BREATHING
ASTHMA AND RESPIRATORY INFECTIONS
IN SCHOOL CHILDREN WITH SPECIAL REFERENCE
TO MOISTURE AND MOULD PROBLEMS IN THE SCHOOL
Moisture
problems in buildings readily lead to fungal growth
within its structures, thereby exposing the inhabitants
to spores and other mould products. The association
between indoor air problems and respiratory symptoms
has been documented in many epidemiological studies.
Therefore, a study was carried out to evaluate whether
exposure to moisture and sensitisation to moulds are
associated with respiratory manifestations in school
children. Two schools were included in the study, one
with moisture problems (index school), the other being
the control school.
It was found that the prevalence of asthma was 4.8, which
was similar in the children from both schools. However,
the children from the index school more often had wheezing
(16% vs 6%) and cough (21% vs 9%) symptoms than control
children. Positive skin reactions to moulds were rare
(2.4%), being present in 7% of asthmatic and in 1-2% of
non-asthmatic children. Lower respiratory tract infections
were more common in the spring than in the fall in children
from the index school, but not in control children, and
the difference between the schools was significant in
emergency visits and antibiotic courses. Thus, evidence
was found of an association between moisture or mould
problems in school buildings and the occurrence of respiratory
infections, repeated wheezing and prolonged cough in school
children.
Taskinen,T. et al
ACTA. PAEDIATR. 1999, 88 (12) 1373-9
IRRITABLE BOWEL SYNDROME, GASTRO-OESOPHAGEAL REFLUX,
AND BRONCHIAL HYPER-RESPONSIVENESS
IN THE GENERAL POPULATION
Symptoms of irritable
bowel syndrome (IBS) and gastro-oesophageal reflux are
common in the general population but only a minority
of people with these symptoms consult a doctor about
them. As the two conditions often coexist it has been
proposed that they may share a common aetiology. Therefore,
a study was carried out to explore the inter-relations
between these conditions and also bronchial hyper-responsiveness
(BHR) using a validated postal symptom questionnaire.
One year prevalences, in men and women respectively, of
IBS were 10.5% and 22.9%, of dyspepsia 26.3% and 25.25%,
of gastro-oesophageal reflux symptoms 29.4% and 28.2%, of
BHR 13.2% and 14.6%, and of chronic bronchitis 8.3% and
4.9%. Logistic regression showed independent associations
between IBS and BHR, gastro-oesophageal reflux symptoms
and dyspepsia. However, there was no significant independent
association between IBS and chronic bronchitis. In men and
women the odds ratio for IBS and gastro-oesophageal reflux
symptoms was 2.6 and for IBS and BHR 2.1. Also, IBS, gastro-oesophageal
reflux symptoms, and bronchial hyper-responsiveness occurred
more frequently together than expected, 2.5% of the sample
having all three conditions compared with an expected prevalence
of 0.7%.
These observations may indicate the presence of an underlying
disorder producing symptoms in both the gastrointestinal
and respiratory systems.
Kennedy, K.M. et al
GUT 1998, 43 (6) 770-4
NEW WAY TO GET RID OF DUST MITES
House dust mites cannot survive without a fungus, Aspergillus
repens, which predigests the flakes of human skin into a
form which they can eat. A new bedding material impregnated
with a fungicide has been produced that kills the fungus
and thus makes the skin indigestible, starving the mites.
It is also impregnated with triclosan, which kills the bacteria
which makes socks smell. Courtaulds say the substances are
unlikely to trigger allergic reactions.
NEW SCIENTIST, 19th Sept. 1998
EFFECTS OF THE MENSTRUAL CYCLE ON MEDICAL DISORDERS
It
is well recognised that certain medical conditions are
exacerbated at specific phases of the menstrual cycle.
Abrupt changes in the concentrations of circulating ovarian
steroids at ovulation and premenstrually may account for
menstrual-cycle related changes in these chronic conditions.
Accurate documentation of symptoms on a menstrual calendar
allows identification of women with cyclic alterations
in disease activity.
The evidence supporting a relationship between oestrogen
withdrawal and migraine headache is compelling. The frequency
of migraine headaches in women increases considerably after
menarche and 60% of women with migraine link attacks to
menstruation. Seventy to ninety percent of women with menstrual
migraine experience improvement during pregnancy but may
experience migraine attacks in the postpartum period.
