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https://www.readbyqxmd.com/read/28396105/eosinophilic-esophagitis-a-case-study-of-a-12-year-old-boy
#1
Katherine Kiely
Eosinophilic esophagitis is an underrecognized chronic condition in which symptoms of gastroesophageal reflux are accompanied by eosinophilia in the esophagus. This disorder affects both children and adults and is associated with a history of other atopic disorders, particularly food allergies. This case study discusses the epidemiology of eosinophilic esophagitis and the proper procedures for diagnosis, referral, and management using the dietary restrictions and pharmacologic treatment included in the clinical recommendations issued by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition; the American Academy of Allergy, Asthma, and Immunology; and the American College of Gastroenterologists...
April 7, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28390477/current-guidelines-for-the-evaluation-and-management-of-atopic-dermatitis-a%C3%A2-comparison-of-the-joint-task-force-practice-parameter-and-american-academy-of-dermatology-guidelines
#2
REVIEW
Lawrence F Eichenfield, Jusleen Ahluwalia, Andrea Waldman, Jenna Borok, Jeremy Udkoff, Mark Boguniewicz
Atopic dermatitis (AD) is a chronic pruritic inflammatory disease that commonly presents in the pediatric population. Although definitions and diagnosis of AD have largely been agreed upon, allergists and dermatologists have similar and divergent approaches to the management of AD. This review facilitated integration of the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma & Immunology Joint Task Force 2012 AD Practice Parameter and the 2014 American Academy of Dermatology guidelines to highlight the basic principles of AD management and discuss therapies and management of AD from the distinct perspectives of the allergist and dermatologist...
April 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28385326/identifying-local-hot-spots-of-pediatric-chronic-diseases-using-emergency-department-surveillance
#3
David C Lee, Stella S Yi, Hiu-Fai Fong, Jessica K Athens, Joseph E Ravenell, Mary Ann Sevick, Stephen P Wall, Brian Elbel
OBJECTIVE: To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. METHODS: Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available...
April 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28377171/benefits-of-subspecialty-adherence-after-asthma-hospitalization-and-patient-perceived-barriers-to-care
#4
Neema Izadi, Jonathan S Tam
BACKGROUND: Comparative studies have demonstrated that asthma education to pediatric patients decreases average hospital usage and that allergy specialists provide stronger asthma education and more improved outcomes. OBJECTIVE: To evaluate the real-world benefits of allergy subspecialty involvement outside inpatient consultation and the impediments for patients in establishing allergy subspecialty care. METHODS: The study population was composed mostly of minority children 0 to 18 years old seen at a large university-affiliated stand-alone children's hospital who had a hospital discharge diagnosis of asthma from 2009 to 2013...
April 1, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28294586/pediatric-eosinophilic-esophagitis-in-portugal
#5
J L Alves Marcelino, R Cardoso de Aguiar, F Cabral Duarte, A Célia Costa, M A Pereira-Barbosa
Eosinophilic esophagitis (EoE) is an increasingly frequent diagnosis in our clinical practice, mainly in pediatric age. Allergic responses to food and aeroallergens have been increasingly implicated in the etiology of this disease. We describe a retrospective data analysis of pediatric EoE patients followed in our Immunoallergology Department. Of the 25 children (22 male, average 10.8 years), 88% had prior history of rhinoconjunctivitis, 76% asthma, 48% eczema and 36% food allergy. After evaluation, we identified in 76% and 92% of patients food and aeroallergen sensitization, respectively; 68% had simultaneously food and inhalant sensitization and 96% had at least one positive test to aeroallergens or food allergens...
March 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28283418/urban-residence-neighborhood-poverty-race-ethnicity-and-asthma-morbidity-among-children-on-medicaid
#6
Corinne A Keet, Elizabeth C Matsui, Meredith C McCormack, Roger D Peng
BACKGROUND: Although poor-urban (inner-city) areas are thought to have high asthma prevalence and morbidity, we recently found that inner cities do not have higher prevalent pediatric asthma. Whether asthma morbidity is higher in inner-city areas across the United States is not known. OBJECTIVE: This study sought to examine relationships between residence in poor and urban areas, race/ethnicity, and asthma morbidity among children with asthma who are enrolled in Medicaid...
