Allergens and pollution are reduced at high altitude. Resiquimod nmr We investigated the effect of asthma rehabilitation at high altitude (HA, 3100m) compared to low altitude (LA, 760m) on exhaled nitric oxide (FeNO) and on specific IgE levels for house dust mites (HDM,d1) and common pollen (sx1).

For this randomized controlled trial adult asthmatics living <1000m were randomly assigned to a 3-week in-hospital-rehabilitation (education, physical- and breathing-exercises) at either LA or HA. Changes in FeNO, d1 and sx1 from baseline to end-rehabilitation were measured.

50 asthmatics (34 females) were randomized [mean±standard deviation LA n=25, 44±11 years, total IgE 267±365kU/l; HA n=25, 43±13 years, total IgE 350±445kU/l]. FeNO significantly improved at HA from 69±56ppbat baseline to the first day at altitude 23±19ppb and remained decreased until end-rehabilitation with 37±23ppb, mean difference 95%CI -31(-50 to -13, p=0.001) whereas at LA FeNO did not change. A significant decrease in d1 and sx1 at end-rehabilitation was observed in the LA-group [mean difference 95%CI -10.2 kUA/l (-18.9 to -1.4) for d1 and -4.95 kUA/l(-9.69 to -0.21) for sx1] but not in the HA-group. No significant difference between groups [d1 5.9 kUA/l(-4.2 to 16.2) and sx1 4.4 kUA/l(-3.5 to 12.4)] was found.

Rehabilitation at HA led to significant FeNO reduction starting from the first day until end-rehabilitation despite unchanged levels of specific IgE. The significant decrease in d1 and sx1 at end-rehabilitation in the LA group might be explained by less HDM in the hospital and/or reduced seasonal pollen, as this decrease was not observed at HA.

Rehabilitation at HA led to significant FeNO reduction starting from the first day until end-rehabilitation despite unchanged levels of specific IgE. The significant decrease in d1 and sx1 at end-rehabilitation in the LA group might be explained by less HDM in the hospital and/or reduced seasonal pollen, as this decrease was not observed at HA.

Allergic rhino-conjunctivitis is a highly prevalent condition. In moderate to severe cases, allergen immunotherapy (AIT) is a cost-effective therapeutic option. Previous data have reported a large difference in treatment compliance of subcutaneously (SCIT) and sublingually (SLIT) administered AIT.

By use of the unique civil registration number assigned to all Danish citizens and the Danish National Health Service Prescription Database, compliance rates of all patients prescribed with grass pollen AIT from January 1998 until December 2016 were analysed annually during the three-year treatment period.

The male/female ratio was close to 11 in SCIT, while SLIT was more frequently used by men. A large proportion of users was children or adolescents (32% and 45%, SCIT and SLIT, respectively). Compliance of both subcutaneous and sublingual treatment gradually fell each year; compliance in year 3 was 57% and 53% for subcutaneous and sublingual treatment, respectively. Compliance of grass pollen sublingual treatment was also analysed each year after registration on the Danish market. Compliance significantly increased following the introduction and stabilised on a relatively high level.

Based on previous studies, we hypothesised that AIT compliance would be low, especially in SLIT. However, in Denmark, compliance in SCIT and SLIT was almost similar, and the majority of patients completed the three-year treatment period with a compliance in the last quintile.

Based on previous studies, we hypothesised that AIT compliance would be low, especially in SLIT. However, in Denmark, compliance in SCIT and SLIT was almost similar, and the majority of patients completed the three-year treatment period with a compliance in the last quintile.

Reference equations from the Global Lung Function Initiative (GLI) are now available for both spirometry and diffusion. However, respiratory phenotypes defined by GLI-based measures of diffusion have not yet been evaluated in GLI-based normal-for-age spirometry or spirometric impairments.

We evaluated cross-sectional data from 2100 Caucasians, aged 40-85 years. GLI-based spirometric categories included normal-for-age and the impairments of restrictive-pattern and three-level severity of airflow-obstruction (mild, moderate, severe). GLI-based diffusion included diffusing capacity of the lung for carbon monoxide (D

) and measured components of alveolar volume (V

) and transfer coefficient (K

) D

=[V

]x[K

]. Using multivariable regression models, adjusted odds ratios (adjORs) for D

, V

, and K

<lower limit of normal (LLN) were calculated for spirometric impairments, relative to normal-for-age spirometry.

Relative to normal-for-age spirometry, the restrictive-pattern increased the adjORs (95% cond, in turn, the spirometric evaluation of respiratory disease.

Children admitted to the intensive care unit (ICU) for asthma are at higher risk of future morbidity and mortality. Although Canada and the United States (US) may have different population compositions, studies have documented that up to 34% of American children hospitalized for asthma require ICU admission, compared to 4.5% in Canada. However, whether there are differences in the post-ICU asthma-related morbidity between the two countries is not known. This study compared the post-ICU asthma-related readmissions and ICU readmissions in children with critical asthma between Canada and the US.

In this retrospective cohort study, we included children aged 2-17 years with an ICU admission for asthma in a pan-Canadian database (2008-2014) and a 4-state American database (2005-2014). The time to the first asthma-related readmission, the distribution of asthma-related readmissions within 1 year, and the proportion of ICU readmissions within 1 year were compared between the 2 countries.

1055 Canadian and 9377 American children were admitted to the ICU for asthma during the study period. The time to asthma-related readmission (p=0.29) and the frequency of asthma-related readmissions within 1 year (p=0.73) did not differ between Canada and the US. However, the proportion of children readmitted to the ICU for asthma within 1 year was significantly higher in the US (US 40.1%, Canada 28.9%; p=0.02).

While the overall asthma-related readmissions in children with critical asthma did not differ between Canada and the US, a greater proportion of children were readmitted to the ICU in the US. Future studies should elucidate the causes underlying this difference.

While the overall asthma-related readmissions in children with critical asthma did not differ between Canada and the US, a greater proportion of children were readmitted to the ICU in the US. Future studies should elucidate the causes underlying this difference.