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Minami-rinkan, Japan

Sasaki M.,Tokyo Metropolitan Childrens Medical Center | Yoshida K.,Tokyo Metropolitan Childrens Medical Center | Adachi Y.,University of Toyama | Furukawa M.,Tokyo Metropolitan Childrens Medical Center | And 4 more authors.
Pediatric Allergy and Immunology | Year: 2014

Background: Although achieving and maintaining control of asthma is considered to be the goal of asthma treatment, determinants of asthma control are not fully understood. Our aim was to assess factors associated with asthma control among paediatric patients in the general population. Methods: In June 2012, a Web-based survey was conducted to identify Japanese children aged 6 to 11 yr who currently have asthma and evaluate control of their disease using the Childhood Asthma Control Test (C-ACT). Associations were evaluated among uncontrolled asthma (C-ACT score <20) between environmental factors, demographics and comorbid allergic diseases. Results: Among the 3066 children with current asthma, 447 (14.6%) had uncontrolled asthma. Multivariable analysis identified factors such as low birthweight (adjusted OR 1.65, 95% CI 1.25-2.18), obesity (adjusted OR 1.44, 95% CI 1.05-1.99) and pet ownership before birth (adjusted OR 1.68, 95% CI 1.24-2.29) to be associated with uncontrolled disease. Comorbid allergic diseases, especially rhinitis were a significant risk of uncontrolled asthma (adjusted OR for severe rhinitis: 3.88, 95% CI 2.50-6.00). The severity of rhinitis symptoms was inversely correlated with the C-ACT score (p < 0.001). Conclusions: A population-based Web survey showed an association between several factors and the control of paediatric asthma. The assessment of these factors may help identify the children at risk with uncontrolled asthma. © 2014 John Wiley & Sons A/S.

Ebisawa M.,Clinical Research Center for Allergy and Rheumatology | Shibata R.,Fukuoka National Hospital | Sato S.,Clinical Research Center for Allergy and Rheumatology | Borres M.P.,Phadia AB | And 2 more authors.
International Archives of Allergy and Immunology | Year: 2012

Background: There are contradictory results regarding the clinical usefulness of the determination of IgE antibodies to ω-5 gliadin in children with a suspicion of wheat allergy (WA). Methods: The study comprised 311 children and young adults with suspected wheat intolerance treated at three separate pediatric clinics and, with the exception of 25, were found to be positive in specific IgE antibody determinations to wheat. Their ages ranged from 6 months to 20.4 years (median age, 2.3 years). Possible relationships between IgE antibodies to ω-5 gliadin and a physician's diagnosis of WA and challenge symptoms were studied. Results: The mean concentration of IgE antibodies to ω-5 gliadin was 1.2 kU A/l in WA patients and <0.35 kU A/l in patients without WA (p < 0.0001). Seventy-two percent of the WA patients had positive ω-5 gliadin levels and 75% of the patients without WA had negative levels. Logistic regression showed a significant relationship between the probability of WA and the concentration of IgE antibodies to ω-5-gliadin with a 2.6-fold (95% CI: 2.0-3.3) increased risk. Age was an important factor to consider as the risk of WA increased 5.4-fold (95% CI: 1.4-21) for children ≤1 year of age and 2.5-fold (95% CI: 2.0-3.2) for children >1 year of age with increasing levels of IgE. Conclusion: Detection of IgE to ω-5 gliadin seems to be associated with responsiveness to the challenge test and is particularly useful in infants with a suspicion of WA. Copyright © 2011 S. Karger AG, Basel.

