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Severe pediatric asthma

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https://www.readbyqxmd.com/read/28725641/mechanisms-mediating-pediatric-severe-asthma-and-potential-novel-therapies
#1
REVIEW
Aldara Martin Alonso, Sejal Saglani
Although a rare disease, severe therapy-resistant asthma in children is a cause of significant morbidity and results in utilization of approximately 50% of health-care resources for asthma. Improving control for children with severe asthma is, therefore, an urgent unmet clinical need. As a group, children with severe asthma have severe and multiple allergies, steroid resistant airway eosinophilia, and significant structural changes of the airway wall (airway remodeling). Omalizumab is currently the only add-on therapy that is licensed for use in children with severe asthma...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28724795/alx-receptor-ligands-define-a-biochemical-endotype-for-severe-asthma
#2
Isabell Ricklefs, Ioanna Barkas, Melody G Duvall, Manuela Cernadas, Nicole L Grossman, Elliot Israel, Eugene R Bleecker, Mario Castro, Serpil C Erzurum, John V Fahy, Benjamin M Gaston, Loren C Denlinger, David T Mauger, Sally E Wenzel, Suzy A Comhair, Andrea M Coverstone, Merritt L Fajt, Annette T Hastie, Mats W Johansson, Michael C Peters, Brenda R Phillips, Bruce D Levy
BACKGROUND: In health, inflammation resolution is an active process governed by specialized proresolving mediators and receptors. ALX/FPR2 receptors (ALX) are targeted by both proresolving and proinflammatory ligands for opposing signaling events, suggesting pivotal roles for ALX in the fate of inflammatory responses. Here, we determined if ALX expression and ligands were linked to severe asthma (SA). METHODS: ALX expression and levels of proresolving ligands (lipoxin A4 [LXA4], 15-epi-LXA4, and annexin A1 [ANXA1]), and a proinflammatory ligand (serum amyloid A [SAA]) were measured in bronchoscopy samples collected in Severe Asthma Research Program-3 (SA [n = 69], non-SA [NSA, n = 51] or healthy donors [HDs, n = 47])...
July 20, 2017: JCI Insight
https://www.readbyqxmd.com/read/28689839/severe-asthma-in-children
#3
Sima K Ramratnam, Leonard B Bacharier, Theresa W Guilbert
Severe asthma in children is associated with significant morbidity and is a highly heterogeneous disorder with multiple clinical phenotypes. Cluster analyses have been performed in several groups to explain some of the heterogeneity of pediatric severe asthma, which is reviewed in this article. The evaluation of a child with severe asthma includes a detailed diagnostic assessment and excluding other possible diagnoses and addressing poor control due to comorbidities, lack of adherence to asthma controller medications, poor technique, and other psychological and environmental factors...
July 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28686637/endotypes-of-difficult-to-control-asthma-in-inner-city-african-american-children
#4
K R Brown, R Z Krouse, A Calatroni, C M Visness, U Sivaprasad, C M Kercsmar, E C Matsui, J B West, M M Makhija, M A Gill, H Kim, M Kattan, D Pillai, J E Gern, W W Busse, A Togias, A H Liu, G K Khurana Hershey
African Americans have higher rates of asthma prevalence, morbidity, and mortality in comparison with other racial groups. We sought to characterize endotypes of childhood asthma severity in African American patients in an inner-city pediatric asthma population. Baseline blood neutrophils, blood eosinophils, and 38 serum cytokine levels were measured in a sample of 235 asthmatic children (6-17 years) enrolled in the NIAID (National Institute of Allergy and Infectious Diseases)-sponsored Asthma Phenotypes in the Inner City (APIC) study (ICAC (Inner City Asthma Consortium)-19)...
