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Pediatric acute asthma

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https://www.readbyqxmd.com/read/28816890/improving-timeliness-of-%C3%AE-agonist-and-corticosteroid-administration-in-patients-with-acute-wheezing
#1
Mandisa McIver, William Stoudemire, Cherrelle Smith-Ramsey, Mousumee Panigrahi, Christine Walsh-Kelly
OBJECTIVE: Timely delivery of β-agonists and steroids to patients with acute recurrent wheezing is a key component of the National Heart, Lung, and Blood Institute recommended emergency department (ED) asthma care. We conducted an ED improvement initiative to standardize asthma care and improve time to treatments. METHODS: Our multidisciplinary team identified key contributing factors to timeliness, developed key driver diagrams, implemented and refined a management pathway, designed and executed rapid cycle improvements, and implemented interventions...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28804700/abridged-version-of-the-awmf-guideline-for-the-medical-clinical-diagnostics-of-indoor-mould-exposure-s2k-guideline-of-the-german-society-of-hygiene-environmental-medicine-and-preventive-medicine-ghup-in-collaboration-with-the-german-association-of-allergists
#2
Gerhard A Wiesmüller, Birger Heinzow, Ute Aurbach, Karl-Christian Bergmann, Albrecht Bufe, Walter Buzina, Oliver A Cornely, Steffen Engelhart, Guido Fischer, Thomas Gabrio, Werner Heinz, Caroline E W Herr, Jörg Kleine-Tebbe, Ludger Klimek, Martin Köberle, Herbert Lichtnecker, Thomas Lob-Corzilius, Rolf Merget, Norbert Mülleneisen, Dennis Nowak, Uta Rabe, Monika Raulf, Hans Peter Seidl, Jens-Oliver Steiß, Regine Szewszyk, Peter Thomas, Kerttu Valtanen, Julia Hurraß
This article is an abridged version of the AWMF mould guideline "Medical clinical diagnostics of indoor mould exposure" presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established...
2017: Allergo Journal International
https://www.readbyqxmd.com/read/28757228/cluster-analysis-of-acute-care-use-yields-insights-for-tailored-pediatric-asthma-interventions
#3
Mahshid Abir, Aaron Truchil, Dawn Wiest, Daniel B Nelson, Jason E Goldstick, Paul Koegel, Marie M Lozon, Hwajung Choi, Jeffrey Brenner
STUDY OBJECTIVE: We undertake this study to understand patterns of pediatric asthma-related acute care use to inform interventions aimed at reducing potentially avoidable hospitalizations. METHODS: Hospital claims data from 3 Camden city facilities for 2010 to 2014 were used to perform cluster analysis classifying patients aged 0 to 17 years according to their asthma-related hospital use. Clusters were based on 2 variables: asthma-related ED visits and hospitalizations...
July 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28754601/magnesium-sulfate-infusion-for-acute-asthma-in-the-emergency-department
#4
REVIEW
Jose Enrique Irazuzta, Nicolas Chiriboga
OBJECTIVES: To describe the role of intravenous magnesium sulfate (MgSO4) as therapy for acute severe asthma in the pediatric emergency department (ED). SOURCE: Publications were searched in the PubMed and Cochrane databases using the following keywords: magnesium AND asthma AND children AND clinical trial. A total of 53 publications were retrieved using this criteria. References of relevant articles were also screened. The authors included the summary of relevant publications where intravenous magnesium sulfate was studied in children (age <18 years) with acute asthma...
July 26, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28745850/noninvasive-ventilation-for-patients-in-acute-respiratory-distress-an-update-digest
#5
Nikita Joshi, Molly K Estes, Kayla Shipley, Hyun-Chul Danny Lee, Milana Zaurova
Over the last 20 years, noninvasive ventilation (NIV) strategies have been used with increasing frequency. The ease of use of NIV makes it applicable to patients presenting in a variety of types of respiratory distress. In this review, the physiology of positive pressure ventilation is discussed, including indications, contraindications, and options for mask type and fit. Characteristics of patients who are most likely to benefit from NIV are reviewed, including those in respiratory distress from chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema...