Menstrual exacerbations occur with all types of seizures.
Catamenial epilepsy is believed to result from cyclic alterations
in both ovarian hormone levels and drug metabolism.
In many women with asthma there is an increased frequency
and severity of attacks premenstrually or at menstruation
and may be related to changing levels of progesterone or
prostaglandins.
Symptoms of rheumatoid arthritis often improve in the luteal
phase when gonadal steroid production is maximal. A subjective
increase in morning stiffness and arthritic pain during
menstruation and the early follicular phase has been shown.
In women with irritable bowel syndrome symptoms tend to
recur and become cyclic, with exacerbation during the postovulatory
and premenstrual phases of the menstrual cycle, suggesting
a hormonal influence.
Menstrual cycle-related alterations in glycemic control
during the luteal and premenstrual phases have been reported
in some women with diabetes.
Other disorders exacerbated by the postovulatory and premenstrual
phases of the menstrual cycle include acne, endocrine
allergy and anaphylaxis, erythema multiforme, urticaria,
apthous ulcers, glaucoma and multiple sclerosis.
Case,
A.M. and Reid, R.L.
ARCH.INT.MED. 1998, 158 (13) 1405-12
IMPAIRMENT OF HEALTH AND QUALITY OF LIFE IN PEOPLE WITH
LARGE WAIST CIRCUMFERENCE
A study was carried out to
define the symptoms associated with excess central fat
distribution and to assess the risks of chronic disorders.
A cross-sectional study of 5,887 men and 7,018 women
aged 20-59 years assessed respiratory insufficiency,
low back pain, degree of physical function, presence
of non-insulin-dependent diabetes, and cardiovascular
risk factors. Bodyweight, body-mass index, and waist
circumference were measured by action levels (men; less
than action level 1 <94.0 cm, action levels 1-2 94.0-101.9
cm, more than action level 2 >102.0 cm; women: less
than action level 1 <80.0 cm, action levels 1-2 80.0-87.9
cm, more than action level 2 >88.0 cm). The reference
group were people with waist circumferences lower than
action level 1. It was found that all symptoms and risks
increased among participants higher than action level
2, after adjustment for age and lifestyle, by 3.1 in
men and 2.7 in women for shortness of breath when walking
upstairs; 4.5 and 3.8 for non-insulin dependent diabetes;
and 4.2 and 2.8 for at least one major cardiovascular
risk factor. Above action level 2, compared with the
reference group, men and women were at twice the risk
of difficulties in everyday life, and women were 1.5
times more likely to have low back pain or symptoms
of intervertebral disc herniation. The researchers conclude
that waist action levels could be useful for health
promotion to raise awareness of the need for weight
management.
Lean,M.E. et al
LANCET 1998, 351 (9106) 853-56
SUMMARY OF ANALYSIS OF ASTHMA AND ECZEMA PILOT STUDY
The
Natural Medicines Society initiated a pilot study to
ascertain whether naural medicines were helpful to people
suffering with either asthma or eczema, or both. Eighty
people completed the section relating to asthma and 98
people completed the section on eczema. Some completed
both. The Nuffield Institute for Health was asked to analyse
the responses and their summary is as follows.
Between two-thirds and three-quarters of the questionnaires
were completed by women. In both the asthma and eczema surveys:
• the under twentys were the largest group
• around 50% have used natural medicines for over
2 years
• between 56-60% of all products used had been prescribed
by practitioners
• between 88-95% of respondents experienced no side-effects
• only 9% of patients felt that they had not benefited
from using natural medicines
• in both conditions 42% of respondents were still
taking natural medicines to control their symptoms
• almost 70% of the asthma respondents and only 37%
of the eczema respondents were taking orthodox medicine
as well as natural medicine
• if respondents had experienced any problem with
their natural medicine, they reported back to the practitioner
• the majority of respondents had turned to natural
medicine due to worries about side effects and a lack of
confidence in the efficacy of the orthodox treatment
Homoeopathy was used by 17.8% of respondents and the rest
were split between a variety of therapies, mainly nutrition,
yoga, diet, acupuncture, etc. It was concluded that natural
medicines may be useful in the treatment of asthma and
especially of eczema. The small sample may not be representative.
Further research should be carried out, but funding is
so far unobtainable.
NMS NEWS No. 42, Spring 1998