2017: PloS One
https://www.readbyqxmd.com/read/28684363/investigation-of-multiphase-multicomponent-aerosol-flow-dictating-pmdi-spacer-interactions
#5
Saurabh Sarkar, S Prasad Peri, Bodhisattwa Chaudhuri
The use of Pressurized metered dose inhalers (pMDIs) for the treatment of asthma and other chronic obstructive pulmonary diseases is frequently associated with breath-actuation synchronization problems and poor pulmonary delivery, particularly amongst the pediatric and geriatric population groups. Spacers, or Valved Holding Chambers (VHCs), are frequently used to address these problems. However, the performance of spacers with different pMDIs is also highly variable and needs to be investigated. The purpose of the current study is to develop a computational fluid dynamics (CFD) model which can characterize multiphase multicomponent aerosol flow issuing from a commercial suspension-based pMDI into a spacer...
July 4, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28683659/towards-non-conventional-methods-of-designing-register-based-epidemiological-studies-an-application-to-pediatric-research
#6
Tong Gong, Bronwyn Brew, Arvid Sjölander, Catarina Almqvist
AIMS: Various epidemiological designs have been applied to investigate the causes and consequences of fetal growth restriction in register-based observational studies. This review seeks to provide an overview of several conventional designs, including cohort, case-control and more recently applied non-conventional designs such as family-based designs. We also discuss some practical points regarding the application and interpretation of family-based designs. METHODS: Definitions of each design, the study population, the exposure and the outcome measures are briefly summarised...
July 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28660698/breastfeeding-and-the-risk-of-childhood-asthma-a-two-stage-instrumental-variable-analysis-to-address-endogeneity
#7
Nivita Divya Sharma
BACKGROUND: Several explanations for the inconsistent results on the effects of breastfeeding on childhood asthma have been suggested. The purpose of this study is to investigate one unexplored explanation, which is the presence of a potential endogenous relationship between breastfeeding and childhood asthma. Endogeneity exists when an explanatory variable is correlated with the error term for reasons such as selection bias, reverse causality, and unmeasured confounders. Unadjusted endogeneity will bias the effect of breastfeeding on childhood asthma...
June 29, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28657592/sino-nasal-5-questionnaire-is-associated-with-poor-asthma-control-in-children-with-asthma
#8
Sasikumar Kilaikode, Prateek J Shukla, Gurpreet Phull, James H Jackson, Dominique C Prue, Claudia Martinez, Krista Scheffey, Dinesh K Pillai
Up to 80% of asthmatic children may experience upper airway symptoms which are often perceived as coming from the lower airways. Currently, there are no validated questionnaires to assess upper airway contribution to pediatric asthma symptoms. The Sino-Nasal 5 (SN-5) questionnaire was previously validated for identifying radiographic confirmed sinus disease in children. In this study, we hypothesize that significant SN-5 scores (≥3.5) are associated with abnormal National Asthma Education and Prevention Program (NAEPP) based asthma impairment and control in asthmatic children...
June 28, 2017: Children
https://www.readbyqxmd.com/read/28649293/small-airways-disease-and-severe-asthma
#9
REVIEW
Tara F Carr, Roula Altisheh, Myron Zitt
The small airways of the lungs are commonly affected in pediatric and adult asthma. Small airways disease has been related to asthma control, severity, and risk of exacerbation. Diagnosis of small airways disease can be best made through evaluation of surgical lung specimens. Noninvasive techniques including spirometry, plethysmography, nitrogen washout, impulse oscillometry, and cross-sectional imaging have been utilized to assess and infer the extent of small airways disease in asthma and can be used longitudinally to assess response to treatment...
