According to a research conducted at the National Jewish Medical and Research Center, black asthmatic teens are at an increased risk of developing resistant to steroid-based asthma therapy than their white counterparts.
The study disclosed that black asthmatic teens are also more likely to suffer from high mortality rate and be sick when compared to the white teens.
“Our results suggest that children with steroid-resistant asthma are more likely to be African-American, to have required treatment with oral steroids at an earlier age and to require larger amounts of oral steroids for only marginal control of their asthma,” said Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish.
Other recent epidemiological studies have shown that blacks with asthma are sicker and have a higher mortality rate than whites with asthma. Doctors at National Jewish now are trying to determine whether blacks have a more vigorous immune response to airway inflammation–which means that higher doses of steroids must be used to control inflammation–or a poor response to steroids secondary to a genetic resistance to the drugs.
“The theory is that with ongoing airway inflammation you get worsening asthma and diminished steroid sensitivity,” Dr. Spahn said.
This study of 164 teen-agers treated at National Jewish also showed that 25 percent of the group was steroid resistant. Children with less than a 15 percent improvement in lung function following a “burst” of inhaled steroids–high doses over seven days–were considered steroid resistant.
“Twenty-five percent of the kids admitted to National Jewish have steroid-resistant asthma, which is much greater than anyone thought,” Dr. Spahn said.
According to Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish, African-American children are at increased risk to develop steroid-resistant asthma.
The study was published in the Journal of Allergy and Clinical Immunology.
Even though steroid treatment is one of the most commonly recommended treatment options for asthma, yet bodies of some children may show no response to such treatment. This finding was disclosed by a new study presented at the American Thoracic Society.
It was suggested that some children may respond well while others may achieve no benefit at all with steroids, as per Gregory Sawicki, M.D. of Children’s Hospital in Boston.
“The majority of children with mild asthma are less likely to have symptoms as they get older and may not need to be on daily steroids,” Dr. Sawicki said. “The flip side is that if a child has poor asthma control, the parents and doctor need to make sure the child is adhering to their inhaled steroid treatment. But variation in response to inhaled steroids, as other medications, is well described.”
The data comes from the Child Asthma Management Program Continuation Study (CAMPCS), one of the largest groups of children with mild to moderate asthma in the nation who have been followed over 10 years. “This study gives us a good sense of real-world practice in asthma management,” Dr. Sawicki says. “The children’s care is not directed by anyone in the study; it’s an observation of what goes on when the children’s care is directed by their own physicians.”
It was further noted by Sawicki that asthma control cannot be managed even if higher doses of steroids were administered to non-responsive children, much like all adult asthmatic patients do not derive benefit from steroids.
Individuals suffering from mild, persistent asthma and being administered with twice-daily use of inhaled steroids are likely to make lesser use of inhalers or find it easy to switch to a new pill.
It was remarked by Stephen P. Peters, M.D., Ph.D., lead author and a professor of pediatrics, internal medicine-pulmonary and associate director of the Center for Human Genomics, that this is good news for asthmatic patients because it offers them more choices in terms of asthma management.
The study, involving 500 children and adults with mild asthma, was conducted by the American Lung Association’s Asthma Clinical Research Centers. Its goal was to determine if patients whose symptoms are well controlled on twice daily inhaled corticosteroid can “step down” their medication use. The results are reported in the May 17 issue of the New England Journal of Medicine.
Asthma is considered mild, but persistent, when symptoms occur more than two times a week or cause the patient to awaken during the night more than twice a month. The standard treatment for mild-persistent asthma is twice-daily use of an inhaled steroid to prevent symptoms. Patients may also take additional drugs such as the inhaler albuterol, known as “rescue” therapy, to treat symptoms. A majority of people with asthma have mild disease, according to Peters.
The study involved patients whose asthma was treated with twice-daily inhaled fluticasone propionate (Flovent Discus), a commonly prescribed synthetic steroid. This drug is designed to suppress inflammation within the airways that can cause narrowing.
It was further remarked by Peters that asthmatic patients treated with twice a day inhaled corticosteroid doses and seeking other options must talk to their doctors before finalizing a decision.
The use of inhaled steroids increased significantly in asthmatic women pregnant with a female fetus, but did not change in asthmatic women pregnant with a male. This is because pregnant women with asthma who are carrying a female baby are more likely to experience a worsening of their asthma than pregnant asthmatic women carrying a baby boy.
Although there is no definite reason for this difference, Dr. Gibsonbelieves that female fetus may produce a substance in response to the inflammation of the asthmatic mother’s airways that somehow worsens the asthma.
The study followed 151 pregnant women; 33 did not have asthma, 38 had asthma but did not use inhaled steroids during pregnancy, and 80 had asthma and used inhaled steroids every day during their pregnancy. Steroidscontrol the inflammation of the airways that occurs in asthma. “Inhaled steroids are generally considered safer for the fetus than oral steroids,” Dr. Gibson said.
He found that 60% of asthmatic women who were pregnant with a male fetus were symptom-free throughout their pregnancy and did not report nighttime breathing problems from the 18th to the 30th week of pregnancy. In contrast, 61% of asthmatic women pregnant with a female fetus were symptom-free at 18 weeks, but at 30 weeks only 28% were symptom-free. Nighttime symptoms increased significantly from 18 to 30 weeks in women pregnant with a female fetus.
