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preschool wheeze

Hanna Knihtilä, Anne Kotaniemi-Syrjänen, Anna S Pelkonen, Satu Kalliola, Mika J Mäkelä, L Pekka Malmberg
INTRODUCTION: Early origins of chronic obstructive pulmonary disease have been recognized. Impulse oscillometry (IOS) is suitable for assessment of lung function also in preschool children, and some novel indices have been connected to assessment of small airway function. However, limited data exist on the sensitivity of these new indices to detect lung function deficits in young symptomatic children. METHODS: IOS measurements of 103 healthy preschool children were evaluated to establish reference equations for the difference between respiratory resistance at 5 and 20 Hz (R5-20), the relative difference of R5-20 (R5-20%), and area under the reactance curve (AX)...
October 13, 2016: Pediatric Pulmonology
Anna James, Katarina Stenberg Hammar, Lovisa Reinius, Jon R Konradsen, Sven-Erik Dahlén, Cilla Söderhäll, Gunilla Hedlin
BACKGROUND: The chitinase-like protein YKL-40 (CHI3L1) is elevated in the circulation of adults and schoolchildren with chronic severe asthma. It is unknown whether YKL-40 is altered in younger, preschool children with wheeze, acute or chronic. We therefore examined YKL-40 in preschool children during an acute episode of wheeze and during remission, in comparison to healthy controls. METHODS: Blood was obtained from 128 children (aged 6 to 44 months) at the emergency department during an acute episode of wheeze, and at two follow-up visits (approximately 3 months and 1 year later), as well as from 100 age-matched healthy controls on one occasion...
October 12, 2016: Pediatric Allergy and Immunology
Jonathan Grigg, Jürg Barben, Kajsa Bohlin, Mark L Everard, Graham Hall, Mariëlle Pijnenburg, Kostas N Priftis, Franca Rusconi, Fabio Midulla
The Paediatric Assembly of the European Respiratory Society (ERS) maintained its high profile at the 2015 ERS International Congress in Amsterdam. There were symposia on preschool wheeze, respiratory sounds and cystic fibrosis; an educational skills workshop on paediatric respiratory resuscitation; a hot topic session on risk factors and early origins of respiratory diseases; a meet the expert session on paediatric lung function test reference values; and the annual paediatric grand round. In this report the Chairs of the Paediatric Assembly's Groups highlight the key messages from the abstracts presented at the Congress...
April 2016: ERJ Open Research
Fernando Maria de Benedictis, Andrew Bush
Wheeze is a common symptom in young children and is usually associated with viral illnesses. It is a major source of morbidity and is responsible for a high consumption of healthcare and economic resources worldwide. A few children have a condition resembling classical asthma. Rarer specific conditions may have a wheezy component and should be considered in the differential diagnosis. Over the last half century, there have been many circular discussions about the best way of managing preschool wheeze. In general, intermittent wheezing should be treated with intermittent bronchodilator therapy, and a controller therapy should be prescribed for a young child with recurrent wheezing only if positively indicated, and only then if carefully monitored for efficacy...
October 4, 2016: Archives of Disease in Childhood
Leah Stiemsma, Marie-Claire Arrieta, Pedro Dimitriu, Jasmine Cheng, Lisa Thorson, Diana Lefebvre, Meghan B Azad, Padmaja Subbarao, Piush Mandhane, Allan Becker, Malcolm Sears, Tobias Kollmann, William Mohn, Brett Finlay, Stuart Turvey
Asthma is a chronic disease of the airways affecting one in ten children in Westernized countries. Recently, our group showed that specific bacterial genera in early life are associated with atopy and wheezing in one-year-old children. However, little is known about the link between the early life gut microbiome and the diagnosis of asthma in preschool age children. To determine the role of the gut microbiota in preschool age asthma, children up to 4 years of age enrolled in the Canadian Healthy Infant Longitudinal Development (CHILD) study were classified as asthmatic (n = 39) or matched healthy controls (n = 37)...
September 15, 2016: Clinical Science (1979-)
Chen Huang, Wei Liu, Jiao Cai, Louise B Weschler, Xueying Wang, Yu Hu, Zhijun Zou, Li Shen, Jan Sundell
OBJECTIVES: We investigated associations of breastfeeding (BF) durations and patterns and of timing of other dietary introductions with prevalences of asthma, wheeze, hay fever, rhinitis, pneumonia, and eczema among preschool children. METHODS: During April 2011-April 2012, we conducted a cross-sectional study in 72 kindergartens from five districts of Shanghai, China and obtained 13,335 questionnaires of children 4-6 year-old. We used multiple logistic regression models to evaluate the target associations...