2017: World Allergy Organization Journal
https://www.readbyqxmd.com/read/28642859/exercise-induced-bronchospasm-and-allergy
#10
REVIEW
Serena Caggiano, Renato Cutrera, Antonio Di Marco, Attilio Turchetta
Sport is an essential part of childhood, with precious and acknowledged positive health effects but the impact of exercise-induced bronchoconstriction (EIB) significantly reduces participation in physical activity. It is important to recognize EIB, differentiating EIB with or without asthma if the transient narrowing of the airways after exercise is associated with asthmatic symptoms or not, in the way to select the most appropriate treatment among the many treatment options available today. Therapy is prescribed based on symptoms severity but diagnosis of EIB is established by changes in lung function provoked by exercise evaluating by direct and indirect tests...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28641549/relevance-of-cat-and-dog-sensitization-by-skin-prick-testing-in-childhood-eczema-and-asthma
#11
Kam Lun E Lun Hon, Kathy Yin Ching Tsang, Ting Fan Leung
BACKGROUND: Household animal dander has been implicated as aeroallergen in childhood atopic diseases. Many parents seek healthcare advice if household pet keeping may be detrimental in atopic eczema (AE) and atopies. AIM: We investigated if skin sensitization by cat/dog dander was associated with disease severity and quality of life in children with AE. METHODS: Demographics, skin prick test (SPT) results, disease severity (Nottingham eczema severity score NESS), Children Dermatology Life Quality Index (CDLQI), blood IgE and eosinophil counts of a cohort of AE patients were reviewed...
June 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28631599/efficacy-and-safety-of-omalizumab-in-children-and-adolescents-with-moderate-to-severe-asthma-a-systematic-literature-review
#12
Jonathan Corren, Abhishek Kavati, Benjamin Ortiz, Jennifer A Colby, Kimberly Ruiz, Brett A Maiese, Sarah M Cadarette, Reynold A Panettieri
BACKGROUND: There are limited pediatric data about the use of omalizumab, especially the effectiveness and safety of omalizumab in the real-world management of allergic asthma. OBJECTIVE: The objective of this study was to summarize the safety and efficacy of omalizumab in both randomized clinical trials (RCT) used for U.S. Food and Drug Administration registration and real-world studies (RWS) based on clinical care of children with moderate-to-severe asthma. METHODS: Studies that evaluated omalizumab use in patients <18 years old and with asthma, published between January 2003 and October 2016, were retrieved from medical literature data bases...
July 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28619722/corticosteroid-therapy-during-acute-bronchiolitis-in-patients-who-later-develop-asthma
#13
Steven L Shein, Alexandre T Rotta, Richard Speicher, Katherine N Slain, Benjamin Gaston
BACKGROUND AND OBJECTIVE: Meta-analyses show that corticosteroids are not effective in patients with bronchiolitis. However, risk factors for asthma such as eczema or familial atopy prompt some practitioners to prescribe corticosteroids for bronchiolitis. We assessed if corticosteroid prescription is associated with shorter hospitalization for bronchiolitis among patients who later develop asthma. METHODS: The Pediatric Health Information System database was interrogated for patients with bronchiolitis aged <2 years hospitalized between 2006 and 2015...
June 15, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28607943/poor-adherence-with-medication-refill-and-medical-supplies-maintenance-as-risk-factors-for-inpatient-asthma-admission-in-children
#14
Pavadee Poowuttikul, Benjamin Hart, Ronald Thomas, Elizabeth Secord
Background. Asthma results in significant pediatric hospitalizations in the inner city. Many asthmatic children were admitted to our hospital as a result of lack of medications or medical supplies that had been previously prescribed ("ran out," "broken," or "lost"). Objective. To identify the incidence of children admitted for asthma because of lack of prescribed medications/supplies and to assess risk factors for poor adherence between groups. Methods. This was a prospective chart review of 200 asthmatic children admitted to Children's Hospital of Michigan, Detroit...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28592704/the-added-value-of-exhaled-breath-temperature-in-respiratory-medicine
#15
Todor A Popov, Tanya Kralimarkova, Marina Labor, Davor Plavec
Recognition of the huge economic burden chronic respiratory diseases pose for society motivated fundamental and clinical research leading to insight into the role of airway inflammation in various disease entities and their phenotypes. However, no easy, cheap and patient-friendly methods to assess it have found a place in routine clinical practice. Measurement of exhaled breath temperature (EBT) has been suggested as a non-invasive method to detect inflammatory processes in the airways as a result of increased blood flow within the airway walls...
