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https://www.readbyqxmd.com/read/29308548/management-of-recurrent-preschool-doctor-diagnosed-wheeze
#1
REVIEW
Ka-Ka Siu, Shuk-Yu Leung, Sum-Yi Kong, Daniel Kwok-Keung Ng
Preschool wheeze occurs in half of the children before they reach 6 y of age and recurrence is also common. Recurrent preschool wheeze is classified as either typical or atypical. For typical recurrent preschool wheeze, the diagnoses are either asthma or bronchiolitis/bronchitis. Responsiveness to a properly administered bronchodilator confirms asthma, atopic or otherwise. All atypical preschool wheeze should be referred to pediatric respirologist for assessment. Lung function test by impulse oscillometry (IOS) before and after bronchodilator is helpful to confirm airway hyperresponsiveness, an essential feature of asthma...
January 8, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29220200/a-practical-approach-to-severe-asthma-in-children
#2
Emily E Barsky, Lauren M Giancola, Sachin N Baxi, Jonathan M Gaffin
Severe asthma accounts for only a small proportion of the children with asthma, but a disproportionately high amount of resource utilization and morbidity. It is a heterogeneous entity and requires a step-wise, evidence based approach to evaluation and management by pediatric subspecialists. The first step is to confirm the diagnosis by eliciting confirmatory history and objective evidence of asthma and excluding possible masquerading diagnoses. The next step is to differentiate difficult-to-treat asthma, asthma which can be controlled with appropriate management, from asthma which requires the highest level of therapy to maintain control or remains uncontrolled despite management optimization...
December 8, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29206057/school-nurse-asthma-program-reduces-healthcare-utilization-in-children-with-persistent-asthma
#3
Michelle Trivedi, Janki Patel, Darleen Lessard, Ted Kremer, Nancy Byatt, Wanda Phipatanakul, Lori Pbert, Robert Goldberg
OBJECTIVE: We examined the impact of a novel, school nurse-supervised asthma therapy program on healthcare utilization. METHODS: We retrospectively reviewed charts of 84 children enrolled in this program in central Massachusetts between 2012 and 2015. Physicians identified children with persistent asthma and poor medication adherence. These children were enrolled in the program to receive daily-inhaled corticosteroid at school, supervised by their school nurse, with ongoing communication between physician's office and school nurse through the school year...
December 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29182799/inhaled-magnesium-sulfate-in-the-treatment-of-acute-asthma
#4
REVIEW
Rachel Knightly, Stephen J Milan, Rodney Hughes, Jennifer A Knopp-Sihota, Brian H Rowe, Rebecca Normansell, Colin Powell
BACKGROUND: Asthma exacerbations can be frequent and range in severity from mild to life-threatening. The use of magnesium sulfate (MgSO₄) is one of numerous treatment options available during acute exacerbations. While the efficacy of intravenous MgSO₄ has been demonstrated, the role of inhaled MgSO₄ is less clear. OBJECTIVES: To determine the efficacy and safety of inhaled MgSO₄ administered in acute asthma. SPECIFIC AIMS: to quantify the effects of inhaled MgSO₄ I) in addition to combination treatment with inhaled β₂-agonist and ipratropium bromide; ii) in addition to inhaled β₂-agonist; and iii) in comparison to inhaled β₂-agonist...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29142562/drug-poisoning-and-associated-factors-in-western-saudi-arabia-a-five-year-retrospective-chart-review-2011-2016
#5
Sami H Alzahrani, Ali H Alqahtani, Fayssal Mostafa Farahat, Mohammed Abdel Galil Elnour, Jamil Bashawri
Objective: Drug poisoning is a globally common cause of emergency-room admissions. This study explores drug-poisoning prevalence patterns, associated risk factors (gender, age and exposure circumstances), and outcomes in western Saudi Arabia. Methods: Retrospective analysis of Clinical drug poisoning cases (2011-2016). The data were retrieved from the Saudi Ministry of Health's record and Patients' medical charts were analyzed. Results: The Ministry of Health received 1,474 reports of drug poisoning during 2011-2016...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29130803/steroid-sparing-effect-of-sublingual-immunotherapy-real-life-study-in-mono-polisensitized-children-with-asthma
#6
Nerin Nadir Bahceciler, Nilufer Galip, Arzu Babayigit
AIM: Steroid-sparing effect of sublingual immunotherapy (SLIT) in mono/polisensitized asthmatic children were evaluated. MATERIALS AND METHODS:  Children undergoing allergen-specific SLIT between 2010 and 2014 were included. Asthma control and usage/dose of inhaled corticosteroid (ICS) in the previous year was determined. Asthma control without ICS need ≥6 months was defined as 'ICS avoidance'. RESULTS:  90 children (mean ± SD age 8...
