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Importance of Allergy in Asthma: An Epidemiologic Perspective

Abstract  
There has been a global epidemic of asthma during the past half-century. More recently, the prevalence has leveled off or declined in many Western countries, whereas the prevalence in less affluent nations is still increasing. The reasons for this and the different geographical patterns of asthma prevalence remain unclear. This paper provides an epidemiologic perspective on whether allergen exposure and allergies can explain these trends. In particular, the paper discusses 1) geographical and temporal trends in asthma and the role of allergens and allergy, 2) the importance of nonallergic mechanisms, 3) nonallergenic exposures that may modify the risk of allergies and asthma, and 4) new and emerging risk and protective factors. Although allergy and asthma are closely related, allergen exposure and allergy alone cannot explain current time trends and geographical patterns of asthma. Population-based studies focusing on recently identified risk and protective factors may provide further insight.
  • Content Type Journal Article
  • Pages 1-11
  • DOI 10.1007/s11882-011-0215-6
  • Authors
    • Jeroen Douwes, Centre for Public Health Research, Massey University, P.O. Box 756, Wellington, 6140 New Zealand
    • Collin Brooks, Centre for Public Health Research, Massey University, P.O. Box 756, Wellington, 6140 New Zealand
    • Christine van Dalen, Centre for Public Health Research, Massey University, P.O. Box 756, Wellington, 6140 New Zealand
    • Neil Pearce, Centre for Public Health Research, Massey University, P.O. Box 756, Wellington, 6140 New Zealand

Inhaled anticholinergic drug therapy and the risk of acute urinary retention in chronic obstructive pulmonary disease: a population-based study.

Inhaled anticholinergic drug therapy and the risk of acute urinary retention in chronic obstructive pulmonary disease: a population-based study.

Arch Intern Med. 2011 May 23;171(10):914-20

Authors: Stephenson A, Seitz D, Bell CM, Gruneir A, Gershon AS, Austin PC, Fu L, Anderson GM, Rochon PA, Gill SS

Inhaled anticholinergic medications (IACs) are widely used treatments for chronic obstructive pulmonary disease (COPD). The systemic anticholinergic effects of IAC therapy have not been extensively studied. This study sought to determine the risk of acute urinary retention (AUR) in seniors with COPD using IACs.

PMID: 21606096 [PubMed - indexed for MEDLINE]

Carotid arterial stiffness in patients with chronic obstructive pulmonary disease.

Carotid arterial stiffness in patients with chronic obstructive pulmonary disease.

Acta Physiol Hung. 2011 Jun;98(2):117-27

Authors: Albu A, Fodor D, Bondor C, Suciu O

Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality.Patients with COPD have a cardiovascular risk three times greater than the normal population and cardiac disease accounts for about 50% of deaths in these patients. Arterial stiffness is a marker of increased cardiovascular risk and a predictor for cardiovascular morbidity and mortality. There is evidence of increased aortic stiffness in COPD. The aim of our study is to determine parameters of carotid arterial stiffness in patients with stable COPD.

PMID: 21616770 [PubMed - indexed for MEDLINE]

Increased blood volume following resolution of acute cardiogenic pulmonary oedema: a retrospective analysis.

Increased blood volume following resolution of acute cardiogenic pulmonary oedema: a retrospective analysis.

Crit Care Resusc. 2011 Jun;13(2):108-12

Authors: Kanhere MH, Bersten AD

Acute cardiogenic pulmonary oedema (APO) occurs due to an increase in pulmonary microvascular pressure and massive transvascular fluid filtration into the lungs, causing respiratory insufficiency.

PMID: 21627579 [PubMed - indexed for MEDLINE]

COPD: criteria to assist in the identification of the palliative phase.

COPD: criteria to assist in the identification of the palliative phase.

Br J Nurs. 2011 May 27-Jun 9;20(10):635-9

Authors: Trueman J, Trueman I

For people with chronic obstructive pulmonary disease (COPD), hospital admission can be associated with a poor prognosis. Consequently, the end stage of the illness needs to be recognized for timely palliative care to be initiated. Tools to enhance the palliative phase such as the Gold Standards Framework and the Liverpool Care Pathway rely on the recognition of the final phase of a person's life. The illness trajectory of cancer makes this recognition far easier than for COPD, as a result many patients and their families manage at home with limited support. Lincolnshire Respiratory Network has developed criteria to help recognize the end-stage COPD, which correlate well with recent recommendations from the Consultation on a Strategy for Services for COPD in England (Department of Health, 2010). However, there needs to be appropriate training to assist practitioners in their confidence to refer patients with end-stage COPD to palliative care providers.

PMID: 21646997 [PubMed - indexed for MEDLINE]

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