The review was conducted in Colorodo and results were published in the April issue of the American Journal of Respiratory and Critical Care Medicine.

The authors conluded that adults who are overweight or obese have a 50 percent increase in asthma risk compared to a person with a normal or even low BMI.

Asthma affects millions of children and adults in the US. It is an inflammatory disorder of the airways often tied to allergies and exposure to second hand smoke. It is a significant cause of hospital admission in children and can lead to further complications in adults.

Obsesity is an epidemic in the US. It is increases one's risk for diabetes, cancer, heart disease, and premature death. Often obsese or overweight adults can develop sleep apnea, another respiratory disorder.

The study authors stressed to need for exercise counseling and weight loss to help prevent obesity and lower the rate of new asthma cases each year. Though the study only looked at adults, the benefit would also be evident in children who are both obese and asthmatic.

The randomized, double-blind, placebo-controlled study, published in the American Journal of Respiratory and Critical Care Medicine, investigated whether low dose aspirin is associated with a decreased risk of newly diagnosed asthma. Researchers at Brigham and Women's Hospital in Boston, analyzed the data of 22,071 healthy male physicians ages 40 to 84 years participating in the Physicians Health Study. The participants were administered 325 mg of aspirin or a placebo on alternate days for 4.9 years. Questionnaires obtained from the participants at the beginning of the study, at six months, then annually thereafter were analyzed for self-reported asthma diagnoses.

The researchers found that there was a 22 percent lower risk of developing asthma among the participants who received aspirin. This risk was not changed by smoking status, body mass index, or age. Furthermore, there were 113 participants who developed asthma in the aspirin group and 145 participants who developed asthma in the placebo group.

"Aspirin reduced the risk of newly diagnosed adult-onset asthma in a large, randomized clinical trial of apparently healthy, aspirin-tolerant men," the study authors write. "This result requires replication in randomized trials designed a priori to test this hypothesis; it does not imply that aspirin improves symptoms in patients with asthma."

REFERENCES:
1. Barr RG et al. Aspirin and decreased adult-onset asthma: randomized comparisons from the physicians' health study. Am J Respir Crit Care Med. 2007 Jan 15;175(2):120-5. Epub 2006 Oct 26.

The American College of Chest Physicians (ACCP) recommends that children under the age of 15 should not take OTC cough medicines. This advice is part of new comprehensive guidelines on diagnosing and treating coughs that were published in the journal Chest. The guidelines committee reviewed hundreds of studies dating back decades and found no scientific evidence that OTC drugs relieve coughs that are the result of colds. Findings also revealed that OTC cough medicines have a strong placebo effect and cold-related coughs eventually resolve on their own.

To relieve an adult's cough, the panel recommends the use of the antihistamine brompheniramine and the decongestant pseudoephedrine, found in some OTC cold medicines. Drinking warm beverages, using a humidifier for a dry cough, and rest can also help soothe a cough. Nonsedating antihistamines were not found to be effective in relieving coughs.

Wyeth, maker of Robitussin products, disagrees with the ACCP's conclusions. "Our stance is that the FDA has reviewed dextromethorphan and guaifenesin and found the two ingredients to be both safe and effective," says Fran Sullivan, Wyeth's spokesperson, in a USA Today interview. "We don't believe that consumers would re-purchase these products if they weren't efficacious."

REFERENCES:
1. Irwin RS et al. Diagnosis and Management of Cough Executive Summary: ACCP Evidence-Based Clinical Practice Guidelines. Chest. 2006;129:1S-23S.

2. Rubin R. "Cough syrup left out in the cold." USA Today, January 9, 2006, online: http://www.usatoday.com/news/health/2006-01-09-cough_x.htm

The study gathered dietary information from parental questionaires on nearly 600 children age 8 to 13 years. Medical tests specific to the respiratory system were also given. The aim was to determine if certain dietary habits had any effect on the prevalence of wheezing or asthma in children.

Prior studies had shown that diets high in fruits and vegetables, dairy, fish, and whole grain products may be protective to the respiratory system because of high amounts of antioxidants and low sugar.

This study did not find any relationship between fruits and vegetables or dairy. But a strong relationship was found between the incidence of both wheezing and asthma and the intake of fish and whole grains.

Children who at high amounts of whole grains had a much less chance of developing asthma and wheezing, with the risk reduced by 54percent and 45 percent respectively.

And children who ate high amounts of fish had similar reductions in risk, 66 percent and 56 percent for asthma and wheezing respectively.

The overall occurance of wheezing in the group was more than 25 percent and for asthma nearly 20 percent.

