Search

A new version of the Japanese pediatric guideline for the treatment and management of bronchial asthma was published in Japanese at the end of 2011. The guideline sets the pragmatic goal for clinicians treating childhood asthma as maintaining a 'well-controlled level' for an extended period in which the child patient can lead a trouble-free daily life, not forgetting the ultimate goal of obtaining remission and/or cure. Important factors in the attainment of the pragmatic goal are: (i) appropriate use of anti-inflammatory drugs; (ii) elimination of environmental risk factors; and (iii) educational and enlightening activities for the patient and caregivers regarding adequate asthma management in daily life. The well-controlled level refers to a symptom-free state in which no transient coughs, wheezing, dyspnea or other symptoms associated with bronchial asthma are present, even for a short period of time. As was the case in the previous versions of the guideline, asthmatic children younger than 2 years of age are defined as infantile asthma patients. Special attention is paid to these patients in the new guideline: they often have rapid exacerbation and easily present chronic asthmatic conditions after the disease is established. [ABSTRACT FROM AUTHOR]

Background: Asthma is the most common chronic diseases in school-aged children in Japan. It is important to consider health-related quality of life (QoL) among children with chronic diseases when treatment decisions are made. Methods: A school-based survey was conducted in randomly selected public schools in Tokyo by using a KINDL® questionnaire for evaluating QoL and the international study of asthma and allergy on childhood (ISAAC) questionnaire, which is designed for comparing the asthma prevalence in various countries, from May to June in 2005. We recruited approximately 10% of the total children 6-7-years-old and 13-14-years-old living in Tokyo for sampling. Results: Response rate of this questionnaire was 86% (22,645 children) in the 6-7-year-old group and 64% (12,879 children) in the 13-14-year-old group. Comparing asthmatics with non-asthmatics in the same age, QoL of children with asthma was significantly impaired. The severity of QoL of children with asthma was significantly impaired. QoL of children with exercise-induced asthma (EIA) were more significantly impaired than ones without EIA and showed lower scores in the categories of physical functioning, emotional and school activities than those without EIA. Of note, QoL was more impaired in the EIA-positive group among severe asthmatics, suggesting that QoL of children with even severe asthma could be improved when EIA is appropriately controlled. Conclusions: Existence of EIA among asthmatic children most strongly impairs their QoL. We should be more cautious about the management of EIA. [ABSTRACT FROM AUTHOR]

The Niigata Institute for Sports Medicine, established in 2002, conducted the medical examination and consultation of 4474 young athletes, mainly students of junior and senior high schools, in Niigata Prefecture from August, 2002 to April, 2006. When they were found to have clinico-pathologically diseases or disorders, we took care of them by ourselves in our clinic or introduced them to Niigata University Hospital or regional hospitals close to their residence. It is important to note that we have continued to maintain contact with the staff of these hospitals and to follow up the condition of these athletes until the present time. Concerning the research projects, the frequency of bronchial asthma and therapeutic trials for latent or occult asthma in young athletes and the effects of obesity or metabolic syndrome on chronic kidney disease, particularly chronic glomerulonephritis, were reported in this lecture. These subjects have been overlooked so far, but will become important issues for strengthening the ability of players with these handicaps. [ABSTRACT FROM AUTHOR]