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Asthma pediatrics

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https://www.readbyqxmd.com/read/29034999/home-supply-of-emergency-oral-steroids-and-reduction-in-asthma-healthcare-utilization
#1
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/29034996/interleukin-1%C3%AE-polymorphism-and-serum-level-are-associated-with-pediatric-asthma
#2
Paulina Sobkowiak, Irena Wojsyk-Banaszak, Maja Kowalewska, Eliza Wasilewska, Wojciech Langwiński, Zdzisława Kycler, Maria Skibińska, Anna Bręborowicz, Ewa Jassem, Aleksandra Szczepankiewicz
BACKGROUND AND AIM: Interleukin-1 is a pro-inflammatory cytokine found in two forms (α and β). The α form is mainly cell-bound, whereas IL-1β is primarily secreted by macrophages in response to immune system stimulation. We hypothesized that polymorphic variants of interleukin 1 genes may play a role in childhood asthma risk. The aim of this study was to investigate if IL-1α and β polymorphism is associated with asthma in a pediatric population and if the genotype affects its serum level...
October 16, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29031700/cost-benefit-of-comprehensive-primary-and-preventive-school-based-health-care
#3
William V Padula, Katherine A Connor, Josiah M Mueller, Jonathan C Hong, Gabriela Calderon Velazquez, Sara B Johnson
INTRODUCTION: The Rales Health Center is a comprehensive school-based health center at an urban elementary/middle school. Rales Health Center provides a full range of pediatric services using an enriched staffing model consisting of pediatrician, nurse practitioner, registered nurses, and medical office assistant. This staffing model provides greater care but costs more than traditional school-based health centers staffed by part-time nurses. The objective was to analyze the cost benefit of Rales Health Center enhanced staffing model compared with a traditional school-based health center (standard care), focusing on asthma care, which is among the most prevalent chronic conditions of childhood...
October 11, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29029580/uncovering-longitudinal-health-care-behaviors-for-millions-of-medicaid-enrollees-a-multistate-comparison-of-pediatric-asthma-utilization
#4
Ross Hilton, Yuchen Zheng, Anne Fitzpatrick, Nicoleta Serban
BACKGROUND: This study introduces a framework for analyzing and visualizing health care utilization for millions of children, with a focus on pediatric asthma, one of the major chronic respiratory conditions. METHODS: The data source is the 2005 to 2012 Medicaid Analytic Extract claims for 10 Southeast states. The study population consists of Medicaid-enrolled children with persistent asthma. We translate multiyear, individual-level medical claims into sequences of discrete utilization events, which are modeled using Markov renewal processes and model-based clustering...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29028809/nasal-dna-methylation-differentiates-corticosteroid-treatment-response-in-pediatric-asthma-a-pilot-study
#5
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/29028376/interprofessional-pulmocheck-care-pathway-an-innovative-approach-to-managing-pediatric-asthma-care-in-the-netherlands
#6
J M J E Meuwissen, J Heynens, T Dauven, L Crasborn, F W J M Smeenk, T van der Weijden, J W M Muris
OBJECTIVES: Under-diagnosis and suboptimal asthma control in children persists. An innovative care pathway was developed by a hospital department of pediatrics with the aim to detect pulmonary problems in children and provide appropriate treatment possibilities through systematic feedback towards the referring primary care physician. Primary care physicians can use this pathway to refer children with asthma-like symptoms for a one-day assessment. Goals are to measure the usage of the pathway by primary care general practitioners (GPs), the outcomes in terms of new diagnoses of asthma, the reduction in regular referrals, generated recommendations/therapy and the adequacy of asthma follow-up...
October 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29027824/a-computable-phenotype-for-asthma-case-identification-in-adult-and-pediatric-patients-external-validation-in-the-chicago-area-patient-outcomes-research-network-capricorn
#7
Majid Afshar, Valerie G Press, Rachel G Robison, Abel N Kho, Sindhura Bandi, Ashvini Biswas, Pedro C Avila, Harsha Vardhan Madan Kumar, Byung Yu, Edward T Naureckas, Sharmilee M Nyenhuis, Christopher D Codispoti
OBJECTIVE: Comprehensive, rapid, and accurate identification of patients with asthma for clinical care and engagement in research efforts is needed. The original development and validation of a computable phenotype for asthma case identification occurred at a single institution in Chicago and demonstrated excellent test characteristics. However, its application in a diverse payer mix, across different health systems and multiple electronic health record vendors, and in both children and adults was not examined...