The study supports the fact that foods do affect allergy and asthma symptoms in children, though the exact mechanism is not fully understood. Fish and whole grains are high in essential fatty acids which act as natural anti-inflammatories. They also contain high amounts of vitamins and minerals that improve immune system function.

Look for more studies to be developed in this area.

The reviewers were two physicians from the University of Virginia Commonwealth. They reviewed all past studies that measured the efficacy of antibiotics on prognosis and outcome in acute bronchitis cases.

On average 75 percent of adults diagnosed with acute bronchitis are given a prescription for antibiotics even though the most common cause is viral. Viral illness is not affected by antibiotics, though the patient may feel that symptoms have decreased in severity.

The reviewers stated three primary reasons for physicians to avoid writing the prescription for antibiotics. They included cost, side effects, and antibiotic resistant bacteria.

This review follows suit with several other studies that found antibiotic prescriptions for ear infections in children should be delayed.

The editorial, published in The Lancet, discussed whether asthma may be a symptom of several distinct diseases. Because asthma is a group of conditions with different symptoms and treatments, experts believe that asthma is not likely to be a single disease. For this reason, the editorial contends that the term asthma does not properly define this complex ailment.

"Perhaps asthma as a symptom is really only the clinical manifestation of several distinct diseases," the editorial authors write. "Rather than confusing scientists, doctors and patients even further, is it not time to step out of the straightjacket of a seemingly unifying name that has outlived its usefulness?"

However, some experts caution that eliminating the term asthma may increase the risk of under treating the condition. Instead, asthma patients should be carefully diagnosed and treated according to their type of asthma. For research purposes, asthma patients participating in studies should be carefully characterized, so that treatments that were proven for certain asthma syndromes were not applied to every type of asthma.

REFERENCES:
1. Editorial. A plea to abandon asthma as a disease concept. Lancet 2006 Aug 26;368(9537):705.

It can seem like an easy arguement to solve, but it is not. Because if one looks at the statistics for adults we see that adult allergy suffers are less likely to have a pet, if already allergic. And if those without allergies are more likely to have a pet.

But researchers in Norway wanted to look at the situation closer to see the true relationship. They analyzed information from 9,812 adults. They inquired about allergies and asthma during both childhood and adulthood and then coorelated that information with having a household pet in childhood and/or adulthood. They published their results in the Journal of Allergy and Clinical Immunology October issue.

They found that pet owners had about a 30 percent less risk of having allergies than those who did not own pets. This finding was similar to previous studies. However, this effect was not due to pet avoidance by allergy sufferers because adults with allergies were not less likely to have pets than those without allergies. In fact, adults who developed allergies later in life were more likely to use more medication than get rid of their pet.

So, this study supports the arguement that children exposed to pets at a young age may have less allergies (to pets) as adults. The authors stress that buying a pet will not solve the allergy problem, and if the allergy already exists it could make it worse. But parents should not fear that their new baby or young child will get an allergy from being exposed, instead they should believe it may offer some protection.

The study, presented by the American Academy of Allergy, Asthma and Immunology (AAAAI), investigated the effect of secondhand smoke on allergens and immune system response. Researchers at the University of California, Los Angeles, collected nasal fluid samples of 19 participants with allergies to ragweed. The participants were then exposed to either cigarette smoke or clean air. Following this, the researchers collected nasal fluid samples again. The experiment was repeated with ragweed exposure and clean air, and nasal fluid samples were collected. The researchers analyzed the participants' nasal fluid samples for levels of IgE allergy antibodies and histamine (a substance that causes inflammation).

The researchers found that IgE levels were 16.6 times higher in participants exposed to ragweed and cigarette smoke, compared to participants exposed to ragweed and clean air. Furthermore, histamine levels were 3.3 times higher in participants exposed to ragweed and cigarette smoke, than participants exposed to ragweed and clean air.

"The authors noted the study provides the first experimental evidence that secondhand smoke can exacerbate allergic responses and also suggest patients with allergies should avoid tobacco smoke," states the AAAAI news release.

REFERENCES:
1. Secondhand smoke proven to make allergies worse, from the JACI. American Academy of Allergy, Asthma and Immunology News Release, June 14, 2006:
http://www.aaaai.org/media/news_releases/2006/06/061406.stm

The study, published in the British Medical Journal, investigated the prevalence of obesity, smoking, and both health risk factors together in U.S. adults. Researchers from Columbia University in New York, analyzed data from a 2002 U.S. national health interview survey including 29,305 adults, aged 18 or older. Surveys obtained from the participants were reviewed for age, sex, ethnic group, education, and income.