November 2017: Immunotherapy
https://www.readbyqxmd.com/read/29121247/prediction-of-individual-outcomes-for-asthma-sufferers
#7
B Storlie Curtis, E Branda Megan, R Gionfriddo Michael, D Shah Nilay, A Rank Matthew
We consider the problem of individual-specific medication level recommendation (initiation, removal, increase, or decrease) for asthma sufferers. Asthma is one of the most common chronic diseases in both adults and children, affecting 8% of the US population and costing $37-63 billion/year in the United States of America. Asthma is a complex disease, whose symptoms may wax and wane, making it difficult for clinicians to predict outcomes and prognosis. Improved ability to predict prognosis can inform decision making and may promote conversations between clinician and provider around optimizing medication therapy...
November 6, 2017: Biostatistics
https://www.readbyqxmd.com/read/29062584/adrenal-insufficiency-in-pediatric-eosinophilic-esophagitis-patients-treated-with-swallowed-topical-steroids
#8
Stephanie Hsu, Colleen Wood, Zhaoxing Pan, Haseeb Rahat, Philip Zeitler, David Fleischer, Calies Menard-Katcher, Glenn T Furuta, Dan Atkins
Swallowed topical steroids (STS) are the only effective pharmacological therapy for eosinophilic esophagitis (EoE). Thus far, studies of small populations of EoE patients have reported conflicting results in relation to adrenal insufficiency (AI). We sought to measure AI in a clinical setting in children taking STS for EoE. We performed a quality improvement study of pediatric EoE patients seen in a multidisciplinary clinic, who were treated with STS for at least 3 months. Two hundred twenty-five patients completed questionnaires to assess for signs of AI...
September 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/29042872/accuracy-of-maximal-expiratory-flow-volume-curve-curvilinearity-and-fractional-exhaled-nitric-oxide-for-detection-of-children-with-atopic-asthma
#9
Sang Hoo Park, Min Ji Im, Sang-Yong Eom, Youn-Soo Hahn
PURPOSE: Airway pathology in children with atopic asthma can be reflected by the concave shape of the maximal expiratory flow-volume (MEFV) curve and high fractional exhaled nitric oxide (FeNO) values. We evaluated the capacity of the curvilinearity of the MEFV curve, FeNO, and their combination to distinguish subjects with atopic asthma from healthy individuals. METHODS: FeNO and angle β, which characterizes the general configuration of the MEFV curve, were determined in 119 steroid-naïve individuals with atopic asthma aged 8 to 16 years, and in 92 age-matched healthy controls...
