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J Asthma 2021 Jul 30:1-17. Epub 2021 Jul 30.

Aydin Adnan Menderes University, School of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Aydin, Turkey.

The lung functions of children with obese asthma seem to be distinct from those of obese children or lean asthmatics. To measure baseline lung function, exercise-induced bronchoconstriction (EIB), and bronchial hyperreactivity (BHR) in school-age obese asthmatics (OA group) and to compare the data with obese children (O group), lean asthmatics (A group), and healthy controls (H group). One hundred seventy school-age children were enrolled in this prospective cross-sectional study. Read More

Pediatr Allergy Immunol 2021 Jul 29. Epub 2021 Jul 29.

Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil.

Background: Respiratory symptoms after exercise are frequently reported by asthmatics and exercise-induced bronchoconstriction (EIB) is a frequent cause which requires objective testing for diagnosis. Eucapnic voluntary hyperpnoea (EVH) is recommended as a surrogate stimulus for this purpose. Its short-term reproducibility is not yet established in children and young adolescents with asthma. Read More

J Asthma Allergy 2021 15;14:907-917. Epub 2021 Jul 15.

Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Various clinical patterns based on routes of sensitization and sensitized allergens are reported in adult-onset IgE-mediated wheat allergy. There is still a paucity of data on IgE-bound wheat allergen profiles in wheat challenge-proven adult-onset wheat allergic cases. Therefore, we aim to identify the major sensitized allergens in Thai adult-onset wheat allergic patients whose first symptom occurred after the age of 18 years despite previous tolerance. Read More

Eur Respir Rev 2021 Sep 20;30(161). Epub 2021 Jul 20.

Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

During submaximal exercise, minute ventilation ( ) increases in proportion to metabolic rate ( carbon dioxide production ( )) to maintain arterial blood gas homeostasis. The ratio / , commonly termed ventilatory efficiency, is a useful tool to evaluate exercise responses in healthy individuals and patients with chronic disease. Emerging research has shown abnormal ventilatory responses to exercise (either elevated or blunted / ) in some chronic respiratory and cardiovascular conditions. Read More

J Asthma 2021 Jul 22:1-9. Epub 2021 Jul 22.

Physiotherapy Department, Federal University of São Carlos - UFSCar, São Carlos, Brazil.

Objective: To determine the accuracy of incremental Shuttle Walking Test (ISWT) in detecting exercise-induced bronchospasm (EIB) in adults with asthma and to verify whether there is an association of the drop in FEV between ISWT and cardiopulmonary exercise testing with constant-load CPET-CL.

Methods: In this cross-sectional study 32 individuals with asthma performed two ISWTs, an incremental cardiopulmonary exercise test (CPET-I) and a constant-load cardiopulmonary exercise test (CPET-CL) with na interval of 48 h between tests. Spirometric measurements were obtained 5, 10, 15, 20 and 30 min after exercise; an FEV1 decline > 10% was considered EIB. Read More

Life Sci 2021 Oct 3;282:119792. Epub 2021 Jul 3.

Department of Physiology and Biophysics, National Institute of Science and Technology in Nanobiopharmaceutics (INCT-Nanobiofar), Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address:

Aims: Exercise training increases circulating and tissue levels of angiotensin-(1-7) [Ang-(1-7)], which was shown to attenuate inflammation and fibrosis in different diseases. Here, we evaluated whether Ang-(1-7)/Mas receptor is involved in the beneficial effects of aerobic training in a chronic model of asthma.

Material And Methods: BALB/c mice were subjected to a protocol of asthma induced by ovalbumin sensitization (OVA; 4 i. Read More

An Pediatr (Engl Ed) 2021 Jul 30;95(1):40-47. Epub 2020 Dec 30.

Laboratory of Pediatric Physical Activity, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil; Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.

Introduction: The aim of the study was to evaluate the diagnostic performance of the item concerning physical activity of the Global Initiative for Asthma (GINA) asthma control questionnaire for detection of exercise-induced bronchoconstriction (EIB) in children and adolescents.