The researchers found that 23.5 percent of participants were obese, 22.7 percent smoked, and 4.7 percent smoked and were also obese. More men were obese than women. Findings also revealed that 7 percent of African Americans were obese smokers, compared with 4.6 percent whites and 4.2 percent Hispanics. Furthermore, participants with yearly incomes under $20,000 had a 6.5 percent incidence of obesity and smoking, compared to 4.5 percent for those with incomes over $20,000.

The study authors suggest that more research is needed to effectively treat low- income, obese smokers. "Although the proportion of adults who smoke and are obese is relatively low, this subgroup is concentrated among lower socioeconomic groups," the study authors conclude.

REFERENCES:
1. Healton CG et al. Smoking, obesity, and their co-occurrence in the United States: cross sectional analysis. BMJ 2006 Jul 1;333(7557):25-6. Epub 2006 May.

Exercise-induced bronchospasm (EIB), a temporary bout of asthma induced by exercise, can even affect elite athletes including many Olympic athletes. A study published in Medicine & Science in Sports & Exercise found that 23 percent of Olympic athletes had a history of EIA. In the 1998 Winter Olympic Games several athletes with EIB won gold, silver and bronze medals.

In the study, the authors conclude: "These data suggest that: 1) EIB is prevalent in several Olympic winter sports and affects nearly one of every four elite winter sport athletes; 2) the winter sport with the highest incidence of EIB is cross-country skiing; 3) in general, EIB is more prevalent in female versus male elite winter sport athletes; and 4) athletes may compete successfully at the international level despite having EIB."

The study suggests that individuals with EIA can still train and compete optimally in sports. Diagnosis and an individualized treatment regimen are essential for people with EIA to safely continue exercising and participating in sports. EIA is diagnosed with a lung function test (spirometry) before and after exercise.

Treatment for EIA can include using a short-acting inhaler about 10 to 15 minutes prior to exercise. Experts also recommend sustained exercise warm-up and cool-down periods. If EIA symptoms occur, you should stop exercising. Good activities for those with EIA include swimming, walking and leisure biking. Activities that may worsen EIA include cross-country skiing, long-distance running and basketball.

REFERENCES:
1. Wilber RL. Incidence of exercise-induced bronchospasm in Olympic winter sport athletes. Med Sci Sports Exerc 2000 Apr;32(4):732-7.

2. Managing Exercise-Induced Asthma: Interview with Clifford Bassett, MD, WebMD, August 18, 2004: http://www.webmd.com/content/chat_transcripts/1/103846.htm

3. Exercise-Induced Asthma, 24hourFitness:
http://www.24hourfitness.com/html/fitness/articles/induced_asthma

Results from a study at the University of Florida in Tampa were published in the Journal of Clinical Investigation. In the study scientists looked at the effects of nicotine on cancer cell growth and replication.

They saw that nicotine binds to cancer cells and encourages or promotes replication and growth. Nicotine did not show any signs of initiating the changes in normal healthy cells needed to change a cell into cancer. The authors state that is left up to the carcinogenic compounds added to cigarettes.

So for smokers who have been breathing in toxic chemicals, small changes may have occured in bronchial and lung cells that signal tumor induction. And once these changes happen, nicotine can come in and bind and promote growth of the cells that are now cancerous.

And what may be alarming is that the nicotine does not have to be from cigarettes to cause growth in these cancerous cells. Nicotine from chewing gum or patches that people use to help kick the habit can still promote growth of cancer once the changes have been initiated by carcinogens in cigarettes.

This may be bad news for smokers. Cancer must grow for many years before it becomes recognizable or causes any symptoms in humans. A tumor the size of a bb contains more than a billion cells, and takes years to acheive that growth. But from that point on the tumor can double in size in a matter of days, and become deadly in months.

The authors state that these findings may deter some from the use of nicotine supplements to stop smoking, but some good may have come from this evidence as well. If we know that nicotine receptors on the tumor promote growth, there is a possibility that cancer treatments can use this avenue to stop growth or promote cell death.

There will be more to come on this interesting finding in cancer research.

A new study was published in the Annals of Family Medicine that documented the fears, apprhensions, and success of individuals enrolled in a nasal therapy "group session". A total of 28 patients were used for the study, each of whom had previously participated in a study documented the effects of nasal saline on chronic stuffiness and sinusitis.

Each person took part in group training sessions that lasted 30 minutes. The training sessions were geared to provided technical support and trouble shooting as well as mental support to help overcome fears and anxieties.

Particpants sited the following issues about nasal irrigation prior to study:
1. Fear of placing water in the nose.
2. Discomfort of using saline solution.
3. Side effects of irrigation.
4. Scheduling into daily routine.
5. Proper technique to increase effectiveness.

After the study participants stated the following benefits of coached sessions:
1. Overcame fear of water in the nose.
2. Learned how to alter salt content to adjust for burning sensation.
3. Learned proper technique to avoid/decrease side effects.
4. Learned proper timing and keys to working irrigation into schedule.

