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Severe pediatric asthma

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https://www.readbyqxmd.com/read/27923646/role-of-the-allergist-immunologist-and-upper-airway-allergy-in-sleep-disordered-breathing
#1
Dennis Shusterman, Fuad M Baroody, Timothy Craig, Samuel Friedlander, Talal Nsouli, Bernard Silverman
BACKGROUND: Sleep-disordered breathing in general and obstructive sleep apnea in particular are commonly encountered conditions in allergy practice. Physiologically, nasal (or nasopharyngeal) obstruction from rhinitis, nasal polyposis, or adenotonsillar hypertrophy are credible contributors to snoring and nocturnal respiratory obstructive events. Nevertheless, existing practice parameters largely relegate the role of the allergist to adjunctive treatment in cases of continuous positive airway pressure intolerance...
December 3, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27920408/asthma-and-other-allergic-diseases-among-saudi-schoolchildren-in-najran-the-need-for-a-comprehensive-intervention-program
#2
Jobran M Alqahtani
BACKGROUND: In the last three decades, an increasing incidence of allergic diseases has been associated with increasing morbidity and mortality in children and young adults. OBJECTIVES: The study aimed to investigate the prevalence and risk factors associated with allergic diseases among Saudi schoolchildren in the southwestern Saudi region of Najran, and to determine the sensitization of patients to a set of allergens. DESIGN: Cross-sectional observational study...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27909980/omalizumab-in-severe-refractory-vernal-keratoconjunctivitis-in-children-case-series-and-review-of-the-literature
#3
Serge Doan, Flore Amat, Eric Gabison, Sarah Saf, Isabelle Cochereau, Jocelyne Just
INTRODUCTION: Vernal keratoconjunctivis (VKC) is a severe form of pediatric ocular allergy, characterized by acute and chronic corneoconjunctival inflammation that may lead to visual sequelae. Although topical immunosuppressive drugs such as cyclosporine are usually effective, some severe forms may be refractory and require prolonged steroid therapy. Very few papers report the use of omalizumab in VKC in the literature. In the present study, we describe our clinical experience with omalizumab in severe VKC children...
December 1, 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27887621/pediatric-emergency-department-visits-and-ambient-air-pollution-in-the-u-s-state-of-georgia-a-case-crossover-study
#4
Qingyang Xiao, Yang Liu, James A Mulholland, Armistead G Russell, Lyndsey A Darrow, Paige E Tolbert, Matthew J Strickland
BACKGROUND: Estimating the health effects of ambient air pollutant mixtures is necessary to understand the risk of real-life air pollution exposures. METHODS: Pediatric Emergency Department (ED) visit records for asthma or wheeze (n = 148,256), bronchitis (n = 84,597), pneumonia (n = 90,063), otitis media (n = 422,268) and upper respiratory tract infection (URI) (n = 744,942) were obtained from Georgia hospitals during 2002-2008. Spatially-contiguous daily concentrations of 11 ambient air pollutants were estimated from CMAQ model simulations that were fused with ground-based measurements...
November 25, 2016: Environmental Health: a Global Access Science Source
https://www.readbyqxmd.com/read/27875593/enterovirus-d68-in-hospitalized-children-sequence-variation-viral-loads-and-clinical-outcomes
#5
Katherine Moyer, Huanyu Wang, Douglas Salamon, Amy Leber, Asuncion Mejias
BACKGROUND: An outbreak of enterovirus D68 (EV-D68) caused severe respiratory illness in 2014. The disease spectrum of EV-D68 infections in children with underlying medical conditions other than asthma, the role of EV-D68 loads on clinical illness, and the variation of EV-D68 strains within the same institution over time have not been described. We sought to define the association between EV-D68 loads and sequence variation, and the clinical characteristic in hospitalized children at our institution from 2011 to 2014...
2016: PloS One
https://www.readbyqxmd.com/read/27865715/time-dependent-severity-change-during-treatment-of-pediatric-patients-hospitalized-for-acute-asthma-exacerbations
#6
Colin G Walsh, Marion R Sills, Donald H Arnold
No abstract text is available yet for this article.
November 16, 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27852427/monitoring-the-hospital-management-of-acute-asthma-the-italian-pediatric-network-experience
#7
A G Martelli, R Bianchi, B Boldrighini, M Bosoni, A De Vuono, A Flores D'Arcais, G Gargantini, R Longhi, M T Ortisi, E Racchi, L Parola
BACKGROUND: The Study Group on Accreditation and Quality Improvement of the Italian Society of Pediatrics has developed an observational study about the hospital management of pediatric patients affected by severe asthma, in order to evaluate how the Guidelines for severe asthma in childhood are applied in the daily practice. METHODS: This study included patients between 2 and 17 years, hospitalized or under short intensive observation for acute asthma. The data collection was carried out through the compilation of on-line forms...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27831833/direct-concurrent-comparison-of-multiple-pediatric-acute-asthma-scoring-instruments
#8
Michael D Johnson, Flory L Nkoy, Xiaoming Sheng, Tom Greene, Bryan L Stone, Jennifer Garvin
OBJECTIVE: Appropriate delivery of Emergency Department (ED) treatment to children with acute asthma requires clinician assessment of acute asthma severity. Various clinical scoring instruments exist to standardize assessment of acute asthma severity in the ED, but their selection remains arbitrary due to few published direct comparisons of their properties. Our objective was to test the feasibility of directly comparing properties of multiple scoring instruments in a pediatric ED. METHODS: Using a novel approach supported by a composite data collection form, clinicians categorized elements of 5 scoring instruments before and after initial treatment for 48 patients 2-18 years of age with acute asthma seen at the emergency department of a tertiary care pediatric hospital ED from August to December 2014...