February 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28696803/thai-pediatricians-current-practice-toward-childhood-asthma
#6
Harutai Kamalaporn, Pongpan Chawalitdamrong, Aroonwan Preutthipan
BACKGROUND: Childhood asthma is a substantial health burden in Thailand. Due to a lack of pediatric respiratory specialists (pediatric pulmonologists and allergists; RS), most Thai children are cared for by general pediatricians (pediatric primary care providers (PCP)). OBJECTIVES: We investigated whether current practices of Thai pediatricians complied with asthma guidelines and compared practices (diagnosis and treatments) provided by PCP and RS. METHODS: A cross-sectional study was conducted using electronic surveys including four case scenarios of different asthma phenotypes distributed to Thai pediatricians...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28667069/role-of-human-metapneumovirus-and-respiratory-syncytial-virus-in-asthma-exacerbations-where-are-we-now
#7
REVIEW
Penny A Rudd, Belinda J Thomas, Ali Zaid, Martin MacDonald, Keiko Kan-O, Michael S Rolph, Anand R Soorneedi, Philip G Bardin, Suresh Mahalingam
Since its discovery in 2001, human metapneumovirus (hMPV) has been identified as an important cause of respiratory tract infection in young children, second only to the closely related respiratory syncytial virus (RSV). Clinical evidence suggests that hMPV is associated with acute exacerbations of asthma in both children and adults, and may play a role in initiating asthma development in children. Animal models have demonstrated that airway hyperresponsiveness (AHR) and inflammation are triggered following hMPV infection, and hMPV is able to persist in vivo by inhibiting innate immune responses and causing aberrant adaptive responses...
July 15, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28649417/pilot-study-of-a-randomized-trial-to-evaluate-a-web-based-intervention-targeting-adolescents-presenting-to-the-emergency-department-with-acute-asthma
#8
Christine L M Joseph, Prashant Mahajan, Stephanie Stokes-Buzzelli, Dayna A Johnson, Elizabeth Duffy, Renee Williams, Talan Zhang, Dennis R Ownby, Shannon Considine, Mei Lu
BACKGROUND: Low-income African-American adolescents use preventive medical services less frequently than their White counterparts, indicating a need for effective interventions targeting this group. Puff City is a Web-based, asthma management program for urban adolescents that has been evaluated in high school settings with promising results. The objective of this pilot was to assess the feasibility of initiating Puff City (treatment) in an emergency department setting, thereby informing the conduct of an individual randomized trial to evaluate its effectiveness compared to a generic, Web-based program (control) in preventing subsequent emergency department (ED) visits...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28634021/mycoplasma-pneumoniae-and-health-outcomes-in-children-with-asthma
#9
Pamela R Wood, Jordan C Kampschmidt, Peter H Dube, Marianna P Cagle, Paola Chaparro, Norma S Ketchum, Thirumalai R Kannan, Harjinder Singh, Jay I Peters, Joel B Baseman, Edward G Brooks
BACKGROUND: Acute infections with Mycoplasma pneumoniae (Mp) have been associated with worsening asthma in children. Mp can be present in the respiratory tract for extended periods; it is unknown whether the long-term persistence of Mp in the respiratory tract affects long-term asthma control. OBJECTIVE: To determine the effect of Mp on asthma control. METHODS: We enrolled 31 pediatric subjects 3 to 10 years of age with persistent asthma who completed up to 8 visits over a 24-month period...
June 17, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28619722/corticosteroid-therapy-during-acute-bronchiolitis-in-patients-who-later-develop-asthma
#10
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...
July 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28546371/pediatric-aerosol-therapy
#11
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/28526210/early-control-treatment-with-montelukast-in-preschool-children-with-asthma-a-randomized-controlled-trial
#12
Mizuho Nagao, Masanori Ikeda, Norimasa Fukuda, Chizu Habukawa, Tetsuro Kitamura, Toshio Katsunuma, Takao Fujisawa
BACKGROUND: While Japanese guideline recommends initial control treatment for preschool children with asthma symptoms more than once a month, Western guidelines do not. To determine whether control treatment with montelukast was more effective than as-needed β2-agonists in this population, we conducted a randomized controlled trial. METHODS: Eligible patients were children aged 1-5 years who had asthma symptoms more than once a month but less than once a week. Patients were randomly assigned in a 1:1 ratio to receive montelukast 4 mg daily for 48 weeks or as-needed β2-agonists...
May 16, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28472533/a-systematic-review-of-the-impact-of-physician-implicit-racial-bias-on-clinical-decision-making
#13
REVIEW
Erin Dehon, Nicole Weiss, Jonathan Jones, Whitney Faulconer, Elizabeth Hinton, Sarah Sterling
OBJECTIVES: Disparities in diagnosis and treatment of racial minorities exist in the emergency department (ED). A better understanding of how physician implicit (unconscious) bias contributes to these disparities may help identify ways to eliminate such racial disparities. The objective of this systematic review was to examine and summarize the evidence on the association between physician implicit racial bias and clinical decision making. METHODS: Based on PRISMA guidelines, a structured electronic literature search of PubMed, CINAHL, Scopus, and PsycINFO databases was conducted...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28457766/authors-response-to-commentary-on-point-of-care-lung-ultrasound-of-children-with-acute-asthma-exacerbations-in-the-pediatric-emergency-department
#14
Alexander Sasha Dubrovsky, Patricia Li, Samantha Dankoff, Adam Shapiro, Terry Varshney
No abstract text is available yet for this article.
