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Chitra Dinakar, Bradley E Chipps
Asthma affects an estimated 7 million children and causes significant health care and disease burden. The most recent iteration of the National Heart, Lung and Blood Institute asthma guidelines, the Expert Panel Report 3, emphasizes the assessment and monitoring of asthma control in the management of asthma. Asthma control refers to the degree to which the manifestations of asthma are minimized by therapeutic interventions and the goals of therapy are met. Although assessment of asthma severity is used to guide initiation of therapy, monitoring of asthma control helps determine whether therapy should be maintained or adjusted...
January 2017: Pediatrics
Merritt L Fajt, Sally E Wenzel
Persistent asthma has long been treated with inhaled corticosteroids (CSs), as the mainstay of therapy. However, their efficacy in patients with more severe disease is limited, which led to the incorporation of poor response to ICSs (and thereby use of high doses of ICS) into recent definitions of severe asthma. Several studies have suggested that severe asthma might consist of several different phenotypes, each with ongoing symptoms and health care utilization, despite the use of high doses of ICS, usually in combination with a second or third controller...
January 2017: Allergy, Asthma & Immunology Research
Carla Mastrorilli, Daniela Posa, Francesca Cipriani, Carlo Caffarelli
Novel approaches are currently offered for the diagnostic workup and therapeutic management of allergic rhinitis and asthma. New predictive biomarkers of allergy and asthma are available. Primary and secondary prevention, earlier intervention, and modification of the natural history of allergic rhinitis and asthma are being intensively investigated. This review highlights advances in the understanding of the etiology, diagnosis, and management of atopic airway diseases in childhood, as well as prenatal and early-life risk factors and strategies for prevention...
December 2016: Pediatric Allergy and Immunology
Alexander Wade, Christopher Chang
The heterogeneity of asthma is illustrated by the significantly different features of pediatric asthma compared to adult asthma. One phenotype of severe asthma in pediatrics includes atopy, lack of reduction in lung function, and absence of gender bias as the main characteristics. Included in the NIH NAEPP EPR-3 are recommendations for the treatment and management of severe pediatric asthma and critical asthma syndrome, such as continuous nebulization treatments, intubation and mechanical ventilation, heliox, and magnesium sulfate...
February 2015: Clinical Reviews in Allergy & Immunology
(no author information available yet)
No abstract text is available yet for this article.
March 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Elham Hossny, Nelson Rosario, Bee Wah Lee, Meenu Singh, Dalia El-Ghoneimy, Jian Yi Soh, Peter Le Souef
Despite the availability of several formulations of inhaled corticosteroids (ICS) and delivery devices for treatment of childhood asthma and despite the development of evidence-based guidelines, childhood asthma control remains suboptimal. Improving uptake of asthma management plans, both by families and practitioners, is needed. Adherence to daily ICS therapy is a key determinant of asthma control and this mandates that asthma education follow a repetitive pattern and involve literal explanation and physical demonstration of the optimal use of inhaler devices...
2016: World Allergy Organization Journal
Prasad Muley, Monali Shah, Arti Muley
CONTEXT AND AIM: Asthma is a common problem in paediatric population. International treatment guidelines recognize the role of inhaled corticosteroids for asthma in young children. Inhaled fluticasone propionate is reported to have greater systemic effects like other corticosteroids. Limited data is available on safety of this drug when used for longer duration. So, we conducted a systematic review to study the effect of inhaled fluticasone propionate on adrenal suppression, growth and bone mineral density in paediatric patients...
July 2013: Current Drug Safety
Catalina Dumitru, Susan M H Chan, Victor Turcanu
At present, the main indications for leukotriene receptor antagonists (LTRA) in pediatric asthma are as add-on therapy to inhaled corticosteroids (ICS) and as initial controller therapy in children with mild asthma, especially those who cannot or will not use ICS. LTRA are also useful for patients who have concomitant rhinitis, and patients with viral-induced wheeze and exercise-induced asthma. It should be noted that the benefits of LTRA therapy have been demonstrated in children as young as 6 months of age and recent clinical trials have further proven the benefits of LTRA in acute asthma exacerbations...