Use of inhaled steroids increased significantly in asthmatic women pregnant with a female fetus, but did not change in asthmatic women pregnant with a male.
In order to address this condition, Dr. Gibson suggests that pregnant women should continue to treat their asthma with inhaled corticosteroids. According to him, asthma is dangerous to the mother and baby since it can result in reduced oxygen, which is needed for normal fetal growth and development.
A US research led by Dr Michael Schatz showed that asthmatic pregnant women should continue their inhaled steroids. According to Dr. Schatz, inhaled steroids during pregnancy do not affect the growth of the fetus inside the womb, where as non-medication could result to greater risks on the health of the babies.
The US study looked at the effect of inhaled steroids on the birth weight of children of women with asthma. Researchers compared the birth weights of around 400 babies whose mothers used a range of inhaled steroids for their asthma throughout pregnancy.
Inhaled steroids have no effect on the growth of babies in the womb, according to a new study that should offer reassurance for pregnant women with asthma.
But many people with asthma have concerns about their medication: Asthma UK research shows more than 50% are worried about the long-term side effects of steroid treatment, including a possible impact on growth.
‘This study provides reassuring data that specific inhaled steroids do not lead to a restriction in fetal growth,’ said Dr Michael Schatz of theKaiser Permanente Medical Center, San Diego, who led the research.
Katie Shepherd, Asthma UK’s Care Development Manager, echoed this: ‘It is most important that asthma is well controlled throughout pregnancy. Where inhaled steroids have been prescribed, women with asthma should feel safe taking them, as under-treated asthma can pose a much greater risk to the health of their fetus.’
The study proved that there were no differences between the range of birth weights of the children born to women who undergo treatment and those who are in healthy condition. Also, there were no differences in the numbers of pre-term births or the incidence of low birth weight children. In conclusion, inhaled steroids on pregnant women are safe on both mothers and their babies.
Most people have misconceptions about the causes and symptoms of cataract. Cataract is not a film that covers the eye. This happens not only to aging individuals but also to children and middle-aged individuals.
Cataract is the clouding of the eye’s natural lens. People who have cataract experience blurred vision, sensitivity to the light, poor night vision, double vision in one eye, and they see colors as if they are faded or yellowish.
People who use both inhaled and oral steroids (corticosteroids) may be at increased risk for cataracts, according to a recent study. Many people with asthmarely on inhaled, and sometimes oral, steroids, as do people with chronic obstructive pulmonary disease (COPD). The study assessed the inhaled and/or oral steroid use and cataract status of more than 3,600 people, following them for up to ten years. Increased cataractriskswere found only in patients who, at the start of the study had ever used inhaled steroids, had used oral steroids for at least one month, and had no cataracts. Although only a small number of patients met these criteria, nearly all of them—seven of 10—were found to have cataracts in follow-up exams. You should talk with your doctor if you are prescribed both oral and inhaled steroids because of the potential for increased cataract risk.
According to a study that involved 3,600 patients who are using oral or inhaled steroid medications showed that they are prone to develop cataracts. It revealed that seven out of 10 patients acquired cataracts since they use steroids over a long period of time.
Aside from aging and steroid medications, there are other medicines which can contribute to cataracts such as psoralens, a class of drugs used along with light therapy to treat skin disorders, such as psoriasis; antipsychotic medications and glaucoma medications.
Asthma treatment all depends upon what and how a child responds to various medications. The child needs to be strong enough to hold the effect of steroids which gives instant relief to the attack. Sometimes even a strong and healthy child can respond in an uncontrolled way to a steroidif used consistently.
As the studies from Child Asthma Management Program Continuation Study (CAMPCS) shows that out of 914 children only 20% of them were less likely to have a well controlled asthmaon comparison with those who never used inhaling steroids. There were found to be many reasons for the unresponsive behavior of the steroid on the patient such as genetically the inhaled steroids can act in a much less responsive way.
Some children may not be able to keep their asthma under control even if they consistently report using inhaled corticosteroids, a mainstay of asthma treatment, suggests a new study.
Several studies of adults with asthma have suggested that even rigorous use of inhaled steroids doesn’t lead to well controlled asthma in all adults, Dr. Sawicki noted. “But this issue hasn’t been looked at closely in children,” he said. “Further studies are needed to see what is different about children who don’t respond to steroids, to see if there is a way to predict whether a child will respond to inhaled steroids.”
In addition, says researcher Gregory Sawicki, M.D. of Children’s Hospital in Boston, that severity of the disease can take over the shortcomings of medication and the inability to completely cure the disease.
Further there have also been studies if steroids were that effective in controlling asthma. It was seen that in adults the results were not that impressive unlike in children who were in a much more controlled state of disease.
According to a research conducted at the National Jewish Medical and Research Center, black asthmatic teens are at an increased risk of developing resistant to steroid-based asthma therapy than their white counterparts.
Even though 
Individuals suffering from mild, persistent asthma and being administered with twice-daily use of inhaled 
The use of 
A US research led by Dr Michael Schatz showed that asthmatic pregnant women should continue their 
Most people have misconceptions about the causes and symptoms of cataract. Cataract is not a film that covers the eye. This happens not only to aging individuals but also to children and middle-aged individuals.
Asthma treatment all depends upon what and how a child responds to various medications. The child needs to be strong enough to hold the 