Severe bronchiolitis profiles and risk of asthma development in Finnish children.

BACKGROUND: Recent studies support the existence of several entities under the clinical diagnosis of bronchiolitis. Among infants with severe bronchiolitis, distinct profiles have been differentially associated with development of recurrent wheezing by age 3 years. However, their associations with actual asthma remain unclear. OBJECTIVE: Our aim was to study the association between severe bronchiolitis profiles identified by using a clustering approach and childhood asthma. METHODS: Among 408 children (aged <2 years) hospitalized with bronchiolitis in Finland (in 2008-2010), latent class analysis identified 3 bronchiolitis profiles: profile A (47%), characterized by history of wheezing and/or eczema, wheezing during acute illness, and rhinovirus infection; profile BC (38%), characterized by severe illness and respiratory syncytial virus infection; and profile D (15%), characterized by the least severely ill children, including mostly children without wheezing and with rhinovirus infection. The children were followed by questionnaire 4 years later (86% [n = 348]) and through a nationwide social insurance database 7 years later (99% [n = 403]). Current asthma at the 4- and 7-year follow-ups was defined by regular use (according to parental report and medical records) or purchase (according to the social insurance database) of asthma control medication. RESULTS: Compared with risk of current asthma associated with profile BC, we observed increased risk of current asthma associated with profile A both at the 4-year follow-up (age- and sex-adjusted odds ratio = 2.42 [95% CI = 1.23-4.75]) and at the 7-year follow-up (age- and sex-adjusted odds ratio = 3.14 [95% CI = 1.33-7.42]). No significant difference in asthma risk was observed between profile D and profile BC. CONCLUSION: These longitudinal results provide further support for an association between a distinct severe bronchiolitis profile (characterized by a history of wheezing and/or eczema and rhinovirus infection) and risk of development childhood asthma.

Opinion paper: Exercise for healthy aging.

The physical demands of daily life in developed countries have decreased remarkably during the last two centuries. General leisure time has increased and the age at retirement has decreased. General health has improved and life expectancy has increased. Most people can expect to live 20-30 years after retirement. By 2050, one in four people in Europe and North America will be aged 65 or over. Furthermore, women live longer than men. Generally, the physical demands on older women will be low. Thus, their physical fitness will decline, which in turn will affect a variety of organ systems and functions, and so impact on mental health, quality of life and independent living. This opinion paper explores exercise strategies for healthy ageing.

Rhinovirus C Is Associated With Severe Wheezing and Febrile Respiratory Illness in Young Children.

BACKGROUND: Rhinovirus is the most common virus causing respiratory tract illnesses in children. Rhinoviruses are classified into species A, B and C. We examined the associations between different rhinovirus species and respiratory illness severity. METHODS: This is a retrospective observational cohort study on confirmed rhinovirus infections in 134 children 3-23 months of age, who were enrolled in 2 prospective studies on bronchiolitis and acute otitis media, respectively, conducted simultaneously in Turku University Hospital, Turku, Finland, between September 2007 and December 2008. RESULTS: Rhinovirus C is the most prevalent species in our study, and it was associated with severe wheezing and febrile illness. We also noted that history of atopic eczema was associated with wheezing. CONCLUSIONS: Our understanding of rhinovirus C as the most pathogenic rhinovirus species was fortified. Existing research supports the idea that atopic characteristics are associated with the severity of the rhinovirus C-induced illness.