October 1, 2012: Paediatric Drugs
Mark Anselmo
The treatment of children with asthma has historically relied upon expert opinion using data extrapolated from adult studies. Over the past few years, landmark studies have been completed providing healthcare professionals with evidence on which a reasonable approach can be made for children suffering from this common and serious disease. Asthmatic phenotype in children, unlike adults, tends to differ according to age, which must be taken into account as well as triggers, severity, and level of control. The care of the child with asthma is complex, but accumulating data have demonstrated that we are on the right path for optimizing control while reducing the burden of side effects...
February 1, 2011: Paediatric Drugs
Paul D Robinson, Peter Van Asperen
Asthma control remains a significant challenge in the pediatric age range in which ongoing loss of lung function in children with persistent asthma has been reported, despite the use of regular preventer therapy. This has important implications for observed mortality and morbidity during adulthood. Over the past decade, there has been an emergence of other treatment adjuncts, such as anti-Immunoglobulin E (IgE)-directed therapy, low dose theophylline, and the use of macrolide antibiotics, yet their exact role in asthma management remains unclear, despite omalizumab now being incorporated into several international asthma guidelines...
August 2013: Paediatric Drugs
Rachel G Robison, Rajesh Kumar
Approximately one-half of children with asthma present with symptoms before 3 years of age. The typical history describes recurrent episodes of wheezing and/or cough triggered by a viral upper respiratory infection, activity, or changes in weather or seasons. When symptoms occur after a viral respiratory infection, children with asthma often take longer than the usual week to recover fully from their respiratory symptoms. Wheezing and coughing during exercise or during laughing or crying and episodes triggered in the absence of infection suggest asthma...
May 2012: Allergy and Asthma Proceedings:
Glenn Clinton Shedd, Sarah M Noe
In this column, we examine an original research article by S. Torres et al. (2012) on the subject of magnesium sulfate use in pediatric patients with acute asthma. These researchers found that patients treated with 25 mg/kg of intravenous magnesium sulfate in addition to the conventional treatment options for acute asthma were less likely to require mechanical ventilation than patients in the control group. We review and critique this article and use a case study to illustrate the clinical implications of this research...
January 2014: Advanced Emergency Nursing Journal
Anne VanGarsse, Richard D Magie, Aubree Bruhnding
Asthma is a complex disease, involving many different allergic, inflammatory, and environmental components. It is a disease for which patient and family education and a team-based approach are paramount for successful management. Guidelines have been put forth by the National Heart, Lung and Blood Institute, which provide a helpful framework in which to begin to manage patients and to navigate the many medication choices available. It is only through diligent attention to control of asthma symptoms that improved quality of life and prevention of long-term sequelae are possible for the pediatric patient with asthma...
March 2015: Primary Care
John S Giuliano, Edward Vincent S Faustino, Simon Li, Matthew G Pinto, Michael F Canarie, Christopher L Carroll
OBJECTIVES: IV corticosteroids are routinely prescribed to treat critically ill children with asthma. However, no specific dosing recommendations have been made for children admitted to the PICU. We aim to determine current asthma corticosteroid dosing preferences in PICUs within North America. DESIGN: Cross-sectional, self-administered survey. SETTING: North American PICUs. SUBJECTS: Pediatric intensivists working in the United States and Canada...
June 2013: Pediatric Critical Care Medicine
Bridget M Kuehn
No abstract text is available yet for this article.
