an increased risk of dementia in individuals aged 55 and over. Anticholinergic drugs used to treat asthma, muscle problems, heart rhythm issues and gastrointestinal problems were not found to pose a dementia risk. Speaking about the findings of the study, Dr Jana Voigt, from Alzheimer's Research UK, said: “There is a growing body of evidence that suggests certain anticholinergic drugs are linked to an increased dementia risk. “While finding a link between certain strong anticholinergic drugs and an increased risk of dementia, it doesn’t tell us if these drugs cause the condition.”
Nobody likes to see a baby with a cold. After all, runny noses and a cough are bad enough when you’re fully grown, let alone when you’re still just an infant. But new research suggests that babies who are born with lots of different bacteria in their noses are more likely to recover quicker from their first cold and could help bolster the way we deal with colds going forward. The findings of the research are interesting because the common cold is caused by a virus, yet it would appear that bacteria found in the respiratory tract do play a part when it comes to recovery. Indeed, the researchers from the University Children's Hospital of Basel found that babies who have lots of different bacteria living in their nose tend to recover more quickly from their first respiratory virus. Moreover, babies with fewer different types of bacteria take longer to recover. Prof Tobias Welte, President of the European Respiratory Society, said: “There is an association between respiratory symptoms in babies in the first year of life and the development of asthma by school age. “We do not yet fully understand this link but the bacteria living in the upper airways could play a role.” He also welcomed further research to help determine the relationship between bacteria, respiratory infections and long-term lung health.
Using cleaning products regularly can be as bad for your lungs as smoking 20 cigarettes a day, a new study has found. Tracking people with an average age of 34 over a 20-year period, scientists at Norway’s University of Bergen found that women who regularly used cleaning products had lung function decline equivalent to those who smoked 20 cigarettes a day. For the study, the researchers measured the lung function of participants by testing the amount of air they were able to forcibly breathe out. They then examined the results alongside surveys answered by the study participants. They found that women who regularly used cleaning products had noticeably decreased lung capacities, as well as increased rates of asthma. Prof Cecile Svanes, who led the team from Bergen, said: "We feared that such chemicals, by steadily causing a little damage to the airways day after day, year after year, might accelerate the rate of lung function decline that occurs with age". So what should you be using instead of cleaning products? According to the scientists, microfiber cloths and water should be “enough for most purposes”, while keeping your home ventilated and using liquid cleaners, not sprays, could also help lessen the impact of cleaning products.
The benefits of exercising regularly are well-known and abundant, but now new research suggests that it may also help relieve symptoms of asthma in adults. The study, which was published in MJ Open Respiratory Research, focused on the physical activity levels of 643 adults diagnosed as having asthma. It found that those who exercised the recommended amount each day (30 minutes) were almost 2.5 times more likely to have their asthma symptoms under good control, compared to those who did zero exercise. Furthermore, the exercise does not necessarily need to be strenuous, according to lead author Simon Bacon, a professor in the Department of Exercise Science at Concordia University in Montreal, Canada. "Just 30 minutes a day of walking, riding a bike, doing yoga - anything active, really - can result in significant reduction of asthma symptoms,” he said. Asthma cannot be cured, but its symptoms can be controlled and the individual can enjoy a good quality of life if it is effectively managed and it seems exercise is now a key factor for that management. World Health Organisation (WHO) figures show that there are around 235 million people in the world who have asthma. Conventional advice was that asthma sufferers should try and avoid exercise as it can trigger attacks. But Professor Bacon says this can be avoided if the right measures are taken: "The issue of exercise-induced bronchospasm is real - but if you use your reliever medication, blue puffer, before you exercise, and then take the time to cool down afterwards, you should be okay. Even if you have asthma, there's no good reason not to get out there and exercise,” he said.