The authors stated that each of the particpants gained a sense of empowerment and control over a health situation that had previously controlled them. This in addition to decreased nasal symptoms including congestion, runny nose, sinus headaches, and infection.

Asthma is a progressive disorder of the respiratory system that results in a decreased ability to inhale air, primarily due to constriction of the airway with increased secretions. Children who have allergies are more susceptible to asthma. There are several different types of asthma, triggered by different mediators such as exercise, cold, or allergens.

A recent study from Belgium was published in the journal Occupational and Environmental Medicine. It found that asthma incidence may be linked to indoor swimming pool use. Indoor swimming pools and the air inside is a significant source of chlorine bi-products. The lead researchers believe that these bi-products may be the cause of asthma.

In the study rates of asthma in children were compared to the number of indoor swimming pools in more than 21 European countries. They found that for every one swimming pool, asthma rates increased by 2-3 percent. They do not state that indoor swimming pools are the only reason for a nearly 50 percent increase in asthma rates, but their influence definately cannot be negated.

The study authors call for more controlled studies relating asthma and indoor swimming pools, and in particular the exposure to chlorine bi-products. For parents who have children at risk for asthma, or who already have the disease, staying away from indoor chlorinated pools may be an effective form of reducing attacks.

Each year asthma attacks contribute to the death of more than 150,000 people worldwide. Preventative measures are so important, such as reducing exposure to allergens, proper cleaning and maintenance of bedding, as well as having needed medications handy.

Milk thistle continues to be used as a primary alternative treatment for conditions such as Hepatitis C, cirrhosis of the liver, alcholic liver disease, mononucleosis, HIV, and many more. The most active and recognized compounds in milk thistle are silymarin and silibinin. Both compounds are currently at the center of cancer research around the world.

Results from a recent animal study on lung cancer were published in the June issue of the Journal of the National Cancer Institute. Though it was a preliminary animal based study, the results were so promising that larger trials, including clinical are slated for completion in the next few years.

In the study mice were exposed to chemicals known to induce large lung cell tumors. The mice in the treatment group were given various amounts of silibinin, an isolated compound from milk thistle. When comparing mice treated with silibinin to those without treatment, the rate of large lung cell tumors was significantly different.

In those mice receiving silibinin, less lung cell tumors were reported. The apparent mechanism of silibinin is blockage of tumor angiogenesis, or blood vessel growth. For a tumor to grow and invade surrounding structures it must create a new blood supply.

Many of the current cancer fighting drugs being researched today focus on blockage of this process, angiogenesis, to stop the tumor from growing. Blockage of angiogenesis is also one of the first steps in halting metastasis, or tumor spread, to other sites in the body.

Many tumors are not considered deadly until they have spread to other parts of the body. Preventing metastasis, as well as killing cells that may have spread to other areas, is one key objective to chemotherapy.

The area of cancer research is booming today, with more and more medicinal plants in the spotlight. This study marks a successful finding in the use of milk thistle and its components as a strong anti-cancer herb.

The authors state that larger animal based studies are already underway, and clinical trials are expected to follow after such promising results as those published this month.

Some treatments based on alternative and complementary medicine are from centuries ago, while new treatments are being found today. Researchers in Finland wanted to study the benefit of salt inhalation therapy for persons with chronic asthma based on historical use and new research. Results were published in the journal Allergy this May.

Salt inhalation therapy is practiced widely in Europe and Asia as an alternative asthma treatment. Most people will go into salt caves or salt mines to receive benefit. While some spas will offer a salt room, that may be lined with rock salt. The exact mechanism is not well understood, but benefit has been reported.

To test the hypothesis 32 person with chronic asthma and low to moderate use of inhaled steroids enrolled into the study. They were randomized to either 40 minutes in a manmade salt chamber five times a week for two weeks or placebo treatment. Several variables were measured to assess for changes to airway function including the amount of air exhaled in one second, medication use, perceived symptoms and airway responsiveness to inhaled substances.

What researchers found supported the use of salt inhalation as a complementary and alternative treatment in those who suffer from chronic asthma. In the treatment group there was a 15% improvement in the amount of air exhaled in the first second. As well the lining of the airways were significantly less reactive in those who received the salt treatment. There was no statistical difference between the groups when it came to perceived symptoms and medication use.

The authors conclude that the benefit of salt inhalation can not be excluded as a complementary treatment, but is not effective as a sole treatment alone. There are some logistical issues associated with salt inhalation therapy. It can be difficult to find a natural salt mine, and also expensive to attempt to create your own simulated salt mine. More research is needed to determine the effects of long term treatment.