The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.
Introduction: Despite effective treatments, asthma outcomes remain suboptimal. Interest exists in herbal remedies. Aims: To evaluate AKL 1, an herbal mixture, in a randomised double blinded placebo controlled cross-over trial. Methods: 32 asthmatics (8 male, median (range) age 40.5 (22-73) yrs., median (range) FEV1% predicted 87.5 (33-126)%, median (range) daily ICS dose 800 (0-4000) mcg beclomethasone) completed a 36 week trial consisting of; four week baseline, twelve-week treatment with AKL or identical placebo, eight week washout and further twelve-week crossover treatment period. The change occurring over treatment periods was observed for lung function, Asthma Control Questionnaire (ACQ), Asthma Quality of Life Questionnaire (AQLQ), Leicester Cough Questionnaire (LCQ) scores. The mean (95% Confidence Interval) individual patient changes between active minus placebo periods was calculated. Results: No significant differences in lung function (active-placebo) were found (FEV1: mean (95% CI) difference = 0.01 (−0.12 to 0.14)L, p = 0.9. PEF: −4.08 (−35.03 to 26.89) L/min, p = 0.8). Trends to clinical improvements favouring active treatment were however consistently seen in the patient-centred outcomes: ACQ mean difference (active − placebo) = −0.35 (−0.78 to 0.07, p = 0.10, AQLQ difference 0.42 (−0.08 to 0.93, p = 0.09), LCQ difference 0.49, (−0.18 to 1.16, p = 0.15). With a change in ACQ and AQLQ score of 0.5 signifying a clinically relevant changes in control or health status, on the ACQ, 28% were unchanged, 22% better on placebo and 50% better on AKL, and on the AQLQ 29% had no change, 29% were better on placebo and 42% better on AKL. Nine exacerbations occurred during placebo treatment and five whilst on AKL. No significant adverse events were noted. Conclusions: AKL1 treatment was well tolerated. Consistent trends to symptom and quality of life improvements were observed, although no improvements in lung function seen. Further studies. Conflict of interest and funding None. Funding: The study was funded by Bridgehead Technologies Ltd.
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