November 10, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27826964/comorbidities-and-phenotypes-of-rhinitis-in-korean-children-and-adolescents-a-cross-sectional-multicenter-study
#9
Kyung Suk Lee, Hye Yung Yum, Youn Ho Sheen, Yong Mean Park, Yong Ju Lee, Bong Seok Choi, Hye Mi Jee, Sun Hee Choi, Hyun Hee Kim, Yang Park, Hyo Bin Kim, Yeong Ho Rha
PURPOSE: Rhinitis is a nasal inflammatory disease in children and adolescents. However, little is known about the phenotypes and characteristics of allergic rhinitis (AR) in Korean children and adolescents. The objective of this study was to analyze the symptoms and comorbidities of rhinitis, to compare AR to non-allergic rhinitis (NAR), and to reveal the phenotypes and features of AR in a Korean pediatric population. METHODS: Patients under 18 years of age with rhinitis symptoms were recruited from January 2013 to January 2015 by pediatric allergists...
January 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27826962/asthma-severity-and-the-controller-prescription-in-children-at-12-tertiary-hospitals
#10
Dong In Suh, Hyeon Jong Yang, Bong Seong Kim, Youn Ho Shin, So Yeon Lee, Geunhwa Park, Woo Kyung Kim, Hyo Bin Kim, Heysung Baek, Ja Kyoung Kim, Jin Tack Kim, Dae Hyun Lim
PURPOSE: Guidelines need to be tailored to where they are applied. We aimed to describe the distinctive asthma severity profile and the pattern of controller prescription in Korean children. METHODS: Twelve pediatric allergists from tertiary medical centers reviewed medical records of all asthmatic children who visited their clinics between September 1 and November 30 of 2013. Controller prescriptions were re-classified into 4 categories, then the prevalence of each asthma severity category and the controller prescription patterns according to asthma severity assessed by a Western (Global Initiative for Asthma, GINA) and an Asia-Pacific (Japanese Pediatric GuideLine, JPGL) guideline were evaluated...
January 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27803176/examining-profiles-of-family-functioning-in-pediatric-asthma-longitudinal-associations-with-child-adjustment-and-asthma-severity
#11
Nour Al Ghriwati, Marcia A Winter, Robin S Everhart
OBJECTIVE : Identify profiles of functioning in families of children with asthma and examine whether profile membership predicts subsequent child mental and physical well-being. METHODS : Primary caregivers and children (N = 1,030) from the Childhood Asthma Management Program completed questionnaires assessing family functioning and child adaptation at five time points. Asthma severity was also assessed via spirometry. RESULTS : Latent profile analyses identified a four-profile solution as best fitting the data: cohesive, permissive, controlling/disengaged, and controlling/enmeshed families...
November 1, 2016: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/27801958/nasal-obstructive-disorders-induce-medical-treatment-failure-in-pediatric-persistent-allergic-rhinitis-the-nodpar-study
#12
Franklin S Mariño-Sánchez, Meritxell Valls-Mateus, Karen Ruiz-Echevarría, Isam Alobid, Paulina Cardenas-Escalante, Rosa Jiménez-Feijoo, Jaime Lozano-Blasco, María T Giner-Muñoz, Jesús Rodríguez-Jorge, Oliver Haag, Ana M Plaza-Martin, Joaquim Mullol
BACKGROUND: Allergic rhinitis (AR) is the most common chronic disease among children. To characterize the disease, a modified classification of severity (m-ARIA) has recently been validated in AR children. When medical treatment fails, surgery for nasal obstructive disorders (NOD) may be a therapeutic option. Our objective was to assess the prevalence of NOD and their influence in medical treatment response among children with persistent AR (PER). METHODS: In a prospective, real-life study, 130 pediatric PER patients (13...