September 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Steven McVea, Thomas Bourke
One third of all preschool children will have an episode of wheeze and many of these present to primary care. Most will fall within a spectrum of diagnosis ranging from episodic viral wheeze to multiple trigger wheeze or early onset asthma. A small proportion will have other rare, but important, diagnoses such as foreign body aspiration, anaphylaxis, gastro-oesophageal reflux, congenital anatomical abnormalities or other chronic lung diseases. Clinical assessment should try to classify children into either episodic viral wheeze or multiple trigger wheeze phenotypes...
June 2016: Practitioner
Shaikh M Iqbal
Wheeze is a common symptom in infants and preschool children. Up to 30% of children wheeze at least once before the age of 3 years and 2% of those have it severe enough to warrant hospital admission. Not only parents but also physicians have difficulty in recognizing wheeze. Wrong diagnosis of the underlying condition leads to inappropriate and unnecessary management and patient morbidity. Asthma is the commonest underlying condition in children with wheeze, but the differential diagnosis is quite broad and a systematic approach including a good clinical history, thorough physical examination and appropriate investigations are essential to reach the accurate diagnosis...
2012: Sudan J Paediatr
Katja Landgraf-Rauf, Bettina Anselm, Bianca Schaub
Asthma represents the most common chronic childhood disease worldwide. Whereas preschool children present with wheezing triggered by different factors (multitrigger and viral wheeze), clinical asthma manifestation in school children has previously been classified as allergic and non-allergic asthma. For both, the underlying immunological mechanisms are not yet understood in depth in children. Treatment is still prescribed regardless of underlying mechanisms, and children are not always treated successfully...
December 2016: Molecular and Cellular Pediatrics
Hengameh H Raissy, Kathryn Blake
The National Asthma Education and Prevention Program's Expert Panel Report 3, Guidelines for the Diagnosis and Management of Asthma does not recommend antibiotics for the management of acute episodes of asthma exacerbation. Macrolides seem to have some potential effect beyond or in addition to their antibacterial effect. It has been reported that macrolides may potentially benefit patients with chronic inflammatory airway diseases due to their antibacterial, antiviral, and/or anti-inflammatory effects. This review presents recent data on use of azithromycin in prevention and management of acute exacerbation of respiratory symptoms in infants and young children...
June 1, 2016: Pediatric Allergy, Immunology, and Pulmonology
Francine M Ducharme, Roger Zemek, Bhupendrasinh F Chauhan, Jocelyn Gravel, Dominic Chalut, Naveen Poonai, Marie-Claude Guertin, Caroline Quach, Lucie Blondeau, Sophie Laberge
BACKGROUND: The management of paediatric asthma exacerbations is based on trials in children of all ages. Recent studies from 2009 raised the possibility that preschoolers (younger than 6 years) with viral-induced wheezing and children exposed to tobacco smoke might be at an increased risk of treatment failure. The study objective was to identify factors associated with management failure in children presenting to the emergency department with moderate or severe asthma exacerbations. METHODS: We undertook a prospective, multicentre cohort study of children aged 1-17 years presenting to five emergency departments with moderate or severe asthma (defined as a Pediatric Respiratory Assessment Measure [PRAM] of 4 to 12)...
July 20, 2016: Lancet Respiratory Medicine
K Stenberg-Hammar, K Niespodziana, C Söderhäll, A James, C R Cabauatan, J R Konradsen, E Melén, M van Hage, R Valenta, G Hedlin
BACKGROUND: Some children with rhinovirus (RV) infections wheeze, but it is unknown whether this is due to more virulent strains of virus or differences in host immune responses. The aim of this study was to investigate the RV species-specific antibody responses measured at a follow-up visit in preschool children in relation to reported time with respiratory symptoms and the presence of different RV species during an acute episode of wheeze. METHOD: Nasopharyngeal swabs and blood samples were taken among 120 preschool children (<4 years of age) at an acute episode of wheeze and at a follow-up visit (median 11 weeks later)...
July 22, 2016: Allergy
Michael R DeBaun, Robert C Strunk
Acute chest syndrome is a frequent cause of acute lung disease in children with sickle-cell disease. Asthma is common in children with sickle-cell disease and is associated with increased incidence of vaso-occlusive pain events, acute chest syndrome episodes, and earlier death. Risk factors for asthma exacerbation and an acute chest syndrome episode are similar, and both can present with shortness of breath, chest pain, cough, and wheezing. Despite overlapping risk factors and symptoms, an acute exacerbation of asthma or an episode of acute chest syndrome are two distinct entities that need disease-specific management strategies...