October 3, 2007: JAMA: the Journal of the American Medical Association
Yuhei Hamasaki, Yoichi Kohno, Motohiro Ebisawa, Naomi Kondo, Sankei Nishima, Toshiyuki Nishimuta, Akihiro Morikawa
The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2013 (JAGL 2013) describes childhood asthma after the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of Pediatric Allergy and Clinical Immunology. JAGL 2013 provides information on diagnosis by age group from infancy to puberty (0-15 years of age), treatment for acute exacerbations, long-term management by anti-inflammatory drugs, daily life guidance, and patient education to allow non-specialist physicians to refer to this guideline for routine medical treatment...
September 2014: Allergology International: Official Journal of the Japanese Society of Allergology
N G Papadopoulos, H Arakawa, K-H Carlsen, A Custovic, J Gern, R Lemanske, P Le Souef, M Mäkelä, G Roberts, G Wong, H Zar, C A Akdis, L B Bacharier, E Baraldi, H P van Bever, J de Blic, A Boner, W Burks, T B Casale, J A Castro-Rodriguez, Y Z Chen, Y M El-Gamal, M L Everard, T Frischer, M Geller, J Gereda, D Y Goh, T W Guilbert, G Hedlin, P W Heymann, S J Hong, E M Hossny, J L Huang, D J Jackson, J C de Jongste, O Kalayci, N Aït-Khaled, S Kling, P Kuna, S Lau, D K Ledford, S I Lee, A H Liu, R F Lockey, K Lødrup-Carlsen, J Lötvall, A Morikawa, A Nieto, H Paramesh, R Pawankar, P Pohunek, J Pongracic, D Price, C Robertson, N Rosario, L J Rossenwasser, P D Sly, R Stein, S Stick, S Szefler, L M Taussig, E Valovirta, P Vichyanond, D Wallace, E Weinberg, G Wennergren, J Wildhaber, R S Zeiger
Asthma is the most common chronic lower respiratory disease in childhood throughout the world. Several guidelines and/or consensus documents are available to support medical decisions on pediatric asthma. Although there is no doubt that the use of common systematic approaches for management can considerably improve outcomes, dissemination and implementation of these are still major challenges. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), recently formed by the EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus on (ICON) Pediatric Asthma...
August 2012: Allergy
L B Bacharier, A Boner, K-H Carlsen, P A Eigenmann, T Frischer, M Götz, P J Helms, J Hunt, A Liu, N Papadopoulos, T Platts-Mills, P Pohunek, F E R Simons, E Valovirta, U Wahn, J Wildhaber
Asthma is the leading chronic disease among children in most industrialized countries. However, the evidence base on specific aspects of pediatric asthma, including therapeutic strategies, is limited and no recent international guidelines have focused exclusively on pediatric asthma. As a result, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology nominated expert teams to find a consensus to serve as a guideline for clinical practice in Europe as well as in North America...
January 2008: Allergy
Michelle Fox Huffaker, Wanda Phipatanakul
Over the past several decades, the evidence supporting rational pediatric asthma management has grown considerably. As more is learned about the various phenotypes of asthma, the complexity of management will continue to grow. This article focuses on the evidence supporting the current guidelines-based pediatric asthma management and explores the future of asthma management with respect to phenotypic heterogeneity and biologics.
February 2015: Immunology and Allergy Clinics of North America
Ambra Nicolai, Antonella Frassanito, Raffaella Nenna, Giulia Cangiano, Laura Petrarca, Paola Papoff, Alessandra Pierangeli, Carolina Scagnolari, Corrado Moretti, Fabio Midulla
BACKGROUND: We sought to know more about how 14 common respiratory viruses manifest clinically, and to identify risk factors for specific virus-induced acute respiratory tract infections (ARTIs) in children younger than 3 years and for wheezing at 36-months follow-up. METHODS: We retrospectively studied the clinical records for 273 full-term children (median age, 2.9 months, range 0.26-39, boys 61.2%) hospitalized for ARTIs whose nasopharyngeal specimen tested positive for a respiratory virus and 101 children with no history of respiratory diseases (median age, 8 months, range: 0...
October 27, 2016: Pediatric Infectious Disease Journal
2016-11-07 15:07:49
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