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  1. Article ; Online: Applying Lessons from the COVID-19 Pandemic to Improve Pediatric Asthma Care.

    Lovinsky-Desir, Stephanie / Volerman, Anna

    Pulmonary therapy

    2022  Volume 9, Issue 1, Page(s) 15–24

    Abstract: Asthma is the most common chronic childhood condition and is a risk factor for severe respiratory viral infections. Thus, early during the coronavirus disease 2019 (COVID-19) pandemic there was concern that children with asthma would be at risk for ... ...

    Abstract Asthma is the most common chronic childhood condition and is a risk factor for severe respiratory viral infections. Thus, early during the coronavirus disease 2019 (COVID-19) pandemic there was concern that children with asthma would be at risk for severe COVID-19 illness and that asthma control could worsen as a result of the pandemic. This article seeks to summarize what was learned in the early stages of the pandemic about the impact of COVID-19 on children with asthma. We review evidence from several studies that demonstrated a significant decline in asthma morbidity in the first year of the pandemic. Additionally, we describe several potential mechanisms that may explain the reduced frequency in childhood asthma exacerbations as well as review lessons learned for future management of childhood asthma. While the COVID-19 pandemic initially brought uncertainty, it soon became clear that the pandemic had several positive effects for children with asthma. Now we can apply the lessons that were learned during the pandemic to re-examine asthma care practices as well as advocate for best approaches for asthma management.
    Language English
    Publishing date 2022-11-29
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2364-1746
    ISSN (online) 2364-1746
    DOI 10.1007/s41030-022-00207-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Structural and Social Determinants of Inequitable Environmental Exposures in the United States.

    Gao, Courtney / Sanchez, Kimberly M / Lovinsky-Desir, Stephanie

    Clinics in chest medicine

    2023  Volume 44, Issue 3, Page(s) 451–467

    Abstract: American Indian (AI)/Alaskan Natives, African Americans, and Latino Americans have disproportionally high exposure to harmful environmental conditions as a consequence of unjust laws and policies, systemic racism, residential segregation, and ... ...

    Abstract American Indian (AI)/Alaskan Natives, African Americans, and Latino Americans have disproportionally high exposure to harmful environmental conditions as a consequence of unjust laws and policies, systemic racism, residential segregation, and discrimination. In this review, we draw connections between historical policies and social movements in the United States' history that have been rooted in racism and classism, leading to social isolation and marginalization of AIs, African Americans, and Latino Americans. We then discuss the structural factors that stem from the aforementioned inequities and that contribute to the inequitable distribution of environmental hazards.
    MeSH term(s) Humans ; Black or African American ; Environmental Exposure/adverse effects ; Racism ; Social Determinants of Health ; United States/epidemiology ; Hispanic or Latino ; Systemic Racism ; Health Inequities ; American Indian or Alaska Native ; Policy ; Residential Segregation ; Social Discrimination ; Social Justice
    Language English
    Publishing date 2023-05-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 447455-7
    ISSN 1557-8216 ; 0272-5231
    ISSN (online) 1557-8216
    ISSN 0272-5231
    DOI 10.1016/j.ccm.2023.03.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The use of biologic therapies for the management of pediatric asthma.

    Lovinsky-Desir, Stephanie

    Pediatric pulmonology

    2019  Volume 55, Issue 3, Page(s) 803–808

    Abstract: With better understanding of the role of type 2 inflammation in allergic asthma, there has been progress made in the development of new biologic therapies targeting these specific pathways. This review will consider diagnostic criteria for using biologic ...

    Abstract With better understanding of the role of type 2 inflammation in allergic asthma, there has been progress made in the development of new biologic therapies targeting these specific pathways. This review will consider diagnostic criteria for using biologic therapies for pediatric asthma with special emphasis on populations that are likely to benefit the most from particular therapies. With the exception of the anti-immunoglobulin E, omalizumab, very few studies have been published on the efficacy and safety of biologic therapies in children, particularly anti-interleukin-5 (IL5) and anti-IL4/IL13 therapies. The review will highlight the scarcity of published data in pediatric-specific populations. In addition, we will consider the cost-effectiveness as well as potential long-term consequences of biologic therapies in pediatric asthma.
    MeSH term(s) Animals ; Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Asthma/immunology ; Biological Products/therapeutic use ; Biological Therapy ; Child ; Cost-Benefit Analysis ; Humans ; Immunoglobulin E/immunology ; Interleukin-13/antagonists & inhibitors ; Interleukin-4/antagonists & inhibitors ; Interleukin-5/antagonists & inhibitors ; Th2 Cells/immunology
    Chemical Substances Anti-Asthmatic Agents ; Biological Products ; IL4 protein, human ; IL5 protein, human ; Interleukin-13 ; Interleukin-5 ; Interleukin-4 (207137-56-2) ; Immunoglobulin E (37341-29-0)
    Language English
    Publishing date 2019-12-27
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.24613
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Early career investigator biocommentary-pediatric research.