September 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29042809/implementation-of-gina-guidelines-in-asthma-management-by-primary-care-physicians-in-vietnam
#10
Vinh Nhu Nguyen, Quynh Nhat Nguyen, Pham Le An, Niels H Chavannes
BACKGROUND: Asthma control is suboptimal in Vietnam. Lack of knowledge of primary care physicians (PCPs) for asthma management may potentially be one of the causes. PURPOSE: The aim of this study was to assess the knowledge and practice of PCPs' asthma management based on the Global Initiative for Asthma (GINA) guidelines (2015 update). METHODS: A cross-sectional study with convenience sampling was conducted among PCPs in an urban and rural area of Vietnam using questionnaires related to asthma patients daily practice: use of spirometry and the asthma control test (ACT), prescription of asthma medications, and frequency of consultations...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29034999/home-supply-of-emergency-oral-steroids-and-reduction-in-asthma-healthcare-utilization
#11
Lisa M Sarzynski, Tiffany Turner, David R Stukus, Elizabeth Allen
OBJECTIVE: To determine if children with moderate-to-severe persistent asthma have decreased healthcare utilization after receiving a prescription and instructions to use an at home emergency supply of oral steroids during asthma exacerbations. METHODS: A quasi-experimental design study with a historical control from retrospective chart review was performed for patients aged 2-18 years seen in a tertiary care pediatric pulmonary clinic for moderate to severe persistent asthma...
October 16, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29028809/nasal-dna-methylation-differentiates-corticosteroid-treatment-response-in-pediatric-asthma-a-pilot-study
#12
Xue Zhang, Jocelyn M Biagini Myers, Veda K Yadagiri, Ashley Ulm, Xiaoting Chen, Matthew T Weirauch, Gurjit K Khurana Hershey, Hong Ji
BACKGROUND: Treatment response to systemic corticosteroid in asthmatic children is heterogeneous and may be mediated by epigenetic mechanism(s). We aim to identify DNA methylation (DNAm) changes responsive to steroid, and DNAm biomarkers that distinguish treatment response. MATERIALS AND METHODS: We followed 33 children (ages 5-18) presenting to the Emergency Department (ED) for asthma exacerbation. Based on whether they met discharge criteria in ≤24 hours, participants were grouped into good and poor responders to steroid treatment...
2017: PloS One
https://www.readbyqxmd.com/read/29027379/impact-of-omalizumab-in-children-from-a-middle-income-country-with-severe-therapy-resistant-asthma-a-real-life-study
#13
Paulo M Pitrez, Rodrigo G de Souza, Cristian Roncada, Joao P Heinzmann-Filho, Giovana Santos, Leonardo A Pinto, Marcus H Jones, Renato T Stein
BACKGROUND: Severe asthma in children is a global health problem. Severe therapy-resistant asthma (STRA) in children is a major clinical challenge due to persistent symptoms despite high doses of corticosteroids and results in high public health costs. Omalizumab (anti-IgE monoclonal antibody) has been described as an effective add-on therapy in these patients. The characteristics of children with STRA from low- and middle-income countries have scarcely been reported, and no real-life study has been published on the effects of omalizumab in this group of patients...
November 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28979893/prenatal-maternal-stress-and-the-risk-of-asthma-in-children
#14
REVIEW
Konstantinos Douros, Maria Moustaki, Sophia Tsabouri, Anna Papadopoulou, Marios Papadopoulos, Kostas N Priftis
Emerging evidence indicate that maternal prenatal stress (MPS) can result in a range of long-term adverse effects in the offspring. The underlying mechanism of MPS is not fully understood. However, its complexity is emphasized by the number of purportedly involved pathways namely, placental deregulated metabolism of maternal steroids, impaired maturation of fetal HPA axis, imbalanced efflux of commensal bacteria across the placenta, and skewed immune development toward Th2. Fetal programming probably exerts a pivotal role in the end result of the above pathways through the modulation of gene expression...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28972652/shared-decision-making-for-people-with-asthma
#15
REVIEW
Kayleigh M Kew, Poonam Malik, Krishnan Aniruddhan, Rebecca Normansell
BACKGROUND: Asthma is a chronic inflammatory disease that affects the airways and is common in both adults and children. It is characterised by symptoms including wheeze, shortness of breath, chest tightness, and cough. People with asthma may be helped to manage their condition through shared decision-making (SDM). SDM involves at least two participants (the medical practitioner and the patient) and mutual sharing of information, including the patient's values and preferences, to build consensus about favoured treatment that culminates in an agreed action...