October 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29019632/racial-and-ethnic-health-disparities-and-trauma-informed-care-for-children-exposed-to-community-violence
#8
Bradley C Stolbach, Seeba Anam
Racial and ethnic disparities in health outcomes and access have been consistently documented for a wide variety of physical and behavioral health conditions. Health inequities are most pronounced in areas with high levels of racial and ethnic segregation, where children and adolescents are also more likely to face economic inequality, which places them at high risk for exposure to neighborhood violence and traumatic loss. Community violence exposure (CVE) has been increasingly recognized as a prominent contributor to negative physical and mental health outcomes...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29018501/quality-of-life-in-pediatric-patients-with-allergic-rhinitis-treated-at-the-medical-clinic-of-integrated-education-unisul
#9
Mariana Dziekanski, Taíse de Freitas Marcelino
Introduction  Allergic rhinitis is a common disease among children and adolescents, reaching up to 40% of the population. During childhood, it is usually underdiagnosed because it has nonspecific symptoms. It has a negative impact on quality of life and may predispose to comorbidities. The diagnosis is clinical and treatment aims prevention. Objective  The objective of this study is to evaluate the quality of life in pediatric patients with allergic rhinitis. Methods This is an observational study with cross-sectional design...
October 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29016970/a-genome-by-environment-interaction-classifier-for-precision-medicine-personal-transcriptome-response-to-rhinovirus-identifies-children-prone-to-asthma-exacerbations
#10
Vincent Gardeux, Joanne Berghout, Ikbel Achour, A Grant Schissler, Qike Li, Colleen Kenost, Jianrong Li, Yuan Shang, Anthony Bosco, Donald Saner, Marilyn J Halonen, Daniel J Jackson, Haiquan Li, Fernando D Martinez, Yves A Lussier
Objective: To introduce a disease prognosis framework enabled by a robust classification scheme derived from patient-specific transcriptomic response to stimulation. Materials and Methods: Within an illustrative case study to predict asthma exacerbation, we designed a stimulation assay that reveals individualized transcriptomic response to human rhinovirus. Gene expression from peripheral blood mononuclear cells was quantified from 23 pediatric asthmatic patients and stimulated in vitro with human rhinovirus...
November 1, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28991947/regional-variation-in-standardized-costs-of-care-at-children-s-hospitals
#11
Jennifer A Jonas, Samir S Shah, Isabella Zaniletti, Matthew Hall, Jeffrey D Colvin, Laura M Gottlieb, Marion R Sills, Jessica Bettenhausen, Rustin B Morse, Michelle L Macy, Evan S Fieldston
OBJECTIVE: (1) To evaluate regional variation in costs of care for 3 inpatient pediatric conditions, (2) assess potential drivers of variation, and (3) estimate cost savings from reducing variation. DESIGN/SETTING: Retrospective cohort study of hospitalizations for asthma, diabetic ketoacidosis (DKA), and acute gastroenteritis (AGE) at 46 children<s hospitals from October 2014 to September 2015. MEASUREMENTS: Variation in trimmed standardized costs were assessed within and across regions...
October 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28986919/mepolizumab-a-novel-option-for-the-treatment-of-hypereosinophilic-syndrome-in-childhood
#12
Carsten Schwarz, Thilo Müller, Susanne Lau, Kirn Parasher, Doris Staab, Ulrich Wahn
BACKGROUND: Mepolizumab was originally intended as a therapeutic agent for atopic asthma in adults, and consequently little is known about its use in children. Up to now corticosteroids have formed the basis of the initial treatment of hypereosinophilic syndromes and are shown to be effective in most patients. To analyse the effect of mepolizumab in children is the aim of this study. METHODS: We are reporting the experience of the effect of mepolizumab in two paediatric patients of hypereosinophilic syndrome that was not sufficiently controlled by other drugs...
October 6, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28986245/applying-interactive-mobile-health-to-asthma-care-in-teens-aim2act-development-and-design-of-a-randomized-controlled-trial
#13
David A Fedele, Andrew McConville, J Graham Thomas, Elizabeth L McQuaid, David M Janicke, Elise M Turner, Jon Moon, Mutasim Abu-Hasan
Early adolescents have difficulties performing asthma self-management behaviors, placing them at-risk for poor asthma control and reduced quality of life. This paper describes the development and plans for testing an interactive mobile health (mHealth) tool for early adolescents, ages 12-15years, and their caregivers to help improve asthma management. Applying Interactive Mobile health to Asthma Care in Teens (AIM2ACT) is informed by the Pediatric Self-management model, which posits that helpful caregiver support is facilitated by elucidating disease management behaviors and allocating treatment responsibility in the family system, and subsequently engaging in collaborative caregiver-adolescent asthma management...
October 3, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28985997/il-33-gene-variants-and-protein-expression-in-pediatric-tunisian-asthmatic-patients
#14
Rihab Charrad, Wajih Kaabachi, Anissa Berraies, Kamel Hamzaoui, Agnès Hamzaoui
Interleukin-33 (IL-33) is one of the last discovered members of the human IL-1 family. It is involved in the pathogenesis of many inflammatory diseases. This study investigates the relationship between IL33 gene variants and serum protein levels with the development of childhood asthma. We analyzed in this case-control study the distribution of two IL33 polymorphisms, rs7044343 and rs1342326, within 200 Tunisian children, using predefined Taqman genotyping assays. IL-33 serum levels were assessed by commercial sandwich Enzyme-linked immunosorbent assay (ELISA)...