    Lovinsky-Desir, Stephanie

    Pediatric research

    2018  Volume 85, Issue 1, Page(s) 6

    MeSH term(s) Biomedical Research/education ; Biomedical Research/history ; Career Choice ; Education, Medical/history ; History, 20th Century ; History, 21st Century ; Humans ; Mentors/history ; Pediatricians/economics ; Pediatricians/history ; Pediatrics/education ; Pediatrics/history ; Research Personnel/education ; Research Personnel/history
    Language English
    Publishing date 2018-10-17
    Publishing country United States
    Document type Autobiography ; Historical Article ; Journal Article ; Portrait
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-018-0212-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The impact of environmental injustice and social determinants of health on the role of air pollution in asthma and allergic disease in the United States.

    Cook, Quindelyn / Argenio, Kira / Lovinsky-Desir, Stephanie

    The Journal of allergy and clinical immunology

    2021  Volume 148, Issue 5, Page(s) 1089–1101.e5

    Abstract: There is clear evidence that exposure to environmental air pollution is associated with immune dysregulation, asthma, and other allergic diseases. However, the burden of air pollution exposure is not equally distributed across the United States. Many ... ...

    Abstract There is clear evidence that exposure to environmental air pollution is associated with immune dysregulation, asthma, and other allergic diseases. However, the burden of air pollution exposure is not equally distributed across the United States. Many social and environmental factors place communities of color and people who are in poverty at increased risk of exposure to pollution and morbidity from asthma and allergies. Here, we review the evidence that supports the relationship between air pollution and asthma, while considering the social determinants of health that contribute to disparities in exposures and outcomes.
    MeSH term(s) Air Pollution/adverse effects ; Asthma/epidemiology ; Asthma/etiology ; Disease Susceptibility ; Environmental Exposure/adverse effects ; Humans ; Hypersensitivity/epidemiology ; Hypersensitivity/etiology ; Public Health Surveillance ; Risk Assessment ; Risk Factors ; Social Determinants of Health ; United States/epidemiology
    Language English
    Publishing date 2021-10-29
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 121011-7
    ISSN 1097-6825 ; 1085-8725 ; 0091-6749
    ISSN (online) 1097-6825 ; 1085-8725
    ISSN 0091-6749
    DOI 10.1016/j.jaci.2021.09.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Evolving Strategies for Long-term Asthma Management.

    Lovinsky-Desir, Stephanie / O'Connor, George T

    JAMA

    2020  Volume 324, Issue 22, Page(s) 2265–2267

    MeSH term(s) Adolescent ; Adult ; Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Education, Nursing ; Humans ; Monitoring, Physiologic
    Chemical Substances Anti-Asthmatic Agents
    Language English
    Publishing date 2020-12-03
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2020.16895
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Bullying and lifetime asthma among children and adolescents in the United States.

    Joseph, Sharon P / Borrell, Luisa N / Lovinsky-Desir, Stephanie / Maroko, Andrew R / Li, Sheng

    Annals of epidemiology

    2022  Volume 69, Page(s) 41–47

    Abstract: Purpose: To examine the association of experiencing bullying within the past year with the prevalence of lifetime childhood asthma in U.S. children and adolescents; and whether this association varies with sex of the child and selected socioeconomic ... ...

