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Severe pediatric asthma

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https://www.readbyqxmd.com/read/29159184/acute-asthma-in-the-pediatric-emergency-department-infections-are-the-main-triggers-of-exacerbations
#1
Arianna Dondi, Elisabetta Calamelli, Valentina Piccinno, Giampaolo Ricci, Ilaria Corsini, Carlotta Biagi, Marcello Lanari
Background: Asthma exacerbations are a common reason for Emergency Department (ED) visits in children. Aim: To analyze differences among age groups in terms of triggering factors and seasonality and to identify those with higher risk of severe exacerbations. Methods: We retrospectively revised the files of children admitted for acute asthma in 2016 in our Pediatric ED. Results: Visits for acute asthma were 603/23197 (2...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29150070/decreased-expression-of-indolamine-2-3-dioxygenase-in-childhood-allergic-asthma-and-its-inverse-correlation-with-fractional-concentration-of-exhaled-nitric-oxide
#2
Ying Hu, Zhiqiang Chen, Ling Jin, Mei Wang, Wei Liao
BACKGROUND: The tryptophan metabolic pathway mediated by indolamine 2,3-dioxygenase (IDO), a tryptophan-degrading enzyme, plays an important role in controlling the development of allergic inflammation. The fractional concentration of exhaled nitric oxide (FeNO) is closely associated with the allergic state and is extensively used for the clinical evaluation of airway allergic inflammation. Clinical trials have rarely assessed the expression of IDO in childhood allergic asthma and its correlation with FeNO...
November 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29133072/treatment-of-pediatric-black-widow-spider-envenomation-a-national-poison-center-s-experience
#3
Miguel Glatstein, Gary Carbell, Dennis Scolnik, Ayelet Rimon, Christopher Hoyte
BACKGROUND: Black widow species (Latrodectus species) envenomation can produce a syndrome characterized by painful muscle rigidity and autonomic disturbances. Symptoms tend to be more severe in young children and adults. We describe black widow spider exposures and treatment in the pediatric age group, and investigate reasons for not using antivenom in severe cases. METHODS: All black widow exposures reported to the Rocky Mountain Poison Center between January 1, 2012, and December 31, 2015, were reviewed...
November 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29108093/the-self-reported-quality-of-life-of-lithuanian-children-with-asthma-was-comparable-to-western-populations
#4
Vaida Taminskiene, Egle Vaitkaitiene, Algirdas Valiulis, Steve Turner, Adamos Hadjipanayis, Rimantas Stukas, Arunas Valiulis
AIM: Quality of life (QoL) has been widely researched among children with asthma in Western countries, but there is a lack of data from Eastern Europe, where the prevalence is relatively low, but hospital admission rates are higher. We evaluated the overall level and major determinants of QoL in Lithuanian children aged 5-11 years with asthma. METHODS: This study was carried out in six asthma outpatient clinics in the two largest cities of Lithuania from January 2015 to July 2016...
November 6, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29096551/moving-toward-consensus-on-diagnosis-and-management-of-severe-asthma-in-children
#5
Désirée Larenas-Linnemann, Antonio Nieto, Oscar Palomares, Paulo Márcio Pitrez, Gherson Cukier
Children with severe asthma continue to experience symptoms despite long-term treatment with high doses of corticosteroids. Moreover, the heterogeneous nature of asthma and the presence of several phenotypes has limited our ability to develop an optimized management strategy for these patients. Adequate management of severe asthma in children necessitates a detailed understanding of what makes asthma difficult to control, knowledge of the causal factors, review of diagnosis for accurate identification of pediatric patients with severe asthma, and a precise definition of the phenotypes to be able to better target the therapy...
November 3, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29059087/controversies-and-opportunities-in-severe-asthma
#6
Marc Humbert, William Busse, Nicola A Hanania
PURPOSE OF REVIEW: Despite currently available treatments, many asthma patients remain inadequately controlled, but identifying distinct patient populations (phenotypes/endotypes) may optimize their management. This review discusses some of the controversies and opportunities for improved disease control in severe asthma. RECENT FINDINGS: Currently approved anti-immunoglobulin E and anti-interleukin 5 biologics, which target specific pathways instead of using a 'one size fits all' strategy, are efficacious and well tolerated therapies for severe asthma...
October 20, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29055500/long-term-systemic-corticosteroid-exposure-a-systematic-literature-review
#7
REVIEW
J Bradford Rice, Alan G White, Lauren M Scarpati, George Wan, Winnie W Nelson
PURPOSE: While corticosteroids are relatively inexpensive and commonly used as treatment for a variety of conditions, long-term use is known to be associated with certain toxicities. Prior systematic reviews have revealed an increased risk for costly adverse events (AEs), including bone fracture, infection, and gastrointestinal bleeding. The objective of this study was to conduct a systematic literature review of recent publications on the burden of long-term corticosteroid exposure, specifically, to summarize the AEs and economic impact of long-term corticosteroid use and to reveal data gaps for additional research...