Okada K.,Fukuoka National Hospital | Miyazaki C.,Fukuoka West Rehabilitation Center for Children | Kino Y.,Chemo Sero Therapeutic Research Institute Kaketsuken | Ozaki T.,Konan Kosei Hospital | And 2 more authors.
Journal of Infectious Diseases | Year: 2013

Background. Phase II and III clinical studies were conducted to evaluate immunogenicity and safety of a novel DTaP-IPV vaccine consisting of Sabin inactivated poliovirus vaccine (sIPV) and diphtheria-tetanus-acellular pertussis vaccine (DTaP).Methods. A Phase II study was conducted in 104 healthy infants using Formulation H of the DTaP-sIPV vaccine containing high-dose sIPV (3, 100, and 100 D-antigen units for types 1, 2, and 3, respectively), and Formulations M and L, containing half and one-fourth of the sIPV in Formulation H, respectively. Each formulation was administered 3 times for primary immunization and once for booster immunization. A Phase III study was conducted in 342 healthy infants who received either Formulation M + oral polio vaccine (OPV) placebo or DTaP + OPV. The OPV or OPV placebo was orally administered twice between primary and booster immunizations.Results. Formulation M was selected as the optimum dose. In the Phase III study, the seropositive rate was 100% for all Sabin strains after primary immunization, and the neutralizing antibody titer after booster immunization was higher than in the control group (DTaP + OPV). All adverse reactions were clinically acceptable.Conclusions. DTaP-sIPV was shown to be a safe and immunogenic vaccine.Clinical Trials Registration. JapicCTI-121902 for Phase II study, JapicCTI-101075 for Phase III study (http://www.clinicaltrials.jp/user/cte-main.jsp). © 2013 The Author 2013. All rights reserved.

Recently, the fraction of exhaled nitric oxide (FENO), which can be measured easily and noninvasively even in children, has attracted attention as a method of evaluating airway inflammation. The aim of this study was to investigate the relationship between compliance with inhaled corticosteroids (ICS) before a summer camp for asthmatic children and the changes in the FENO during camp. Fifty asthmatic children (26 boys and 24 girls) aged 6-12 years old were recruited from the Fukuoka National Hospital Summer Camp between 2008 and 2010. We measured their FENO on the first and last day of camp. The children were taught appropriate inhalation methods by pediatric pulmonologists and nurses and performed ICS under their supervision every day during the camp. Before the camp, we asked the participants to complete a questionnaire regarding the use of ICS. The participants were classified into four groups according to their adherence to this therapy. The changes in FENO were then examined and compared among the groups. The FENO measured on the last day of camp was significantly lower than that measured on the first day of camp among children who tended to forget to perform ICS. However, no significant difference in the FENO measurements were observed during the camp, when the children were performing ICS every day. The FENO decreased significantly after only four days of camp in the poor compliance group. Therefore, teaching children the appropriate method for inhaling ICS is important, especially for children who tend to forget to perform ICS.

Ueda K.,Japan National Institute of Environmental Studies | Nitta H.,Japan National Institute of Environmental Studies | Odajima H.,Fukuoka National Hospital
Environmental Health and Preventive Medicine | Year: 2010

Objective: We assessed the association of fluctuations in ambient temperature, air pollutants, and Asian dust (AD) events with the hospitalization of children for asthma in Fukuoka City. Methods: Data on emergency hospitalizations of children under 12 years of age for asthma were collected at Fukuoka National Hospital. We obtained air pollution and meteorological data for Fukuoka from the National Institute for Environmental Studies. Using a time-stratified case-crossover design, we estimated odds ratios (ORs) of hospitalization corresponding to a unit change in weather variables and concentration of air pollutants. We also evaluated the effect of AD events on asthma hospitalization with data stratified by days with or without an AD event. Results: There were 3427 hospitalizations and 106 AD events from 2001 to 2007. We found that within-day temperature change rather than ambient temperature was associated with asthma exacerbation. In the multi-pollutant model, the ORs per 1°C within-day drop and rise during the period from the hospitalization day to 3 days previously (lag3) were 1.033 [95% confidence interval (CI) 1.005-1.063] and 1.027 (95% CI 0.995-1.060), rspectively. A 10 μg/m 3 increase in suspended particulate matter (SPM) and nitrogen dioxide (NO2) at lag2-lag3 were significantly associated with an increase in asthma hospitalization with ORs of 1.041 (95% CI 1.013-1.070) and 1.112 (95% CI 1.022-1.209), respectively. We did not observe a significant association between asthma hospitalization and AD events. Conclusions: This study showed that temperature fluctuation, SPM, and NO2 were associated with an increased risk of hospitalization of children for asthma. © 2010 The Japanese Society for Hygiene.

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