    Abstract Purpose: To examine the association of experiencing bullying within the past year with the prevalence of lifetime childhood asthma in U.S. children and adolescents; and whether this association varies with sex of the child and selected socioeconomic indicators.
    Methods: We performed secondary analyses using data from the 2018 National Survey of Children's Health participants aged 6 to 17 years (n=19,766). We used log-binomial regression to examine the association between bullying and lifetime childhood asthma before and after controlling for selected covariates. We also tested interactions of bullying with sex and selected socioeconomic indicators.
    Results: Children who experience bullying have a significantly greater probability of having asthma in adjusted analyses. The probability of childhood asthma increased with the frequency of bullying with prevalence ratios starting at 1.28 (95%CI:1.06, 1.55) for children bullied one to two times per year to 1.59 (95%:1.22, 2.09) for those being bullied at least four times per month. This association did not differ with sex of the child or selected socioeconomic indicators.
    Conclusions: We found that children who experienced bullying had a greater probability of having asthma relative to those who never experienced bullying. These findings highlight the impact of psychosocial stressors such as bullying as a nontraditional trigger in children with asthma.
    MeSH term(s) Adolescent ; Asthma/epidemiology ; Bullying ; Child ; Humans ; Prevalence ; Socioeconomic Factors ; United States/epidemiology
    Language English
    Publishing date 2022-02-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1074355-8
    ISSN 1873-2585 ; 1047-2797
    ISSN (online) 1873-2585
    ISSN 1047-2797
    DOI 10.1016/j.annepidem.2022.02.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Urinary metabolites of polycyclic aromatic hydrocarbons and short-acting beta agonist or systemic corticosteroid asthma medication use within NHANES.

    Uong, Stephen P / Hussain, Haider / Thanik, Erin / Lovinsky-Desir, Stephanie / Stingone, Jeanette A

    Environmental research

    2022  Volume 220, Page(s) 115150

    Abstract: Background: Within cross-sectional studies like the U.S. National Health and Nutritional Examination Survey (NHANES), researchers have observed positive associations between polycyclic aromatic hydrocarbon (PAH) exposure and asthma diagnosis. It is ... ...

    Abstract Background: Within cross-sectional studies like the U.S. National Health and Nutritional Examination Survey (NHANES), researchers have observed positive associations between polycyclic aromatic hydrocarbon (PAH) exposure and asthma diagnosis. It is unclear whether similar relationships exist for measures of acute asthma outcomes, including short-term asthma medication use to alleviate symptoms. We examined the relationship between markers of recent PAH exposure and 30-day short-acting beta agonist (SABA) or systemic corticosteroid use, an indicator for recent asthma symptoms.
    Materials and methods: For 16,550 children and adults across multiple waves of NHANES (2005-2016), we fit quasi-Poisson multivariable regression models to describe the association between urinary 1-hydroxypyrene (a metabolite of PAH) and SABA or systemic corticosteroid use. We assessed for effect modification by age group and asthma controller medication use. All models were adjusted for urinary creatinine, age, female/male designation, race/ethnicity, poverty, insurance coverage, and serum cotinine.
    Results: After controlling for confounding, an increase of one standard deviation of 1-hydroxypyrene was associated with greater prevalence of recent SABA or systemic corticosteroid use (PR: 1.06, 95% CI: 1.03-1.10). The results were similar among those with ever asthma diagnosis and across urine creatinine dilution methods. We did not observe effect modification by age group (p-interaction = 0.22) or asthma controller medication use (p-interaction = 0.73).
    Conclusion: Markers of recent PAH exposure was positively associated with SABA or systemic corticosteroid use, across various urine dilution adjustment methods. It is important to ensure appropriate temporality between exposures and outcomes in cross-sectional studies.
    MeSH term(s) Adult ; Child ; Male ; Humans ; Female ; Polycyclic Aromatic Hydrocarbons/urine ; Nutrition Surveys ; Cross-Sectional Studies ; Creatinine ; Asthma/drug therapy ; Asthma/epidemiology
    Chemical Substances 1-hydroxypyrene (N2H6O5V707) ; Polycyclic Aromatic Hydrocarbons ; Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2022-12-23
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 205699-9
    ISSN 1096-0953 ; 0013-9351
    ISSN (online) 1096-0953
    ISSN 0013-9351
    DOI 10.1016/j.envres.2022.115150
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Acute chest syndrome, airway inflammation and lung function in sickle cell disease.

    De, Aliva / Williams, Sanford / Yao, Yujing / Jin, Zhezhen / Brittenham, Gary M / Kattan, Meyer / Lovinsky-Desir, Stephanie / Lee, Margaret T

    PloS one

    2023  Volume 18, Issue 3, Page(s) e0283349

    Abstract: Background: Acute chest syndrome (ACS) is an acute complication in SCD but its effects on lung function are not well understood. Inflammation is a key component of SCD pathophysiology but with an unclear association with lung function. We hypothesized ... ...