October 18, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29055045/diagnostic-relevance-of-ige-sensitization-profiles-to-eight-recombinant-phleum-pratense-molecules
#8
Francesca Cipriani, Carla Mastrorilli, Salvatore Tripodi, Giampaolo Ricci, Serena Perna, Valentina Panetta, Riccardo Asero, Arianna Dondi, Annamaria Bianchi, Nunzia Maiello, Michele Miraglia Del Giudice, Tullio Frediani, Francesco Macrì, Sandra Lucarelli, Iride Dello Iacono, Maria Francesca Patria, Elena Varin, Diego Peroni, Loredana Chini, Viviana Moschese, Roberto Bernardini, Giuseppe Pingitore, Umberto Pelosi, Mariangela Tosca, Francesco Paravati, Ifigenia Sfika, Andrea Di Rienzo Businco, Calotta Povesi Dascola, Pasquale Comberiati, Simone Frediani, Caterina Lambiase, Maria Carmen Verga, Diego Faggian, Mario Plebani, Mauro Calvani, Carlo Caffarelli, Paolo Maria Matricardi
BACKGROUND: Grass pollen-related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood. METHODS: We examined 1120 children (age 4-18y) with SARg...
October 20, 2017: Allergy
https://www.readbyqxmd.com/read/29034999/home-supply-of-emergency-oral-steroids-and-reduction-in-asthma-healthcare-utilization
#9
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/29029580/uncovering-longitudinal-health-care-behaviors-for-millions-of-medicaid-enrollees-a-multistate-comparison-of-pediatric-asthma-utilization
#10
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/29028376/interprofessional-pulmocheck-care-pathway-an-innovative-approach-to-managing-pediatric-asthma-care-in-the-netherlands
#11
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/29018501/quality-of-life-in-pediatric-patients-with-allergic-rhinitis-treated-at-the-medical-clinic-of-integrated-education-unisul
#12
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/28986919/mepolizumab-a-novel-option-for-the-treatment-of-hypereosinophilic-syndrome-in-childhood
#13
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/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/28968668/rhinovirus-viremia-in-patients-hospitalized-with-community-acquired-pneumonia
#15
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/28947906/oral-food-challenge-outcomes-in-a-pediatric-tertiary-care-center
#16
Elissa M Abrams, Allan B Becker
BACKGROUND: Oral food challenges are the clinical standard for diagnosis of food allergy. Little data exist on predictors of oral challenge failure and reaction severity. METHODS: A retrospective chart review was done on all pediatric patients who had oral food challenges in a tertiary care pediatric allergy clinic from 2008 to 2010. RESULTS: 313 oral challenges were performed, of which the majority were to peanut (105), egg (71), milk (41) and tree nuts (29)...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28941390/severe-forms-of-food-allergy
#17
REVIEW
Emanuel Sarinho, Maria das Graças Moura Lins
OBJECTIVES: To guide the diagnostic and therapeutic management of severe forms of food allergy. DATA SOURCES: Search in the Medline database using the terms "severe food allergy," "anaphylaxis and food allergy," "generalized urticaria and food allergy," and "food protein-induced enterocolitis syndrome" in the last ten years, searching in the title, abstract, or keyword fields. SUMMARY OF DATA: Food allergy can be serious and life-threatening...
November 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28927681/adapting-an-evidence-based-pediatric-acute-asthma-exacerbation-severity-assessment-tool-for-pediatric-primary-care
#18
Anne T Magpuri, Jane K Dixon, Ruth McCorkle, Angela A Crowley
INTRODUCTION: The purposes of this project were (a) to examine criteria derived from evidence-based pediatric acute asthma exacerbation assessment tools, asthma scores, and the acute asthma prediction rule validated and used in the emergency department and (b) to adapt these criteria for pediatric primary care. METHOD: The three stages of the project included (a) identification of criteria in a literature review, (b) validation of the criteria by an expert panel, and (c) adaptation of the criteria in the design of an assessment tool...
September 16, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28926508/racial-ethnic-variation-in-emergency-department-care-for-children-with-asthma
#19
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/28915908/advances-in-paediatrics-in-2016-current-practices-and-challenges-in-allergy-autoimmune-diseases-cardiology-endocrinology-gastroenterology-infectious-diseases-neonatology-nephrology-neurology-nutrition-pulmonology
#20
REVIEW
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Silvia Montella, Sergio Bernasconi
This review reports main progresses in various pediatric issues published in Italian Journal of Pediatrics and in international journals in 2016. New insights in clinical features or complications of several disorders may be useful for our better understanding. They comprise severe asthma, changing features of lupus erythematosus from birth to adolescence, celiac disease, functional gastrointestinal disorders, Moebius syndrome, recurrent pneumonia. Risk factors for congenital heart defects, Kawasaki disease have been widely investigated...
September 16, 2017: Italian Journal of Pediatrics
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