March 8, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28276002/different-cutoff-values-of-methacholine-bronchial-provocation-test-depending-on-age-in-children-with-asthma
#7
Eun Lee, Young-Ho Kim, Seungbong Han, Song-I Yang, Young-Ho Jung, Ju-Hee Seo, Hyo-Bin Kim, So Yeon Lee, Ji-Won Kwon, Soo-Jong Hong
BACKGROUND: Bronchial hyperresponsiveness (BHR) is a fundamental pathophysiological characteristic of asthma. Although several factors such as airway caliber can affect BHR, no study has established age-dependent cutoff values of BHR to methacholine for the diagnosis of asthma in children. We investigated the cutoff values of the methacholine challenge test (MCT) in the diagnosis of asthma according to age. METHODS: A total of 2383 individuals aged from 6 to 15 years old were included in this study...
March 8, 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28224093/pediatric-asthma-severity-score-is-associated-with-critical-care-interventions
#8
Danielle K Maue, Nadia Krupp, Courtney M Rowan
AIM: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU). METHODS: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. There were a total of 188 participants between the ages of two and nineteen, excluding patients receiving antibiotics for pneumonia...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28223319/development-and-testing-of-the-pediatric-respiratory-illness-measurement-system-primes-quality-indicators
#9
Rita Mangione-Smith, Carol P Roth, Maria T Britto, Alex Y Chen, Julie McGalliard, Thomas F Boat, John L Adams, Elizabeth A McGlynn
OBJECTIVES: To develop and test quality indicators for assessing care in pediatric hospital settings for common respiratory illnesses. PATIENTS: A sample of 2796 children discharged from the emergency department or inpatient setting at 1 of the 3 participating hospitals with a primary diagnosis of asthma, bronchiolitis, croup, or community-acquired pneumonia (CAP) between January 1, 2010, and December 31, 2011. SETTING: Three tertiary care children's hospitals in the United States...
February 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28192574/primary-care-asthma-management-inhaled-corticosteroids-and-other-clinical-pearls
#10
Zachary Marcus, Nanah Suk Park
Most children in the United States with intermittent, mild, and moderate persistent asthma are cared for by primary care practitioners (PCPs). Despite inhaled corticosteroids (ICS) being highly effective at controlling asthma symptoms, many PCPs are uncomfortable prescribing these medications. Cumbersome guidelines, increasing numbers of medication choices, and concerns regarding side effects are some of the barriers to prescribing ICS for children with asthma. This article serves as a quick-start guide for PCPs that (1) condenses the routine diagnosis and management of asthma into concise clinical tools for children who would benefit from ICS therapy and (2) provides clinical pearls to aid in the treatment of mild- to moderate-persistent asthma...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28181157/comprehensive-neighborhood-portraits-and-child-asthma-disparities
#11
Ashley W Kranjac, Rachel T Kimbro, Justin T Denney, Kristin M Osiecki, Brady S Moffett, Keila N Lopez
Objectives Previous research has established links between child, family, and neighborhood disadvantages and child asthma. We add to this literature by first characterizing neighborhoods in Houston, TX by demographic, economic, and air quality characteristics to establish differences in pediatric asthma diagnoses across neighborhoods. Second, we identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses. Methods We geocoded and linked electronic pediatric medical records to neighborhood-level social and economic indicators...
February 8, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28169982/effect-of-an-asthma-guideline-in-2-pediatric-emergency-departments-and-an-urgent-care-center
#12
Jennifer J Dilts, Sharon G Humiston, Brian R Lee, Nancy H Allen, Jeffrey G Michael
OBJECTIVES: The objective of this study was to evaluate ordering of albuterol via metered-dose inhaler with spacer (MDI-spacer), length of stay (LOS), and 72-hour return rates before and after publication of an internally developed pediatric asthma clinical practice guideline (CPG). METHODS: The internally developed CPG reflected national recommendations. It was explained at faculty meetings by a respected clinician and published on the intranet on February 6, 2012...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28141730/-footprints-in-the-bathroom-the-role-of-spirituality-in-patient-diagnosis
#13
Veronica Meneses, Douglas Vanderbilt, Linda Barnes, Marilyn Augustyn
Lucy is a 12-year-old Latina whose mother brought her to the pediatric clinic for help with her anxiety symptoms, "hearing voices," and episodes of "spacing out." Lucy did not cry at birth secondary to vocal cord paralysis and still has the tracheostomy performed at a few days of life. In addition to her neonatal intensive care unit stay, she has been hospitalized for pneumonia. Her mother says she is "sickly" and has a weak immune system due to her asthma symptoms. Lucy also experiences somatic complaints related to gastroesophageal reflux and constipation...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28139319/paradoxical-vocal-fold-motion-pvfm-in-pediatric-otolaryngology
#14
Blake Smith, Claudio Milstein, Bryan Rolfes, Samantha Anne
INTRODUCTION: Paradoxical vocal fold motion (PVFM) is a condition in which the vocal cords exhibit inappropriate inspiratory adduction, and it has been poorly studied in the pediatric population. METHODS: Pediatric patients diagnosed with PVCM by a pediatric otolaryngologist and doctor of speech pathology from 2008 to 2012 were reviewed. Patients in whom another cause for their respiratory disturbance was eventually identified were excluded. Patient demographics, characteristics, treatment, and outcomes were reviewed...