April 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28457764/letter-to-the-editor-regarding-recent-american-journal-of-emergency-medicine-article-in-press-point-of-care-lung-ultrasound-of-children-with-acute-asthma-exacerbations-in-the-pediatric-emergency-department-by-dankoff-et-al
#15
Mckenna Longacre, Sigmund Kharasch, Andrew Liteplo
No abstract text is available yet for this article.
April 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28455155/-spike-in-acute-asthma-exacerbations-during-enterovirus-d68-epidemic-in-japan-a-nation-wide-survey
#16
Seigo Korematsu, Kengo Nagashima, Yasunori Sato, Mizuho Nagao, Shunji Hasegawa, Haruna Nakamura, Shiro Sugiura, Katsushi Miura, Kenji Okada, Takao Fujisawa
BACKGROUND: In September 2015, Japan experienced an unusual increase in acute asthma hospitalizations of children that coincided with an enterovirus D68 (EV-D68) epidemic. The objective of this study is to investigate whether EV-D68 had a causal relationship with the spike in asthma hospitalizations. METHODS: A nation-wide retrospective survey of asthma hospitalizations of children was performed for the period from January 2010 through October 2015. The Japanese Society of Pediatric Allergy and Clinical Immunology asked its affiliated hospitals to report monthly numbers of hospitalizations, ICU admissions and mechanical ventilations due to acute asthma exacerbation...
April 25, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28416251/initial-asthma-severity-assessment-tools-as-predictors-of-hospitalization
#17
Natalia Paniagua, Amaia Elosegi, Isabel Duo, Ana Fernandez, Elisa Mojica, Lorea Martinez-Indart, Santiago Mintegi, Javier Benito
BACKGROUND: Assessment tools to classify and prioritize patients, such as systems of triage, and indicators of severity, such as clinical respiratory scores, are helpful in guiding the flow of asthmatic patients in the emergency department. OBJECTIVE: Our aim was to assess the performance of the Pediatric Assessment Triangle (PAT), triage level (TL), Pulmonary Score (PS), and initial O2 saturation (O2 sat), in predicting hospitalization in pediatric acute asthma exacerbations...
April 14, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28379349/enterovirus-d68-infection-among-children-with-medically-attended-acute-respiratory-illness-cincinnati-ohio-july%C3%A2-october-2014
#18
Holly M Biggs, Monica McNeal, W Allan Nix, Carolyn Kercsmar, Aaron T Curns, Beverly Connelly, Marilyn Rice, Shur-Wern Wang Chern, Mila M Prill, Nancy Back, M Steven Oberste, Susan I Gerber, Mary A Staat
Background: Enterovirus D68 (EV-D68) caused a widespread outbreak of respiratory illness in the United States in 2014, predominantly affecting children. We describe EV-D68 rates, spectrum of illness and risk factors from prospective, population-based acute respiratory illness (ARI) surveillance at a large U.S. pediatric hospital. Methods: Children <13 years of age with ARI and residence in Hamilton County, Ohio were enrolled from the inpatient and emergency department (ED) settings at a children's hospital in Cincinnati, Ohio, from July 1-October 31, 2014...
April 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28377880/paradoxical-bronchospasm-from-benzalkonium-chloride-bac-preservative-in-albuterol-nebulizer-solution-in-a-patient-with-acute-severe-asthma-a-case-report-and-literature-review-of-airway-effects-of-bac
#19
Mathew George, Saumya Vinod Joshi, Emily Concepcion, Haesoon Lee
Nebulized bronchodilator solutions are available in the United States as both nonsterile and sterile-filled products. Sulfites, benzalkonium chloride (BAC), or chlorobutanol are added to nonsterile products to prevent bacterial growth. Bronchoconstriction from inhaled BAC is cumulative, prolonged, and correlates directly with basal airway responsiveness. The multi-dose dropper bottle of albuterol sulfate solution contains 50 μg BAC per/2.5 mg of albuterol, which may be below or at the lower limit of the threshold dose for bronchoconstriction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28377171/benefits-of-subspecialty-adherence-after-asthma-hospitalization-and-patient-perceived-barriers-to-care
#20
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...
May 2017: Annals of Allergy, Asthma & Immunology
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