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steroides AND asthma children

Alexandra Ahmet, Eric I Benchimol, Ellen B Goldbloom, Janice L Barkey
BACKGROUND: Adrenal suppression (AS), a glucocorticoid (GC) side effect associated with significant morbidity, is well described related to inhaled corticosteroid therapy for asthma. Swallowed topical glucocorticoid therapy is the main pharmacotherapy treatment for eosinophilic esophagitis (EoE) and therefore children with EoE are potentially at increased risk of AS. METHODS: In this prospective cohort study, we included children and youth <18 years diagnosed with EoE and treated with swallowed fluticasone or oral viscous budesonide for more than 1 month...
2016: Allergy, Asthma, and Clinical Immunology
Maxime Luu, Marc Bardou, Philippe Bonniaud, Françoise Goirand
Omalizumab is a subcutaneously administrated monoclonal anti-IgE antibody indicated in adults, adolescents and children 6 years of age and older with moderate to severe allergic asthma uncontrolled by conventional pharmacological treatments and sensitization to at least one perennial allergen. Area covered: This drug evaluation summarizes published data on pharmacokinetic and pharmacodynamic properties of omalizumab, on clinical efficacy and safety, including real-world evidence, and provides a medico-economic evaluation of the drug...
October 17, 2016: Expert Opinion on Drug Metabolism & Toxicology
Cecilia K Andersson, Alexandra Adams, Prasad Nagakumar, Cara Bossley, Atul Gupta, Daphne De Vries, Afiqah Adnan, Andrew Bush, Sejal Saglani, Clare M Lloyd
BACKGROUND: Neutrophils and IL-17A have been linked mechanistically in models of allergic airways disease and have been associated with asthma severity. However, their role in paediatric asthma is unknown. OBJECTIVES: To investigate the role of neutrophils and the IL-17A pathway in mediating paediatric severe therapy resistant asthma (STRA). METHODS: Children with STRA (n=51, age 12.6 (6 -16.3) years) and non-asthmatic controls (n=15, age 4...
October 13, 2016: Journal of Allergy and Clinical Immunology
Michele Miraglia Del Giudice, Annalisa Allegorico
The role of vitamin D in calcium and phosphate homeostasis is well known; however, in addition to traditional functions, vitamin D modulates a variety of processes, and evidence shows that it has an important role in different allergic diseases such as asthma, atopic dermatitis, and food allergy. Vitamin D acts by binding to the vitamin D receptor, which is present in a variety of tissues; for this reason it is considered a hormone. One of the most important functions is to modulate the immune system response, both innate and adaptive, by suppressing Th2-type response and increasing natural killer cells...
November 2016: Journal of Clinical Gastroenterology
Frederik Buchvald, Lue Drasbaek Phillipsen, Thomas Hjuler, Kim G Nielsen
BACKGROUND AND AIMS: Exercise-induced inspiratory symptoms (EIIS) have multiple causes, one of which is exercise-induced laryngeal obstruction (EILO). There is limited knowledge regarding EIIS in children, both in primary care practices and in pediatric asthma clinics. The aim of this study was to describe the feasibility of a diagnostic methodology and its results in a cohort of children with EIIS referred to our tertiary pediatric pulmonary center. METHODS: This study analyzed consecutively collected data in children from East Denmark and Greater Copenhagen referred during a 3½ years period...
November 2016: Pediatric Pulmonology
M Engelkes, H M Janssens, M A J de Ridder, M C J M Sturkenboom, J C de Jongste, K M C Verhamme
Real-life data on the incidence rates (IR) and risk factors of severe asthma exacerbations in children are sparse. We aimed to assess IR and risk factors of severe asthma exacerbations in children in real life. We conducted a population-based cohort study using a Dutch GP database containing complete medical records of >1 million patients. All records of children with physician-diagnosed asthma aged 5-18 years between 2000 and 2012 were examined for exacerbations, defined as either hospitalization, emergency department visit or need of systemic steroids for asthma...
October 2016: Respiratory Medicine
T Pincez, L Calamy, Z Germont, A Lemoine, A-A Lopes, A Massiot, J Tencer, C Thivent, A Hadchouel
Acute and chronic pulmonary complications are frequent in sickle cell disease (SCD), with different spectrum and characteristics in children and adults. Chronic hypoxia is frequent and plays a role in several respiratory complications in SCD. Furthermore, hypoxia has been associated with a higher risk of cerebral ischemia. Despite differing oxygen affinity between hemoglobin A and S, standard pulse oximetry was shown to be accurate in diagnosing hypoxia in SCD patients. Whereas acute hypoxia management is similar to non-SCD patients, chronic hypoxia treatment is mainly based on a transfusion program rather than long-term oxygen therapy...