October 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28928804/efficacy-of-a-leukotriene-receptor-antagonist-for-pediatric-cedar-pollen-allergy-complicated-by-asthma
#16
Shigemi Yoshihara, Yutaka Kikuchi, Mari Saitou, Susumu Yanagawa, Noriko Kanno, Hiroshi Igarashi, Hironobu Fukuda, Akiko Iimura, Toshio Abe, Yumi Yamada, Tamotsu Andou, Osamu Arisaka
Leukotriene receptor antagonists (LTRAs) are identified as a monotherapy for asthma and allergic rhinitis; however, their use in children for treatment of these diseases has not been examined. Accordingly, the present study investigated the efficacy of pranlukast dry syrup for children with both pollinosis and asthma. The subjects were children receiving treatment for asthma who were also diagnosed with cedar pollen allergy. Patients were divided into a group that received continuous treatment with pranlukast (group A; n=20) and a group that commenced add-on treatment for pollinosis following the onset of symptoms (group B; n=20)...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28926508/racial-ethnic-variation-in-emergency-department-care-for-children-with-asthma
#17
Heather G Zook, Nathaniel R Payne, Susan E Puumala, Katherine M Ziegler, Anupam B Kharbanda
OBJECTIVE: To assess the variation between racial/ethnic groups in emergency department (ED) treatment of asthma for pediatric patients. METHODS: This study was a cross-sectional analysis of pediatric (2-18 years) asthma visits among 6 EDs in the Upper Midwest between June 2011 and May 2012. We used mixed-effects logistic regression to assess the odds of receiving steroids, radiology tests, and returning to the ED within 30 days. We conducted a subanalysis of asthma visits where patients received at least 1 albuterol treatment in the ED...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28923762/vitamin-d-in-asthma-mechanisms-of-action-and-considerations-for-clinical-trials
#18
REVIEW
Paul E Pfeffer, Catherine M Hawrylowicz
There is increasing interest in the therapeutic utility of vitamin D in asthma, which is supported by a significant body of evidence on epidemiologic associations between vitamin D insufficiency and worse asthma control. In support of a causal relationship, vitamin D beneficially modulates diverse immunologic pathways in heterogeneous asthma endotypes, regulating the actions of lymphocytes, mast cells, antigen-presenting cells, and structural cells to dampen excessive inflammatory responses. Allergic asthma is characterized by a failure of immune tolerance and the development of pathologic responses to inhaled aeroallergens, and vitamin D has been extensively shown to support immune regulation...
September 18, 2017: Chest
https://www.readbyqxmd.com/read/28893261/a-tale-of-two-systems-practice-patterns-of-a-single-group-of-emergency-medical-physicians-in-taiwan-and-china
#19
I-Anne Huang, Tang-Her Jaing, Chang-Teng Wu, Chee-Jen Chang, Shan-Hsuan Hsia, Nicole Huang
BACKGROUND: The quality of pediatric emergency care has been a major concern in health care. Following a series of health system reforms in China, it is important to do this assessment of pediatric emergency care, and to explore potential influences of health care system. This study aimed to compare practice differences in treating children with respiratory illnesses in two emergency department (ED) settings within different health care systems: China and Taiwan. METHODS: A pooled cross-sectional hospital-based study was conducted in two tertiary teaching hospitals in Xiamen, China and Keelung, Taiwan belong to the same hospital chain group...
September 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28892418/shared-decision-making-and-time-to-exacerbation-in-children-with-asthma
#20
Tsai-Ling Liu, Yhenneko J Taylor, Rohan Mahabaleshwarkar, Christopher M Blanchette, Hazel Tapp, Michael F Dulin
OBJECTIVE: Although shared decision making (SDM) is a promising approach for improving outcomes for patients with chronic diseases, no evidence currently supports the use of SDM to delay asthma exacerbations. We evaluated the impact of an SDM intervention implemented by providers in a real-world setting on time to exacerbation in children with asthma. METHODS: This study used a prospective cohort observed between 2011 and 2013 at five primary care practices that serve vulnerable populations (e...
September 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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