June 8, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28550963/acceptance-of-a-pre-visit-intervention-to-engage-teens-in-pediatric-asthma-visits
#16
Betsy Sleath, Delesha M Carpenter, Scott A Davis, Claire Hayes Watson, Charles Lee, Ceila E Loughlin, Nacire Garcia, Dana Etheridge, Laura Rivera-Duchesne, Daniel S Reuland, Karolyne Batey, Cristina Duchesne, Gail Tudor
OBJECTIVE: The objectives of this study were to: (a) describe teen feedback on an asthma question prompt list/video intervention designed to motivate teens to be more engaged during visits and (b) examine teen demographics associated with teen acceptance of the intervention. METHODS: Two hundred and fifty-nine teens ages 11 to 17 with persistent asthma were enrolled into a randomized, controlled trial and assigned to either a standard care or an intervention group where they watched an educational video with their parents and received a prompt list to complete before visits...
May 5, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28548898/comparison-of-a-rapid-albuterol-pathway-with-a-standard-pathway-for-the-treatment-of-children-with-a-moderate-to-severe-asthma-exacerbation-in-the-emergency-department
#17
Matthew Wilkinson, Ben King, Sujit Iyer, Eric Higginbotham, Anna Wallace, Collin Hovinga, Coburn Allen
OBJECTIVE: The objective of this study was to determine if a rapid albuterol delivery pathway with a breath-enhanced nebulizer can reduce emergency department (ED) length of stay (LOS), while maintaining admission rates and side effects, when compared to a traditional asthma pathway with a standard jet nebulizer. METHODS: Children aged 3-18 presenting to a large urban pediatric ED for asthma were enrolled if they were determined by pediatric asthma score to have a moderate to severe exacerbation...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28546371/pediatric-aerosol-therapy
#18
Ariel Berlinski
Inhaled medications are the mainstay of therapy for many pediatric pulmonary diseases. Device and delivery technique selection is key to improving lung deposition of inhaled drugs. This paper will review the subject in relationship to several pediatric clinical situations: acute pediatric asthma, transnasal aerosol delivery, delivery through tracheostomies, and delivery during noninvasive and invasive mechanical ventilation. This review will focus on the pediatric age group and will not include neonates.
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28541072/associations-between-spontaneous-parental-perspective-taking-and-stimulated-cytokine-responses-in-children-with-asthma
#19
Erika M Manczak, Cynthia S Levine, Katherine B Ehrlich, Devika Basu, Dan P McAdams, Edith Chen
OBJECTIVES: Cognitive empathy in parents-reflecting the extent to which one considers the perspectives and emotions of others-is hypothesized to contribute to family social environments in ways that affect youths' physical health. Using a novel assessment technique for cognitive empathy, the current study examined associations between spontaneous parental perspective-taking and key inflammatory processes implicated in pediatric asthma. METHOD: One hundred thirty children (ages 9-17) with physician-diagnosed asthma, along with 1 parent, participated in the current study...
July 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28540285/allergen-avoidance-in-allergic-asthma
#20
REVIEW
Francesca Cipriani, Elisabetta Calamelli, Giampaolo Ricci
Allergic asthma is the most frequent disease among the chronic respiratory disorders in pediatric age with an important social impact. In the last years, many efforts have been made to identify effective preventive approaches to get a better control of symptoms and to obtain the best future outcomes for the patients. In patients with allergic asthma triggered by the exposure to indoor allergens, the avoidance is the first intervention to prevent the appearance or the worsening of bronchial symptoms. This review article summarized the most recent evidence from literature about the efficacy of specific control interventions for the most important allergens...
2017: Frontiers in Pediatrics
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