    Abstract Background: Acute chest syndrome (ACS) is an acute complication in SCD but its effects on lung function are not well understood. Inflammation is a key component of SCD pathophysiology but with an unclear association with lung function. We hypothesized that children with ACS had worse lung function than children without ACS and aimed to investigate the association of lung function deficits with inflammatory cytokines.
    Methods: Patients enrolled in a previous 2-year randomized clinical trial who had consented to future data use, were enrolled for the present exploratory study. Patients were categorized into ACS and non-ACS groups. Demographic and clinical information were collected. Serum samples were used for quantification of serum cytokines and leukotriene B4 levels and pulmonary function tests (PFTs) were assessed.
    Results: Children with ACS had lower total lung capacity (TLC) at baseline and at 2 years, with a significant decline in forced expiratory volume in 1 sec (FEV1) and mid-maximal expiratory flow rate (FEF25-75%) in the 2 year period (p = 0.015 and p = 0.039 respectively). For children with ACS, serum cytokines IL-5, and IL-13 were higher at baseline and at 2 years compared to children with no ACS. IP-10 and IL-6 were negatively correlated with PFT markers. In multivariable regression using generalized estimating equation approach for factors predicting lung function, age was significantly associated FEV1 (p = 0.047) and ratio of FEV1 and forced vital capacity (FVC)- FEV1/FVC ratio (p = 0.006); males had lower FEV1/FVC (p = 0.035) and higher TLC (p = 0.031). Asthma status was associated with FEV1 (p = 0.017) and FVC (p = 0.022); history of ACS was significantly associated with TLC (p = 0.027).
    Conclusion: Pulmonary function abnormalities were more common and inflammatory markers were elevated in patients with ACS, compared with those without ACS. These findings suggest airway inflammation is present in children with SCD and ACS, which could be contributing to impaired pulmonary function.
    MeSH term(s) Male ; Child ; Humans ; Acute Chest Syndrome/complications ; Anemia, Sickle Cell/complications ; Lung ; Vital Capacity ; Lung Diseases/complications ; Forced Expiratory Volume ; Inflammation/complications ; Cytokines
    Chemical Substances Cytokines
    Language English
    Publishing date 2023-03-30
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0283349
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Social determinants of respiratory health from birth: still of concern in the 21st century?

    Bush, Andrew / Byrnes, Catherine A / Chan, Kate C / Chang, Anne B / Ferreira, Juliana C / Holden, Karl A / Lovinsky-Desir, Stephanie / Redding, Gregory / Singh, Varinder / Sinha, Ian P / Zar, Heather J

    European respiratory review : an official journal of the European Respiratory Society

    2024  Volume 33, Issue 172

    Abstract: Respiratory symptoms are ubiquitous in children and, even though they may be the harbinger of poor long-term outcomes, are often trivialised. Adverse exposures pre-conception, antenatally and in early childhood have lifetime impacts on respiratory health. ...

    Abstract Respiratory symptoms are ubiquitous in children and, even though they may be the harbinger of poor long-term outcomes, are often trivialised. Adverse exposures pre-conception, antenatally and in early childhood have lifetime impacts on respiratory health. For the most part, lung function tracks from the pre-school years at least into late middle age, and airflow obstruction is associated not merely with poor respiratory outcomes but also early all-cause morbidity and mortality. Much would be preventable if social determinants of adverse outcomes were to be addressed. This review presents the perspectives of paediatricians from many different contexts, both high and low income, including Europe, the Americas, Australasia, India, Africa and China. It should be noted that there are islands of poverty within even the highest income settings and, conversely, opulent areas in even the most deprived countries. The heaviest burden of any adverse effects falls on those of the lowest socioeconomic status. Themes include passive exposure to tobacco smoke and indoor and outdoor pollution, across the entire developmental course, and lack of access even to simple affordable medications, let alone the new biologicals. Commonly, disease outcomes are worse in resource-poor areas. Both within and between countries there are avoidable gross disparities in outcomes. Climate change is also bearing down hardest on the poorest children. This review highlights the need for vigorous advocacy for children to improve lifelong health. It also highlights that there are ongoing culturally sensitive interventions to address social determinants of disease which are already benefiting children.
    MeSH term(s) Child ; Child, Preschool ; Humans ; China ; Europe ; Morbidity ; Poverty ; Social Determinants of Health ; Female ; Pregnancy ; Infant, Newborn ; Infant ; Prenatal Exposure Delayed Effects ; Respiration Disorders
    Language English
    Publishing date 2024-04-10
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1077620-5
    ISSN 1600-0617 ; 0905-9180
    ISSN (online) 1600-0617
    ISSN 0905-9180
    DOI 10.1183/16000617.0222-2023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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