Material And Methods: We divided participants (aged 6-18 years) with a diagnosis of asthma into two groups according to the GINA severity classification: mild/moderate asthma (MMA) and severe therapy-resistant asthma (STRA). We collected anthropometric, clinical and functional data (spirometry) and performed an EIB test. Read More

Ann Am Thorac Soc 2021 Jul 2. Epub 2021 Jul 2.

Columbia University Medical Center, 21611, Pediatrics, New York, New York, United States;

Pediatr Allergy Immunol 2021 Jul;32(5):809-812

Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland.

ERJ Open Res 2021 Apr 28;7(2). Epub 2021 Jun 28.

Dept of Respiratory Medicine, Royal Brompton Hospital, London, UK.

Background: Exercise-induced laryngeal obstruction (EILO) is a common cause of exertional breathlessness and wheeze yet is frequently misdiagnosed as asthma. Insight regarding the demographic characteristics, laryngeal abnormalities and impact of EILO is currently limited, with data only available from individual centre reports. The aim of this work was to provide a broader perspective from a collaboration between multiple international expert centres. Read More

J Voice 2021 Jun 20. Epub 2021 Jun 20.

Murray State University, Athletics Department, Murray, KY.

Objectives: Exercise-induced dyspnea (EID) can disrupt an athlete's participation and performance in their given sport. Differential diagnosis of EID is often completed using subjective report and may be inaccurate, therefore increasing the frustration and stress of the athlete. This nonexperimental research study was used to determine prevalence of EID and related respiratory symptoms in athletes at a small, Division I university. Read More

J Sports Med Phys Fitness 2021 Aug 22;61(8):1144-1158. Epub 2021 Jun 22.

Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa -

Protection of the health of the athlete is required for high level sporting performance. Acute respiratory illness is the leading cause of illness and can compromise training and competition in athletes. To date the focus on respiratory health in athletes has largely been on acute upper respiratory infections and asthma/exercise induced bronchoconstriction (EIB), while nasal conditions have received less attention. Read More

Can J Anaesth 2021 Jun 14. Epub 2021 Jun 14.

Department of Pediatric Anesthesia, Montreal Children's Hospital, 1001 Blvd Decarie, Montreal, QC, H4A 3J1, Canada.

Purpose: Anesthesia for endotracheal tumour mass resection in pediatric patients is a rare, complex, and high-risk procedure. The purpose of this case report is to emphasize the importance of multidisciplinary team collaboration and close communication during the perioperative management of shared airway surgery.

Clinical Features: A six-year-old boy with no previous history of comorbidity and a 13-yr-old boy with a six-month history of upper respiratory tract infection, refractory asthma, chronic wheeze, and exercise-related dyspnea presented for acute endobronchial tumour mass resection. Read More

Cureus 2021 May 4;13(5):e14843. Epub 2021 May 4.

Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, LTU.

Background While it is increasingly recognized that exercise-induced bronchoconstriction (EIB) affects a substantial proportion of sport participants, the relation of EIB incidence and severity to the type and intensity of exertion remains under-investigated. The aim of this study was to establish the incidence and severity of EIB during a stair race, a highly demanding all-out effort exercise. We hypothesized that a large proportion of participants would develop EIB to this particular high-intensity competition, and that among the predisposing factors, severity of EIB would depend on the level of exertion. Read More

Pediatr Pulmonol 2021 Aug 1;56(8):2512-2521. Epub 2021 Jun 1.

Faculty of Sport Sciences, European University of Madrid, Madrid, Spain.

Objective: Asthma is a chronic disease that may affect physical fitness, although its primary effects on exercise capacity, muscle strength, functionality and lifestyle, in children and adolescents, are still poorly understood. This study aimed to evaluate the differences in cardiorespiratory fitness, muscle strength, lifestyle, lung function, and functionality between asthmatics with exercise symptoms and healthy children. In addition, we have analyzed the association between clinical history and the presence of asthma. Read More

World Allergy Organ J 2021 May 29;14(5):100538. Epub 2021 Apr 29.

Division of Allergy and Clinical Immunology, Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.

Background: Asthma is a common pediatric chronic respiratory disease worldwide. Previous studies showed the prevalence of childhood asthma increased in developed countries as well as in Taiwan in the late 20th century. Recently, several reports from different parts of the world showed a reversed trend in this epidemic of childhood asthma prevalence. Read More

J Asthma Allergy 2021 20;14:397-403. Epub 2021 Apr 20.

