Exposure to an aeroallergen as a possible precipitating factor in respiratory arrest in young patients with asthma

Article Abstract:

Asthma is rarely fatal, but mortality related to the condition is increasing in England, New Zealand, the United States, Australia and Denmark. There have been a number of reports of sudden deterioration leading to respiratory arrest, and in some cases, sudden death. This study of 11 patients aged 25 years or younger who had episodes of respiratory arrest (two died), related the attacks to the peak outdoor mold-sporulation season in the Midwest, and found the 11 patients were allergic to Alternaria alternata, a common fungus present in the air. There were also 699 control patients. There are three groups of asthma patients who are at especially high risk: those with unexpected and overwhelming episodes of asthma, those with chronic, progressive deterioration requiring long-term steroid use, and those whose asthma was extremely difficult to control in the month prior to death. All the patients in this study were of the first type. The usual risk factors for fatal asthma are an overreactive bronchial airway, major changes in lung function from normal to abnormal, a too-rapid tapering off of steroid therapy, incorrect use of inhaled steroid medications, lack of knowledge of asthma on the part of primary care physicians, age, and stress. In addition to these factors, increased exposure to airborne allergens (aeroallergens), in particular the mold alternaria, may be a cause of these attacks. Inhalation of these mold spores may cause both an immediate and a delayed effect, and is far more likely to cause an allergic response than pollen. Seasonal or perennial exposure to airborne molds and funguses should be included among the risk factors for sudden respiratory arrest among asthma patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Environmental aspects, Fungal antigens

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Ragweed immunotherapy in adult asthma

Article Abstract:

Immune therapy with ragweed extract may have only marginally positive affects on adult asthma. Ragweed pollen causes summertime allergies in some people. Researchers treated 37 asthmatics whose symptoms worsened during the ragweed season with ragweed extract injections. A control group of forty people received placebo injections. Although members of the immunotherapy group reported improved asthma symptoms during both seasons compared to the control group, there was no noticeable group difference overall. Medication use decreased in both groups, but especially in the immunotherapy group during the first treatment year. After two years, medication use, subjective asthma symptoms, and peak flow measurements of lung capacity were similar in both groups. Only 53 of 77 people completed the two-year treatment period.

Health aspects, Care and treatment, Research, Seasonal variations (Diseases), Allergy desensitization, Ragweeds

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Accuracy of the death certificate in a population-based study of asthmatic patients

Article Abstract:

The number of individuals who die from complications of asthma may be higher than the number estimated from death certificate information. The cause of death is usually listed on the death certificate by the physician who was caring for the patient. A study compared a review of the medical records of 339 deceased individuals who were treated for asthma between 1964 and 1983 by a panel of specialists in allergy and pulmonology to the cause of death stated on their death certificate. Six percent of these individuals were diagnosed with asthma as the underlying cause of death on their death certificates, compared with 26% identified as dying from asthma by the panel. Four individuals whose death certificates listed asthma as the underlying cause of death were identified as dying from another cause by the panel.

Patient outcomes, Mortality, Death, Certification

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