November 1, 2016: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/27785078/anti-inflammatory-dosing-of-theophylline-in-the-treatment-of-status-asthmaticus-in-children
#13
Nemr S Eid, Adrian O'Hagan, Scott Bickel, Ronald Morton, Sarah Jacobson, John A Myers
BACKGROUND: Low-dose theophylline has been recognized for its ability to restore histone deacetylase-2 activity which leads to improved steroid responsiveness and thus improved clinical outcome. We retrospectively evaluated the effect of low-dose theophylline therapy in pediatric patients hospitalized for an acute asthma exacerbation as a proof of concept study. METHODS: We compared patients who received low-dose theophylline (5-7 mg/kg/day) in addition to current standard of care to patients who were treated with current standard of care alone...
2016: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/27749021/is-impaired-glucose-metabolism-the-missing-piece-in-the-obesity-asthma-puzzle
#14
Tarig Ali-Dinar, Jason E Lang
Obesity is a major risk factor for several conditions including atherosclerotic disease, metabolic syndrome, and upper airway dysfunction. However, the purported link between obesity and asthma has remained more difficult to define, in part due to limitations in past epidemiologic studies and the inherent challenge in accurately defining asthma in children. It is possible that obesity leads to asthma only in the presence of a mediating variable such as an obesity-related conditions such as esophageal reflux or insulin resistance...
October 17, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27748630/pharmacokinetics-pharmacodynamics-and-clinical-efficacy-of-omalizumab-for-the-treatment-of-asthma
#15
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...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27741074/using-pleth-variability-as-a-triage-tool-for-children-with-obstructive-airway-disease-in-a-pediatric-emergency-department
#16
Ariel Brandwein, Kavita Patel, Myriam Kline, Peter Silver, Sandeep Gangadharan
OBJECTIVES: Patients with obstructive airway disease have varying degrees of pulsus paradoxus that correlate with illness severity. Pulsus paradoxus can be measured using plethysmography. We investigated whether plethysmograph (pleth) variability on admission to the pediatric emergency department (ED) could predict patient disposition. We hypothesized that patients with a larger pleth variability would have a higher likelihood of being admitted to a general pediatrics unit or the intensive care unit (ICU)...
October 6, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27739908/asthma-allergy-and-obesity-examining-the-relationship-among-nevada-children
#17
Jennifer A Lucas, Sheniz Moonie, Kimberly Olsen-Wilson, Mary Beth Hogan
OBJECTIVE: The majority of pediatric asthma is atopic, but whether pediatric obese asthma is atopic is indeterminate in the literature. In Nevada, children become sensitized to aeroallergens, a risk factor for asthma, at young ages. Additionally, Nevada children have high rates of obesity. Our objective is to determine whether elevated body mass index (BMI) is associated with asthma severity, allergen sensitization, and polysensitization. METHODS: Medical records from a pediatric allergy clinic provided BMI percentile, physician-diagnosed asthma severity, skin prick test data, and sociodemographics such as age, race, sex, and insurance status from asthmatic patients...
October 14, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27736038/multidisciplinary-treatment-in-children-with-problematic-severe-asthma-a-prospective-evaluation
#18
Marieke Verkleij, Anita Beelen, Bart E van Ewijk, Rinie Geenen
OBJECTIVE: For children with problematic severe asthma, achieving adequate control of asthma is difficult. The aim of this prospective observational study was to evaluate the effects of intensive multidisciplinary inpatient treatment on multiple outcome variables in children with problematic severe asthma. METHODS: Participants were 89 children with problematic severe asthma (mean age 13.6 ± 2.5 years) treated in tertiary care clinics at high altitude (Switzerland) or sea level (Netherlands) and their parents (85 mothers, 55 fathers)...
October 13, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27729114/asthma-outcomes-after-adenotonsillectomy-a-systematic-review
#19
Nikita Kohli, Dana DeCarlo, Nira A Goldstein, Joshua Silverman
OUTCOME OBJECTIVE: For over fifty years, otolaryngologists, allergists, and immunologists have debated the effect of adenoidectomy or adenotonsillectomy on asthma outcomes in children. Although some have suggested that adenotonsillectomy may contribute to the subsequent development of asthma in children, others have argued that a common mechanism may cause both upper and lower airway disease, and that children who have symptoms severe enough to warrant adenotonsillectomy are also at increased risk of asthma and atopic disease...
November 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27685608/omalizumab-in-patient-with-aspirin-exacerbated-respiratory-disease-and-chronic-idiopathic-urticaria
#20
Federica Porcaro, Antonio Di Marco, Renato Cutrera
Aspirin hypersensitivity associated with chronic rhinosinusitis-with or without nasal polyposis-and asthma resistant to conventional therapy defines the aspirin-exacerbated respiratory disease (AERD). We describe the case of a 15-year-old female patient with adverse reaction to aspirin, chronic rhinosinusitis, and severe asthma. She also experienced chronic idiopathic urticaria worsened by non-steroidal anti-inflammatory drug administration. AERD was diagnosed based on clinical history and symptoms. Given the poor responsiveness to standard therapy for respiratory and cutaneous symptoms, omalizumab was administered for 24 weeks with control of respiratory symptoms and short term improvement of cutaneous symptoms...
September 29, 2016: Pediatric Pulmonology
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