October 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Miguel Tortajada-Girbés, Miriam Moreno-Prat, David Ainsa-Laguna, Silvia Mas
BACKGROUND: Spontaneous pneumomediastinum (SPM) is an uncommon disorder. It is rarely reported in paediatric patients and may be accompanied by subcutaneous emphysema. It is usually benign and self-limiting, with only supportive therapy being needed, but severe cases may require invasive measures. Asthma exacerbations have classically been described as a cause of SPM. However, detailed descriptions in asthmatic children are scarce. We aimed at improving the current understanding of the features of SPM and subcutaneous emphysema, and outcomes, by means of a case report and a systematic review...
October 2016: Therapeutic Advances in Respiratory Disease
Erick Forno, Daniel J Weiner, James Mullen, Gregory Sawicki, Geoffrey Kurland, Yueh Ying Han, Michelle M Cloutier, Glorisa Canino, Scott T Weiss, Augusto A Litonjua, Juan C Celedón
BACKGROUND: For unclear reasons, obese children with asthma have higher morbidity and reduced response to inhaled corticosteroids. We hypothesized that childhood obesity is associated with airway dysanapsis (an incongruence between the growth of the lungs and the airways), and that dysanapsis is associated with asthma morbidity. METHODS: We examined the relation between obesity and dysanapsis in six cohorts of children with and without asthma, as well as the relation between dysanapsis and clinical outcomes in children with asthma...
August 23, 2016: American Journal of Respiratory and Critical Care Medicine
Allen F Shaughnessy
No abstract text is available yet for this article.
August 15, 2016: American Family Physician
Grace Li, Ofran Almossawi, Hasna Dulfeker, Vicky Jones, Felicity Taylor
AIM: To compare the palatability of oral non-soluble and oral soluble prednisolone tablets in paediatric patients admitted to the general paediatric wards in an acute London Trust. METHOD: As part of ongoing quality improvement initiatives, the Paediatric and Pharmacy departments compared tolerability of soluble versus non-soluble prednisolone in a group of 27 patients. Using a modified 5 point hedonic scale with 'smiley' faces we measured palatability and tolerance (swallowed versus refusal or vomiting) over two three week periods: the first period whilst soluble prednisolone was dispensed (n=17) and the second period after the switch to non-soluble prednisolone had been made (n=10)...
September 2016: Archives of Disease in Childhood
Constanza Galleguillos, Bárbara Galleguillos, Guillermo Larios, Gonzalo Menchaca, Louis Bont, Jose A Castro-Rodriguez
AIM: Previous studies have suggested that Down's syndrome is an independent risk factor for severe respiratory infection due to respiratory syncytial virus (RSV). We compared the clinical characteristics of children with and without Down's syndrome hospitalised due to RSV. METHODS: This retrospective cohort study compared data from hospitalisations due to RSV lower respiratory tract infections (LRTI) in children under 14 years of age with (n = 58) and without (n = 58) Down's syndrome...
November 2016: Acta Paediatrica
Suchitra Rao, Kevin Messacar, Michelle R Torok, Anne-Marie Rick, Jeffrey Holzberg, Aaron Montano, Dayanand Bagdure, Donna J Curtis, M Steven Oberste, W Allan Nix, Gina de Masellis, Christine C Robinson, Samuel R Dominguez
OBJECTIVE: In 2014, the Unites States experienced an outbreak of enterovirus D68 associated with severe respiratory illness. The clinical characteristics associated with severe illness from enterovirus D68 during this outbreak compared with those associated with the 2009 H1N1 influenza virus outbreak are unknown. DESIGN AND SETTING: In this retrospective cohort study, we characterized the clinical features of children with enterovirus D68 admitted to the PICU between August 1, 2014, and November 1, 2014, and compared them with critically ill children infected with H1N1 influenza during the pandemic admitted between May 1, 2009, and January 31, 2010...
