Japanese Journal of Allergology

Background: Although the age of onset of childhood bronchial asthma is known to be decreasing, the age of onset of adult-onset asthma has yet to be comprehensively investigated. Methods: We examined the records of 5067 asthma patients (2047 males) aged 16 years or older who visited our clinic during a recent 9-year period (1997 through 2005). The definition of adult-onset asthma (ie, new-onset persistent asthma developing at 20 years or older) was based on the Akiyama classification. We analyzed the associations between a number of putative risk factors and age of onset. Results: Although the age of onset of adult-onset asthma did not change significantly in males (43.0±13.8 [mean±SD] years in 1997 vs 44.5±15.2 years in 2005), a significant increase was observed in females (40.6±15.3 years in 1997 vs 43.5±16.1 years in 2005, p<0.001). Conclusion: Our data indicate that, during a recent 9-year period, the age of onset of adult-onset asthma appears to be increasing in females, most likely because the numbers of female asthmatics who smoke, have a high total serum IgE level (IgE≥300IU/ml), have a high mite-specific IgE antibody score (RAST score≥2), and have complications from or a past history of allergic rhinitis have declined.

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Background: To achieve a good control for asthma, cooperation of pharmacists is necessary. It is important to establish the system that the patients easily obtain advice about asthma from pharmacists and to spread the guideline. Methods: For the first step, we explore the knowledge and usage of asthmatic guideline among pharmacists in the drug stores in this study. The questionnaires were distributed to 465 drug stores in the Seibu, minato-ku and bunnkyo-ku, Tokyo. Results: The knowledge of guideline was 79% but the existence of guideline booklet at the pharmacy was 24%. The major demand at the pharmacy was to distribute pamphlet around 10 pages which contained treatment at the pregnancy and prevention of asthma. Discussion: To spread usage of asthmatic guideline at the pharmacy, newly-devised plan is required.

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Background: We have been conducting a two-day in-hospital parental education program-"Skin Care School"-on childhood atopic dermatitis since April 2007. The program comprises three lecture- and- practical session courses on skin care, the correct skin-cleaning procedure, and the application of ointments based on the "Finger Tip Unit." The program addresses caregivers of patients less than six years old suffering from moderate to severe atopic dermatitis. Methods: To evaluate the effectiveness of this program, questionnaires were administered to 56 participants before, immediately after, one month after, and six months after completion of the program. Results: Although the participants had received doctors' instructions on the amount of the ointments to be applied, most of them recognized on completing the program that they had been applying less amounts than prescribed. They added that the symptoms of the skin conditions, such as pruritis and sleeplessness, improved in one month after proper application and stabilized for six months. Moreover, the amounts of topical corticosteroid ointments required decreased following one month of treatment and reduced further in six months. Conclusion: This educational program was effective in imparting a sound understanding of skin care to the caregivers during their wards' short hospitalization. Appropriate skin care comprises cleaning the skin properly and applying adequate amounts of corticosteroid ointment and skin moisturizer, which results in improvements in conditions like eczema and a reduced requirement for corticosteroids.

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Background: Japanese cedars and grass are famous for causing pollen allergy with antigen. But recently, many other antigens causing pollen allergy are coming to the front. We investigated positive ratios of pollen antigens of the consultation patients. Methods: 151 subjects (90 males and 61 females) were examined for allergic reactions by a scratch test. We used Yasueda's method to take pollen extracts. Results: A positive ratio of Cocksfoot (Dactylis glomerata) (51%) was higher than that of cedar (Cryptomeria japonica) (45%). Each positive ratio of birch (Betula platyphylla var. japonica), walnut (Juglans mandshurica), sheep sorrel (Rumex acetosella), oak (Quercus serrata) and willow (Salix spp.) was 13%, 8%, 9%, 11%, 10%, respectively. These were lower than that of Cocksfoot or cedar, but higher than that of Fungi: Alternaria, Candida and Aspergillus. Conclusion: Grass (Gramineae) pollens and pollens of birch, walnut, sheep sorrel, oak and willow, which are in the air around the same time as grass pollens, are important in clinical medicine, because of their high positive ratio. And in this research, each positive ratio is overlapping, so it is necessary to search an antigen hemology.

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