March 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28121976/variation-in-pediatric-care-between-academic-and-nonacademic-us-emergency-departments-1995-2010
#15
Joyce Li, Michael C Monuteaux, Richard G Bachur
OBJECTIVES: The aim of this study was to describe the resource utilization for children with common pediatric conditions treated in academic and nonacademic emergency departments (EDs). METHODS: We performed a retrospective, cross-sectional descriptive study using the National Hospital Ambulatory Medical Care Survey Data from 1995 to 2010 including children less than 18 years old with a diagnosis of asthma, bronchiolitis, croup, gastroenteritis, fever, febrile seizure, or afebrile seizure...
January 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28108245/japanese-guidelines-for-childhood-asthma-2017
#16
REVIEW
Hirokazu Arakawa, Yuhei Hamasaki, Yoichi Kohno, Motohiro Ebisawa, Naomi Kondo, Sankei Nishima, Toshiyuki Nishimuta, Akihiro Morikawa
The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2017 (JAGL 2017) includes a minor revision of the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of Pediatric Allergy and Clinical Immunology. The section on child asthma in JAGL 2017 provides information on how to diagnose asthma between infancy and adolescence (0-15 years of age). It makes recommendations for best practices in the management of childhood asthma, including management of acute exacerbations and non-pharmacological and pharmacological management...
April 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28108152/vocal-symptoms-and-voice-quality-in-children-with-allergy-and-asthma
#17
Emma Kallvik, Johannes Savolainen, Susanna Simberg
OBJECTIVES: The background for dysphonia is multifactorial, and health-related factors have been listed among the factors affecting voice. In previous studies with adult participants, allergy and asthma have been indicated to have a connection to vocal symptoms. With the majority of previous research being studies involving adult participants, it is unclear what the effect of allergy and asthma on children's voices is. The aim of this study was to investigate if allergies and asthma are risk factors for having vocal symptoms...
January 17, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28081237/co-occurrence-of-asthma-and-nephrolithiasis-in-children
#18
Ganesh K Kartha, Ina Li, Suzy Comhair, Serpil C Erzurum, Manoj Monga
It has been proposed that epithelial dysfunction and inflammation may predispose patients to kidney stone formation. Asthma is another chronic condition related to epithelial dysfunction and inflammation. We hypothesized that pediatric patients with asthma would have an increased prevalence of nephrolithiasis. Furthermore, we investigated if asthma patients with nephrolithiasis have clinical characteristics and urine profiles that point to mechanisms of stone formation. We evaluated 865 pediatric patients who had a diagnosis of nephrolithiasis...
2017: PloS One
https://www.readbyqxmd.com/read/27940683/modification-of-an-established-pediatric-asthma-pathway-improves-evidence-based-efficient-care
#19
Lori Rutman, Robert C Atkins, Russell Migita, Jeffrey Foti, Suzanne Spencer, K Casey Lion, Davene R Wright, Michael G Leu, Chuan Zhou, Rita Mangione-Smith
OBJECTIVE: In September 2011, an established pediatric asthma pathway at a tertiary care children's hospital underwent significant revision. Modifications included simplification of the visual layout, addition of evidence-based recommendations regarding medication use, and implementation of standardized admission criteria. The objective of this study was to determine the impact of the modified asthma pathway on pathway adherence, percentage of patients receiving evidence-based care, length of stay, and cost...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27931532/patient-centered-outcomes-research-to-improve-asthma-outcomes
#20
REVIEW
Ayodola Anise, Romana Hasnain-Wynia
The Patient-Centered Outcomes Research Institute is funding 8 comparative effectiveness research projects to improve patient-centered outcomes for African American and Hispanic/Latino patients with uncontrolled asthma. These projects aim to compare multilevel interventions with known efficacy at the community, home, and health system levels to enhance patient and clinician uptake of the National Heart, Lung, and Blood Institute's National Asthma Education Prevention Program guidelines and improve outcomes. The National Asthma Education Prevention Program guidelines provide clinicians with a range of acceptable approaches for the diagnosis and management of asthma and define general practices that meet the needs of most patients...
December 2016: Journal of Allergy and Clinical Immunology
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