June 18, 2016: Lancet
Andjelka Stojković, Aleksandra Simović, Zoran Bogdanović, Dragić Banković, Mina Poskurica
INTRODUCTION: Urban life is often followed by immune dysfunction and loss of immune tolerance in the youngest children. OBJECTIVE: The study aimed to determine optimal time efficiency of a synbiotic (5 x 10⁹ Lactobacillus acidophilus Rosell-52, Bifidobacterium infantis Rosell-33, Bifidobacterium bifidum Rosell-71) in controlling respiratory infections and wheezing disease. METHODS: We randomly selected a group of children younger than five years, hospitalized earlier, and classified them into three groups...
January 2016: Srpski Arhiv za Celokupno Lekarstvo
Emma Raywood, Sooky Lum, Paul Aurora, Katharine Pike
BACKGROUND: The bronchodilator response (BDR) is frequently used to support diagnostic and therapeutic decision-making for children who wheeze. However, there is little evidence-based guidance describing the role of BDR testing in preschool children and it is unclear whether published cut-off values, which are derived from adult data, can be applied to this population. METHODS: We searched MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception-September 2015) for studies reporting response to a bronchodilator in healthy preschool children, response following placebo inhalation, and the diagnostic efficacy of BDR compared with a clinical diagnosis of asthma/recurrent wheezing...
June 6, 2016: Pediatric Pulmonology
Sunitha V Kaiser, Tram Huynh, Leonard B Bacharier, Jennifer L Rosenthal, Leigh Anne Bakel, Patricia C Parkin, Michael D Cabana
CONTEXT: Half of children experience wheezing by age 6 years, and optimal strategies for preventing severe exacerbations are not well defined. OBJECTIVE: Synthesize the evidence of the effects of daily inhaled corticosteroids (ICS), intermittent ICS, and montelukast in preventing severe exacerbations among preschool children with recurrent wheeze. DATA SOURCES: Medline (1946, 2/25/15), Embase (1947, 2/25/15), CENTRAL. STUDY SELECTION: Studies were included based on design (randomized controlled trials), population (children ≤6 years with asthma or recurrent wheeze), intervention and comparison (daily ICS vs placebo, intermittent ICS vs placebo, daily ICS vs intermittent ICS, ICS vs montelukast), and outcome (exacerbations necessitating systemic steroids)...
June 2016: Pediatrics
Véronique Nève, Sébastien Hulo, Jean-Louis Edmé, Sophie Boileau, Georges Baquet, Guillaume Pouessel, Caroline Thumerelle, Antoine Deschildre, Régis Matran
Uncontrolled wheezing disorder is common in preschoolers and disease control assessment is challenging as parents frequently overestimate the extent to which their child's disease is controlled. This is the first study of forced expiratory volume in t s (FEVt)/forced vital capacity (FVC) ratio measurements (i.e. FEV1/FVC, FEV0.75/FVC and FEV0.5/FVC) in wheezy preschoolers in relation to disease control. Our objective was to evaluate whether FEVt/FVC ratios less than the lower limit of normal (LLN; z-score <-1...
August 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Matti Korppi, Kirsi Nuolivirta, Eero Lauhkonen, Annukka Holster, Johanna Teräsjärvi, Juho Vuononvirta, Merja Helminen, Qiushui He, Petri Koponen
BACKGROUND: Variations in the genes that regulate innate immunity responses may be associated with susceptibility to asthma or atopy after early-life bronchiolitis. The aim of this study was to evaluate the association between four different polymorphisms of the IL-10 gene at rs1800871, rs1800872, rs1800890, and rs1800896, either alone or in combination, and post-bronchiolitis asthma or allergies at 5-7 years of age. METHODS: Data on single nucleotide polymorphisms (SNP) of IL-10 rs1800896 (-1082G/A), rs1800871 (-819C/T), rs1800872 (-592C/A), and IL-10 rs1800890 (-3575T/A) were available for 135 children...
May 26, 2016: Pediatric Pulmonology
Fanny Rancière, Nicolas Bougas, Malika Viola, Isabelle Momas
BACKGROUND: The relation between traffic-related air pollution (TRAP) exposure and the incidence of asthma/allergy in preschool children has been widely studied but results remain heterogeneous, possibly due to differences in methodology and susceptibility to TRAP. OBJECTIVES: To study the relation of early TRAP exposure with the development of respiratory/allergic symptoms and asthma during preschool years, and to investigate parental allergy, 'stressful' family events, and gender as possible effect modifiers...
May 24, 2016: Environmental Health Perspectives
Niki Mitselou, Gunilla Hedlin, Carl-Axel Hederos
OBJECTIVE: To compare administration of bronchodilators by nebulizers with delivery by metered dose inhalers (MDIs) with spacers and to evaluate the clinical effect of the treatment of acute asthma in preschool children. METHODS: A prospective randomized clinical trial in a pediatric emergency department (PED). Preschool children who were admitted for virus induced wheezing or acute asthma exacerbation were randomly allocated to receive bronchodilator treatment by nebulizer or by metered dose inhaler...
December 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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