October 3, 2017: Cytokine
https://www.readbyqxmd.com/read/28975221/association-of-an-asthma-improvement-collaborative-with-health-care-utilization-in-medicaid-insured-pediatric-patients-in-an-urban-community
#15
Carolyn M Kercsmar, Andrew F Beck, Hadley Sauers-Ford, Jeffrey Simmons, Brandy Wiener, Lisa Crosby, Susan Wade-Murphy, Pamela J Schoettker, Pavan K Chundi, Zeina Samaan, Mona Mansour
Importance: Asthma is the most common chronic condition of childhood. Hospitalizations and emergency department (ED) visits for asthma are more frequently experienced by minority children and adolescents and those with low socioeconomic status. Objective: To reduce asthma-related hospitalizations and ED visits for Medicaid-insured pediatric patients residing in Hamilton County, Ohio. Design, Setting, and Participants: From January 1, 2010, through December 31, 2015, a multidisciplinary team used quality-improvement methods and the chronic care model to conduct interventions in inpatient, outpatient, and community settings in a large, urban academic pediatric hospital in Hamilton County, Ohio...
September 18, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28968668/rhinovirus-viremia-in-patients-hospitalized-with-community-acquired-pneumonia
#16
Xiaoyan Lu, Eileen Schneider, Seema Jain, Anna M Bramley, Weston Hymas, Chris Stockmann, Krow Ampofo, Sandra R Arnold, Derek J Williams, Wesley H Self, Anami Patel, James D Chappell, Carlos G Grijalva, Evan J Anderson, Richard G Wunderink, Jonathan A McCullers, Kathryn M Edwards, Andrew T Pavia, Dean D Erdman
Background: Rhinoviruses (RVs) are ubiquitous respiratory pathogens that often cause mild or subclinical infections. Molecular detection of RV from the upper respiratory tract can be prolonged, complicating etiologic association in persons with severe lower respiratory tract infections. Little is known about RV viremia and its value as a diagnostic indicator in persons hospitalized with community-acquired pneumonia (CAP). Methods: Sera from RV-positive children and adults hospitalized with CAP were tested for RV by real-time RT-PCR...
August 29, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28956954/hiv-related-chronic-lung-disease-in-adolescents-are-we-prepared-for-the-future
#17
Pierre Goussard, Robert P Gie
Chronic lung diseases (CLD) are the most chronic disease occurring in adolescents living with human immunodeficiency virus (ALHIV). In ALHIV who received antiretroviral therapy (ART) late in childhood, bronchiectasis, bronchiolitis obliterans and interstitial pneumonitis are common. In adolescents who received ART early in life the spectrum of CLD has changed with asthma and chronic obstructive pulmonary disease being common. Areas covered: The aim of this paper was to review CLD in ALHIV. We conducted a literature review of electronic databases focusing on CLD that were common prior to the introduction of ART (1996-2004), the present situation where ART is widely available (2005 to 2016), and articles which aided us speculating on the impact of HIV-related CLD in adolescents transitioning to adult HIV-clinics...
September 28, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28954042/antisecretory-treatment-for-pediatric-gastroesophageal-reflux-disease-a-systematic-review
#18
Ângelo Zambam de Mattos, Gabriela Meirelles Marchese, Bárbara Brum Fonseca, Carlos Kupski, Marta Brenner Machado
BACKGROUND: Proton pump inhibitors and histamine H2 receptor antagonists are two of the most commonly prescribed drug classes for pediatric gastroesophageal reflux disease, but their efficacy is controversial. Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux, even that causal relation is not proven. OBJECTIVE: To evaluate the use of proton pump inhibitors and histamine H2 receptor antagonists in pediatric gastroesophageal reflux disease through a systematic review...
September 21, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28951646/inpatient-orthopaedic-hardware-removal-in-children-a-cross-sectional-study
#19
Alexandre Boulos, Steven F DeFroda, Justin E Kleiner, Nathan Thomas, Joseph A Gil, Aristides I Cruz
INTRODUCTION: Few data describe the specific reasons for inpatient hardware removal in the pediatric population. This study was designed to understand the conditions necessitating inpatient removal following fracture surgery. Cost data was analyzed to understand the financial implications of these procedures. METHODS: The Kids' Inpatient Database (KID) was evaluated for the year 2012. Patients undergoing open reduction internal fixation following upper and lower extremity fractures as well as those undergoing hardware removal due to hardware complications were identified using ICD-9 CM diagnosis and procedure codes...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28949898/a-randomized-study-of-a-method-for-optimizing-adolescent-assent-to-biomedical-research
#20
Robert D Annett, Janet L Brody, David G Scherer, Charles W Turner, Jeanne Dalen, Hengameh Raissy
PURPOSE: Voluntary consent/assent with adolescents invited to participate in research raises challenging problems. No studies to date have attempted to manipulate autonomy in relation to assent/consent processes. This study evaluated the effects of an autonomy-enhanced individualized assent/consent procedure embedded within a randomized pediatric asthma clinical trial. METHODS: Families were randomly assigned to remain together or separated during a consent/assent process; the latter we characterize as an autonomy-enhanced assent/consent procedure...
July 2017: AJOB Empirical Bioethics
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