August 8, 2016: Pediatric Critical Care Medicine
Kayleigh M Kew, Christopher J Cates
BACKGROUND: Asthma is a chronic disease that causes reversible narrowing of the airways due to bronchoconstriction, inflammation and mucus production. Asthma continues to be associated with significant avoidable morbidity and mortality. Self management facilitated by a healthcare professional is important to keep symptoms controlled and to prevent exacerbations.Telephone and Internet technologies can now be used by patients to measure lung function and asthma symptoms at home. Patients can then share this information electronically with their healthcare provider, who can provide feedback between clinic visits...
2016: Cochrane Database of Systematic Reviews
C Calabrese, G E Carpagnano, V Patella, A Vatrella, P Santus
Carraro et al. measured asymmetric dimethylarginine (ADMA) in the exhaled breath condensate (EBC) obtained from children with asthma and from healthy subjects. The authors demonstrated higher levels of ADMA in EBC of asthmatics compared to controls. ADMA levels in EBC did not correlate with serum levels, lung function parameters, and fractional exhaled nitric oxide. ADMA levels in EBC did not significantly differ between asthmatic patients regularly treated with inhaled steroids and those who were steroid naïve...
October 2015: Minerva Medica
Deborah R Liptzin, Melanie C Gleason, Lisa C Cicutto, Chris L Cleveland, Donna J Shocks, Martha K White, Anna V Faino, Stanley J Szefler
BACKGROUND: Asthma is a significant health problem among children: 9.3% of children in the United States suffer from asthma. Children with persistent asthma in inner cities have increased health care utilization, worse health care outcomes, increased school absences, and worse academic performance. OBJECTIVE: We sought to create and evaluate a school-centered asthma program to reduce asthma morbidity and create asthma-friendly schools. METHODS: We developed, implemented, and evaluated the Step-Up Asthma Program, a multidisciplinary school-centered asthma program...
September 2016: Journal of Allergy and Clinical Immunology in Practice
Kayleigh M Kew, Michael Quinn, Bradley S Quon, Francine M Ducharme
BACKGROUND: People with asthma may experience exacerbations or "attacks" during which their symptoms worsen and additional treatment is required. Written action plans may advocate doubling the dose of inhaled steroids in the early stages of an asthma exacerbation to reduce the severity of the attack and to prevent the need for oral steroids or hospital admission. OBJECTIVES: To compare the clinical effectiveness and safety of increased versus stable doses of inhaled corticosteroids (ICS) as part of a patient-initiated action plan for home management of exacerbations in children and adults with persistent asthma...
2016: Cochrane Database of Systematic Reviews
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
J S Makowska, P Burney, D Jarvis, T Keil, P Tomassen, J Bislimovska, G Brozek, C Bachert, J Baelum, C Bindslev-Jensen, J Bousquet, P J Bousquet, C Kai-Håkon, S E Dahlen, B Dahlen, W J Fokkens, B Forsberg, M Gjomarkaj, P Howarth, E Salagean, C Janson, L Kasper, U Kraemer, C Louiro, B Lundback, J Minov, E Nizankowska-Mogilnicka, N Papadopoulos, A G Sakellariou, A Todo-Bom, E Toskala, J E Zejda, T Zuberbier, M L Kowalski
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most prevalent drugs inducing hypersensitivity reactions. The aim of this analysis was to estimate the prevalence of NSAID-induced respiratory symptoms in population across Europe and to assess its association with upper and lower respiratory tract disorders. METHODS: The GA(2) LEN survey was conducted in 22 centers in 15 European countries. Each of 19 centers selected random samples of 5000 adults aged 15-74 from their general population, and in three centers (Athens, Munich, Oslo), a younger population was sampled...
May 27, 2016: Allergy
Zhonghua Zhang, Jocelyn M Biagini Myers, Eric B Brandt, Patrick H Ryan, Mark Lindsey, Rachael A Mintz-Cole, Tiina Reponen, Stephen J Vesper, Frank Forde, Brandy Ruff, Stacey A Bass, Grace K LeMasters, David I Bernstein, James Lockey, Alison L Budelsky, Gurjit K Khurana Hershey
BACKGROUND: Allergic sensitization to fungi has been associated with asthma severity. As a result, it has been largely assumed that the contribution of fungi to allergic disease is mediated through their potent antigenicity. OBJECTIVE: We sought to determine the mechanism by which fungi affect asthma development and severity. METHODS: We integrated epidemiologic and experimental asthma models to explore the effect of fungal exposure on asthma development and severity...
April 20, 2016: Journal of Allergy and Clinical Immunology
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