Study on asthma control status in children with bronchial asthma and allergic rhinitis

149. Stout JW, Visness CM, Enright P., Lamm C. et al (2006). Classification of severity in children: the contribution of pulmonary function testing. Archives of pediatrics & adolescent medicine, 160(8), 844-850.

150. Siroux V., Basagada X., Boudier A. et al (2011). Identifying adult asthma phenotypes using a clustering approach. European Respiratory Journal, 38(2), 310-317.

151. Agache I., and Akdis CA (2016). Endotypes of allergic diseases and asthma: an important step in building blocks for the future of precision medicine. Allergology international, 65(3), 243-252.

No.:…………………. BA Code:………………

MEDICAL RECORD RESEARCH (first time)

Date ……, month….., year 20…

A. Administration

Patient's full name:……………………………………Age:.......................... Date of birth:……………………………………………………………………... Gender: male □ female □ Ethnicity: Kinh □, other ethnicities □…………....... Address:……………………………………………………………………….... Mother's full name:…………………………………………Phone number:………………….. Educational level: ……………………Occupation: ……………………………… Father's full name:………………………………………….Phone number:………………….. Educational level: ……………………Occupation: ………………………………

B. Prehistory

Personal history

Obstetrics: Second child:……… Normal delivery □, Caesarean section □, Intervention □

Full term □ Preterm □ Birth weight: ……..kg Vaccinations: Full □, No □

Exclusive breastfeeding for the first 4-6 months: yes □, no □. Exclusive formula feeding from birth: yes □, no □. Formula feeding + breast milk for the first 4-6 months: yes □, no □. Medical conditions: ………………………………………………………….. Family history

Hen	VMDU	sinus	VDCD	Medal	DU medicine	DU food	Other
Dad
Mom
Brothers and sisters
Other people

Maybe you are interested!

B. History of asthma and allergic rhinitis History of asthma

When did the child first cough and wheeze (months old) -----

Number of wheezing episodes in 1 year:

_year old

Diagnosis of asthma is confirmed when:

Diagnosed with asthma: Step 1 □, Step 2 □, Step 3 □, Step 4 □

In the past year: HSCC:Emergency times: _Hospitalization: _Times Hospitalization: _day

Wheezing

 Night:  Waking up at night

Every night 1 time/week 1 time/month 2 times/week 2 times/month

 Daytime:  Early morning

 Daily 1 time/week 1 time/month  2 times/week  2 times/month

 Chest pain  Chest heaviness (older children)

 Average number of days of cough/acute episode ….. Cough episode > 10 days  Cough episode < 10 days

 No symptoms between episodes  Sometimes symptoms persist between episodes

Month of year when wheezing occurs

 Spring  Summer  Fall  Winter  Weather changes

Wheezing and wheezing often occur when:

Asthma triggers


Weather change	Yes □	No □
Pollen Inhalation	Yes □	No □
Children inhale cigarette smoke	Yes □	No □
Inhaling other types of fumes: incense, perfume, paint	Yes □	No □
Breathe polluted air when going out	Yes □	No □
After the child exerts himself	Yes □	No □
High fever, runny nose	Yes □	No □
When children are sad, angry, scared	Yes □	No □
Eat allergic food	Yes □	No □
After using the medicine	Yes □	No □
Drug name:…………………………

Medications the child is taking before the first visit

Name of drug used

Dosage	Time of use	Daily use	Use intermittently
ICS
Oral corticosteroids
Corticoid TM
SABA
LABA
Leukotriene
Corticosteroid nasal spray
H1 resistance
Vasoconstrictor

Yes □

No □.
Arbitrary increase in dose	Yes □	No □.
Reduce dose on your own	Yes □	No □.
Quit smoking	Yes □	No □.
Forgot medication	Yes □	No □

Use medication as prescribed by your doctor

Does the child use other medications to treat asthma? Yes □, No □ Medication name:

…………….

Children with allergic diseases such as:

Eczema □, GERD □, Drug allergies □ Food allergies □ Aspirin intolerance □ Allergic rhinitis □

VMDU medical history

First appearance of sneezing, runny nose, itchy nose (months old): ……….. Diagnosis of VMDU year: ………. Age

Symptoms in the nose

Sneezing □ Itchy nose □ Runny nose □

Nasal voice □ Nasal congestion □ Difficulty breathing □ Decreased sense of smell □

Extranasal symptoms?

Itchy eyes □ Red eyes □ Dry cough □ Itchy throat □ Headache □

Other symptoms:

Snoring □ Sleep apnea □ Daytime sleepiness □

What factors cause VMDU symptoms in children?

Weather change

Have	□ No
Dust inhalation	Have	□ No
Smoke (cigarettes, incense, perfume, paint)	Have	□ No
Pollen exposure	Have	□ No
Dog and cat contact	Have	□ No
Feather contact	Have	□ No
Eat foods that cause allergies	Have	□ No

Medication (name) □ Medication name: ………………………………..

When (month) does VMDU appear?

 Spring  Summer  Fall  Winter  Weather changes

VMDU Classification

Interruption □

< 4 days/week □	and/or	< 4 weeks/year □
Persistent □	> 4 days/week	and	> 4 weeks/year □

Do VMDU symptoms cause the following effects on my child?

