The study, published in the journal Pediatrics, raises the possibility that measurement of tobacco exposure could be used in clinical practice to target smoking cessation efforts and reduce the likelihood of future hospitalizations.
To determine tobacco exposure, the researchers at Cincinnati Children's Hospital Medical Center and Penn State Milton S. Hershey Children's Hospital measured cotinine in the blood and in saliva of more than 600 children. Cotinine is a substance produced when the body breaks down nicotine and provides a scientific assessment of tobacco exposure.
"The ability to measure serum and salivary cotinine levels presents the possibility of an objective measure that can be obtained when a child is seen in the emergency department or in the hospital and may be used to predict future hospitalizations," says Robert Kahn, MD, MPH, associate director of general and community pediatrics at Cincinnati Children's and senior author of the study.
"Such a measure for exposure to tobacco smoke could be used to target specific interventions at caregivers of those children before discharge from the hospital. Several interventions, including parental counseling and contact with the primary care physician, could be adopted in clinical practice."
The study is part of the Greater Cincinnati Asthma Risks Study, which seeks to understand the causes of hospital readmission, particularly for low income and minority children. The researchers studied children between the ages of 1 and 16 admitted to Cincinnati Children's between August 2010 and October 2011. Serum and salivary cotinine levels were taken during their hospital stay, and their primary caregivers were asked about tobacco exposure. All children were followed for at least 12 months to see if they were readmitted to the hospital.
The researchers found that there was no correlation between caregiver report of tobacco exposure and readmission. But a more scientific analysis of actual secondhand exposure via measurement of cotinine in the blood and saliva demonstrated a readmission risk in children exposed to secondhand smoke more than twice that of children not exposed.
"Of the 619 children in the study, 76 percent were covered by Medicaid," says Judie Howrylak, MD, PhD, a physician at Hershey Children's and lead author of the study. "Certainly there could be a financial incentive for insurance companies to help caregivers quit smoking, rather than pay the downstream costs of a future asthma readmission."
The study was funded by a grant from the National Institutes of Health (1RO1A188116), a flight Attendant Medical Research Foundation Young Clinical Scientist Award, and a National Institute of Environmental Health Sciences grant (1K23ES016304).
As part of the NIH-funded grant, Dr. Kahn is also studying the association between exposure to traffic-related air pollution and hospital readmission for asthma, and racial differences in pediatric asthma readmission, with a focus on the role of financial and social hardships. He hopes to publish these studies within the coming year.
Analysis of cotinine levels was done at Boston Children's Hospital.
About Cincinnati Children's
Cincinnati Children's Hospital Medical Center ranks third in the nation among all Honor Roll hospitals in U.S.News and World Report's 2013 Best Children's Hospitals ranking. It is ranked #1 for cancer and in the top 10 for nine of 10 pediatric specialties. Cincinnati Children's, a non-profit organization, is one of the top three recipients of pediatric research grants from the National Institutes of Health, and a research and teaching affiliate of the University of Cincinnati College of Medicine. The medical center is internationally recognized for improving child health and transforming delivery of care through fully integrated, globally recognized research, education and innovation. Additional information can be found at http://www.cincinnatichildrens.org. Connect on the Cincinnati Children's blog, via Facebook and on Twitter.
Jim Feuer | EurekAlert!
New evidence: How amino acid cysteine combats Huntington's disease
27.07.2016 | Johns Hopkins Medicine
Cord blood outperforms matched, unrelated donor in bone marrow transplant
27.07.2016 | University of Colorado Anschutz Medical Campus
Transparent electronics devices are present in today’s thin film displays, solar cells, and touchscreens. The future will bring flexible versions of such devices. Their production requires printable materials that are transparent and remain highly conductive even when deformed. Researchers at INM – Leibniz Institute for New Materials have combined a new self-assembling nano ink with an imprint process to create flexible conductive grids with a resolution below one micrometer.
To print the grids, an ink of gold nanowires is applied to a substrate. A structured stamp is pressed on the substrate and forces the ink into a pattern. “The...
A new Fraunhofer MEVIS method conveys medical interrelationships quickly and intuitively with innovative visualization technology
On the monitor, a brain spins slowly and can be examined from every angle. Suddenly, some sections start glowing, first on the side and then the entire back of...
Researchers at the U.S. Department of Energy's (DOE) Ames Laboratory have discovered an unusual property of purple bronze that may point to new ways to achieve high temperature superconductivity.
While studying purple bronze, a molybdenum oxide, researchers discovered an unconventional charge density wave on its surface.
Munich Physicists have developed a novel electron microscope that can visualize electromagnetic fields oscillating at frequencies of billions of cycles per second.
Temporally varying electromagnetic fields are the driving force behind the whole of electronics. Their polarities can change at mind-bogglingly fast rates, and...
Breakup of continents with two speed: Continents initially stretch very slowly along the future splitting zone, but then move apart very quickly before the onset of rupture. The final speed can be up to 20 times faster than in the first, slow extension phase.phases
Present-day continents were shaped hundreds of millions of years ago as the supercontinent Pangaea broke apart. Derived from Pangaea’s main fragments Gondwana...
15.07.2016 | Event News
15.07.2016 | Event News
11.07.2016 | Event News
27.07.2016 | Earth Sciences
27.07.2016 | Materials Sciences
27.07.2016 | Earth Sciences