Allergy, Asthma & Clinical Immunology, Alfred Health, Melbourne, Victoria, Australia.

Background: Allergy to the omega-5-gliadin component of gluten (O-5-G allergy) often manifests when wheat ingestion is followed by a co-factor, usually exercise. There is no established best approach to management.

Objective: We sought to identify the beneficial effects, firstly of establishing a firm diagnosis, and secondly of stringent management, either by avoiding gluten ingestion altogether or separating it temporally from exercise by at least 4 hours. Read More

Rev Mal Respir 2021 Apr 5;38(4):418-422. Epub 2021 Apr 5.

CIC-CRB 1404, unité de physiologie respiratoire et sportive, centre hospitalier universitaire de Rouen, 1, rue de Germont, 76000 Rouen, France.

Introduction: Vocal Cord Dysfunction (VCD) is a syndrome characterized by paradoxical adduction of the vocal folds during breathing. Its non-specific clinical manifestations frequently lead to misdiagnosis and delay in its treatment. The treatment of VCD is not pharmacological but rehabilitative and remains poorly appreciated. Read More

Ann Allergy Asthma Immunol 2021 Apr 2. Epub 2021 Apr 2.

Department of Allergology, Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Background: Separating individuals with viral-induced wheezing from those with asthma is challenging, and there are no guidelines for children under 6 years of age. Impulse oscillometry, however, is feasible in 4-year-old children.

Objective: To explore the use of impulse oscillometry in diagnosing and monitoring asthma in young children and evaluating treatment response to inhaled corticosteroid (ICS). Read More

Exp Biol Med (Maywood) 2021 Jun 1;246(12):1400-1409. Epub 2021 Apr 1.

Biobehavioral Laboratory, The University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, NC 27599, USA.

Asthma is a chronic inflammatory lung disease affecting approximately 7.7% of the US population. Sex differences in the prevalence, incidence, and severity of asthma have been widely described throughout the lifespan, showing higher rates in boys than girls before puberty, but a reversed pattern in adults. Read More

Adv Exp Med Biol 2021 ;1303:319-331

Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York, USA.

Asthma is a chronic disease characterized by airway hyperresponsiveness, which can be caused by exposure to an allergen, spasmogen, or be induced by exercise. Despite its prevalence, the exact mechanisms by which the airway becomes hyperresponsive in asthma are not fully understood. There is evidence that myosin light-chain kinase is overexpressed, with a concomitant downregulation of myosin light-chain phosphatase in the airway smooth muscle, leading to sustained contraction. Read More

Pediatr Allergy Immunol 2021 Aug 18;32(6):1278-1286. Epub 2021 Apr 18.

Immunoallergy Department, Centro Hospitalar Lisboa Norte, Hospital Santa Maria, Lisbon, Portugal.

Background: Anaphylaxis is increasing at pediatric age; however, its characterization is hampered by underdiagnosis and underreporting. The aim of this study was to identify the causes of anaphylaxis in children and adolescents in Portugal, thus contributing to a better knowledge of its etiology, clinical manifestations, and management.

Methods: During a 10-year period, a nationwide notification system for anaphylaxis was implemented, with voluntary reporting by allergists. Read More

J Allergy Clin Immunol Pract 2021 07 17;9(7):2638-2641. Epub 2021 Mar 17.

Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Md.

The U.S. Food and Drug Administration (FDA) became aware of postmarketing reports of neuropsychiatric adverse events with Singulair (montelukast) use in 2007. Read More

Rev Prat 2020 Nov;70(9):997-1004

Centre Universitaire de Médecine du Sport et Activité Physique Adaptée, CHRU de Nancy, Vandoeuvrelès- Nancy, France ; EA DevAH, Département de Physiologie, Université de Lorraine, Vandoeuvrelès- Nancy, France.

Induced asthma and sport. Asthma is a common condition and the symptoms can be particularly triggered by sports activity, exercise being a current stimulus of bronchoconstriction. Nevertheless, the therapeutic arsenal that physician has and the implementation of international recommendations, based on optimal control of asthma, allow for perfectly adapted care. Read More

World J Pediatr 2021 Apr 17;17(2):189-196. Epub 2021 Mar 17.

Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690, 2º andar, Porto Alegre, RS, CEP 90610-000, Brazil.

Background: Lower exercise tolerance is an important component of asthma and the possible effects of non-invasive ventilation on exercise capacity in individuals with severe therapy-resistant asthma (STRA) are unknown. This study aimed to evaluate the immediate effect of continuous positive airway pressure (CPAP) on exercise tolerance in children with STRA.

Methods: We performed a controlled, randomized, crossover clinical trial including subjects aged 6 to 18 years old diagnosed with STRA. Read More

Pediatr Allergy Immunol 2021 Jul 20;32(5):992-998. Epub 2021 Mar 20.

Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Background: The objective of this study was to evaluate the role of body mass index with regard to exercise performance, exercise-induced bronchoconstriction (EIB), and respiratory symptoms in 7- to 16-year-old children.

Methods: A total of 1120 outdoor running exercise challenge test results of 7- to 16-year-old children were retrospectively reviewed. Lung function was evaluated with spirometry, and exercise performance was assessed by calculating distance per 6 minutes from the running time and distance. Read More

Int J Environ Res Public Health 2021 02 26;18(5). Epub 2021 Feb 26.

Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Department of Physiology, University of Lorraine, F-54000 Nancy, France.

Work-related asthma (WRA) is a very frequent condition in the occupational setting, and refers either to asthma induced (occupational asthma, OA) or worsened (work-exacerbated asthma, WEA) by exposure to allergens (or other sensitizing agents) or to irritant agents at work. Diagnosis of WRA is frequently missed and should take into account clinical features and objective evaluation of lung function. The aim of this overview on pulmonary function testing in the field of WRA is to summarize the different available tests that should be considered in order to accurately diagnose WRA. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2021 Feb 20. Epub 2021 Feb 20.

Clinique Universitaire d'ORL et Chirurgie cervico-faciale, CHU Grenoble Alpes, BP 217, 38043 Grenoble Cedex 09, France; Faculté de médecine, Université Grenoble Alpes, Domaine de la Merci, BP 170, 38042 Grenoble Cedex 9, France; UGA/UMR/CNRS 5309/Inserm 1209, Institut pour l'Avancée des Biosciences, Site Santé Allée des Alpes, 38700 La Tronche, France. Electronic address:

The diagnosis of exercise-induced laryngeal obstruction (EILO) should be suspected when exercise triggers inspiratory stridor. EILO is common in adolescent populations and has a significant impact on sports. Identification of laryngeal obstruction during continuous laryngoscopy during exercise (CLE) is the gold standard diagnostic tool for this disorder, which is not widely known in France. Read More

Respir Med 2021 04 12;179:106329. Epub 2021 Feb 12.

Department of Pulmonology, Jolimont Hospital, 159 Rue Ferrer, 7100, La Louvière, Belgium.

Background: The hyperventilation syndrome (HVS) is characterized by somatic/ psychological symptoms due to sustained hypocapnia and respiratory alkalosis without any organic disease.

Objective: The purpose of this study was to compare ventilatory parameters and symptoms reproducibility during the hyperventilation provocation test (HVPT) and cardiopulmonary exercise test (CPET) as diagnostic tools in patients with HVS, and to identify the most frequent etiologies of the HVS by a systematic assessment.

Methods: After exclusion of organic causes, 59 patients with HVS according to Nijmegen's questionnaire (NQ) score ≥23 with associated hypocapnia (PaCO/PET<35 mm Hg) were studied. Read More

Anaesth Rep 2021 Jan-Jun;9(1):32-36. Epub 2021 Feb 7.

Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore MD USA.

We report the case of a patient who failed to meet tracheal extubation criteria due to low tidal volumes from suspected buffalo chest, which is a single pleural space physiology. This presentation followed the resection of a large pleural mass in a 59-year-old woman with a history of exercise-induced asthma, hypertension and tumour-related chronic respiratory failure. Creation of a pleuro-pleural communication during the resection of this large, unilateral pleural mass led to bilateral pneumothoraces and contributed to patients inability to generate negative inspiratory force leading to failure to meet extubation criteria. Read More