Insomnia Yes □ No □

Learning Impact Yes □ No □

Impact on daily activities Yes □ No □ Discomfort due to nasal symptoms Yes □ No □ Grade: Mild Normal sleep and no symptoms above

Moderate - severe Has 1 or more of the above symptoms

Tobacco related issues

Child lived in same apartment with smoker under 12 months of age Yes □, No □

Smokers: father □, mother □, ……………………. Smokers often smoke indoors

Yes □, No □

Smokers who regularly smoke outside the home Yes □, No □

Does the child smoke? Yes □, No □

Child's residence:

Housing 1. Urban □ 3. Rural □ 2. Mountainous area □ Around the house there are: 1. Factory □ 2. Mining area, ore □ House has: dogs □, cats □ birds, poultry □ House uses: Mattress □ Carpet □ Stuffed animals, feather coat □ House uses honeycomb coal stove □

C. Clinical examination

1. General condition:

Province, good contact

□ .Temperature:………..◦C

Skin color:……………

Mucous membrane: pink

□, pale □

Peripheral lymph nodes: yes

□, no □

Weight:…………..kg, Height:…………cm BMI:…………

Cardiovascular: Heart rate:………..beats/minute Fast □, Slow □, Normal □ Heart sounds: normal □, abnormal □ …………………

Respiration: Chest: normal, raised □, collapsed □

Respiratory rate:………….times/minute Fast □, Slow □, normal □ RRPN: clear □, decreased□ SpO2:………………….

Pulmonary rales: moist rales □, wheezing rales □, snoring rales □, bronchial rales □

Nasopharynx: Mucosa: pale □ Red □ Normal □ Nasal turbinate: edematous □ hypertrophied □ Normal □

Nasal polyps: Yes □ No □

Deviated septum: Yes □ No □

Exudate: Clear mucus □ Cloudy mucus □ None □ Enlarged tonsils: Yes □ No □

VA: Yes □ No □

Other parts:………………………………………………………

D. Paraclinical

1. Complete blood count

Visit

BC	N	L	EO	HC	Hb	TC
1

2. Blood Ig E concentration:…………………Normal □, high □.

3. Skin prick test:

Allergen

Result	Allergen	Result
Positive evidence	……………mm	Proof	……………….mm
D.pter	……………mm	D.farine	……………….mm
Blomia	……………mm	Cockroach	……………….mm
Dog	……………mm	Cat	……………….mm
Aspegilus fungus	……………mm	Pollen	……………….mm

4. First measurement of respiratory function and NNO, FENO

Index

Before bronchial reversibility test (2 puffs of ventolin through spacer)	After test
FEV1
FVC
FEV1/FVC
PEAK FLOW
FENO nose
Bronchial FENO

E. Diagnosis

Assessment of asthma severity and control according to GINA at first visit

Characteristics: In the past 4 weeks, the patient has had

Reply	Full control	Partial control	No control
Daytime symptoms > 2 times/week?	Yes □ No □	Do not have	There are 1- 2 characteristic	There are 3 - 4 characteristic
Any night waking due to asthma?	Yes □ No □
Need symptom relief > 2 times/week?	Yes □ No □

ACT score: ……… (questionnaire attached)

Assessment of asthma control with VMDU

CARAT score: ……… (questionnaire attached)

Risk factors for poor asthma outcomes

Risk factors for an asthma attack in the next few months

Risk factors for fixed airflow limitation

Risk factors for drug side effects

Uncontrolled asthma symptoms

 Have  1 severe exacerbation/12 months

 had NKQ placed or was in HSCC

 SABA > 200 doses/month

 Inadequate ICS: not prescribed, poor compliance, incorrect spray technique

 Low FEV1 < 60%

 Exposure: cigarette smoke, pollution, allergens

 Associated diseases: sinusitis, food allergies, obesity

obesity

 Lack of ICS treatment

 Exposure to cigarette smoke, chemicals, etc.

 Low initial FEV1

 High eosinophils in blood and sputum

System:

Oral corticosteroids: No:

High dose ICS: None: Topical:

 Gargle (or drink water) after spraying:

No Yes

 Wipe face and eyes when using ICS spray or through mask:

No Yes

Asthma

Symptom

Level 1

Asthma symptoms or SABA requirement < 2 times/month No nighttime awakenings in the past month; No risk factors for exacerbations;

No asthma attacks in the past year

Level 2

Asthma symptoms are few, but

Have a risk factor for an exacerbation

Asthma symptoms or SABA requirement between > 2 times/month and < 2 times/week

Or waking up at night due to asthma ≥ 1 time/month

Level 3

Asthma symptoms or SABA requirement > 2 times/week

Level 4

Daily asthma symptoms;

Or waking up at night due to asthma ≥ 1 time/week

Diagnosis of asthma

 During the attack

 Out of attack	 B	infection
 No control	 Partial control	 K	H. control all
 There are risk factors	 No risk factors
 Asthma level 1	 Asthma level 2	 H	level 3	 Asthma level 4
Asthma severity according to GINA Mild: Well controlled with first and second line treatment			Yes □ No □
Moderate: Control with third-line treatment			Yes □ No □
Severe: Requires level 4 treatment			Yes □ No □
Not controlled by line 4 treatment			Yes □ No □

F. TREATMENT

Attack relief: Ventolin: …….puffs each time, ……times a day.

Prevention: ………………………………………………….. Comorbidities: …………………………………………….. Control of triggers:……………………………….. Asthma action plan:………………………………….. Follow-up date: ………………………………………………

Study on asthma control status in children with bronchial asthma and allergic rhinitis - 21

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