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Children With Asthma: ETS

The urine cotinine level reflects nicotine exposure within a relatively brief time span. Assays of single urine samples do not quantify the average exposure over long periods of time and may not capture intermittent high exposure levels. Despite the overall association between cotinine level and caregiver-estimated ETS of the child, 47% of children whose parents reported that the child typically was exposed to a “moderate” or “large” amount of tobacco smoke (ie, generally children living in homes where smoking was permitted) had measured cotinine levels at baseline that were quite low (ie, < 10 ng/mL). This apparent discrepancy may reflect parental awareness of patterns of ETS exposure that were not reflected in that specific urine sample. buy glycomet

Medication Regimen: The medication regimen was “stepped up” for a total of 54 of the 87 children (62%) as a result of physician assessment at the enrollment visit. The proportions that were stepped up were comparable between the two groups (intervention group, 61%; control group, 63%). The following levels of asthma severity implied by the resultant regimens, using the criteria of the National Asthma Education and Prevention Program guidelines (mild intermittent, prn bronchodilator alone; mild persistent, prn bronchodilator and low-dose inhaled corticosteroid [ICS], or cromolyn/nedocromil, or leukotriene modifier; moderate persistent, prn bronchodilator and medium-dose ICS or low-to-medium dose ICS with or without a long-acting P-agonist or theophylline; severe persistent, prn bronchodilator and oral steroids with or without ICS, a long-acting P-agonist, or theophylline) also were comparable:
1. Intervention group: mild intermittent, 12%; mild, 45%; moderate, 43%; and severe persistent, 0%; and
2. Control group: mild intermittent, 12%; mild, 44%; moderate, 42%; and severe persistent, 2%.
Intervention Participation: A total of 32 of the 44 intervention families (73%) attended all three sessions, 2 other families (5%) attended two sessions, 5 families (11%) attended one session, and 5 families (11%) failed to attend any sessions. The mean time between the first and third sessions was 37.3 days (SD, 11.4 days).