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Chirag R Kapadia, Todd D Nebesio, Susan E Myers, Steven Willi, Bradley S Miller, David B Allen, Elka Jacobson-Dickman
Inhaled corticosteroids (ICSs) are widely used as first-line treatment for various chronic respiratory illnesses. Advances in devices and formulations have reduced their local adverse effects. However, as delivery of ICSs to the lungs improves, the systemic absorption increases, and an adverse effect profile similar to, although milder than, oral corticosteroids has emerged. The most serious potential adverse effect is adrenal insufficiency, which can be life threatening. Adrenal insufficiency occurs most in patients taking the highest doses of ICSs but is reported with moderate or even low doses as well...
February 2016: JAMA Pediatrics
Kambiz Masoumi, Arash Forouzan, Maryam Haddadzadeh Shoushtari, Samaneh Porozan, Maryam Feli, Mehdi Fallah Bagher Sheidaee, Ali Asgari Darian
We undertook this randomized clinical trial to investigate whether adding furosemide to salbutamol could improve the peak expiratory flow rate (PEFR) and clinical signs of reactive airway disease (RAD) patients. Eligible 18- to 55-year-old patients were randomly divided into intervention and control groups. Patients received 5 mg of nebulized salbutamol and 40 mg of nebulized furosemide in the intervention group and 5 mg of nebulized salbutamol alone in the control group. Patients in both groups received 100 mg of methylprednisolone intravenously stat...
2014: Emergency Medicine International
Eun Lee, Jisun Yoon, Soo-Jong Hong, Jinho Yu
AIM: We investigated airway function in preschoolers with post-infectious bronchiolitis obliterans (PIBO) using impulse oscillometry (IOS). METHODS: This study enrolled 182 children aged 3-5 years: 12 with PIBO, 135 asthma with asthma and 35 non-atopic controls. Respiratory resistance and reactance were assessed using IOS. RESULTS: The percentage predicted (% predicted) of pre-bronchodilator respiratory resistance at 5Hz was significantly higher in children with PIBO (177...
October 15, 2016: Acta Paediatrica
Fernando Maria de Benedictis, Andrew Bush
Wheeze is a common symptom in young children and is usually associated with viral illnesses. It is a major source of morbidity and is responsible for a high consumption of healthcare and economic resources worldwide. A few children have a condition resembling classical asthma. Rarer specific conditions may have a wheezy component and should be considered in the differential diagnosis. Over the last half century, there have been many circular discussions about the best way of managing preschool wheeze. In general, intermittent wheezing should be treated with intermittent bronchodilator therapy, and a controller therapy should be prescribed for a young child with recurrent wheezing only if positively indicated, and only then if carefully monitored for efficacy...
October 4, 2016: Archives of Disease in Childhood
Thomas Westergren, Sveinung Berntsen, Karin C Lødrup Carlsen, Petter Mowinckel, Geir Håland, Liv Fegran, Kai-Håkon Carlsen
BACKGROUND: Children with asthma may be less physically active than their healthy peers. We aimed to investigate if perceived exercise limitation (EL) was associated with lung function or bronchial hyperresponsiveness (BHR), socio-economic factors, prenatal smoking, overweight, allergic disease, asthma severity or physical activity (PA). METHODS: The 302 children with asthma from the 10-year examination of the Environment and Childhood Asthma birth cohort study underwent a clinical examination including perceived EL (structured interview of child and parent(s)), measure of overweight (body mass index by sex and age passing through 25kg/m(2) or above at18 years), exercise-induced bronchoconstriction (forced expiratory volume in one second (FEV1 ) pre- and post-exercise), methacholine bronchial challenge (severe BHR; provocative dose causing ≥20% decrease in FEV1≤1μmol) and asthma severity score (dose of controller medication and exacerbations last 12 months)...
October 13, 2016: Pediatric Allergy and Immunology
Fariba Ahmadizar, Susanne J H Vijverberg, Hubertus G M Arets, Anthonius de Boer, Jason E Lang, Meyer Kattan, Colin N A Palmer, Somnath Mukhopadhyay, Steve Turner, Anke H Maitland-van der Zee
To estimate the association between obesity and poor asthma control or risk of exacerbations in asthmatic children and adolescents, and to assess whether these associations are different by sex.A meta-analysis was performed on unpublished data from three North-European paediatric asthma cohorts (BREATHE, PACMAN (Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) and PAGES (Pediatric Asthma Gene Environment Study)) and 11 previously published studies (cross-sectional and longitudinal studies)...
October 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Sandeep Puranik, Erick Forno, Andrew Bush, Juan C Celedón
Severe exacerbations negatively impact the quality of life and education of children with asthma, while also causing substantial healthcare costs. Preventing severe asthma exacerbations requires identifying patients at high risk, in order to develop personalized care protocols to prevent such exacerbations. In this review, we assess and discuss recently published data on risk factors and predictive tools for severe asthma exacerbations in childhood. Although few genome-wide association studies have focused on severe asthma exacerbations, one such study recently identified cadherin-related family member 3 (CDHR3, implicated on integrity of the airway epithelium), as a susceptibility gene for recurrent severe asthma exacerbations in young children...
October 6, 2016: American Journal of Respiratory and Critical Care Medicine
Fernando Maria de Benedictis, Marina Attanasi
Several topics on childhood asthma were addressed in the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress. With regard to the relationship between lower respiratory tract infections and asthma, it emerges that is the number of respiratory episodes in the first years of life, but not the particular viral trigger, to be associated with later asthma development. Understanding which characteristics of individual patients are associated with an increased risk for asthma exacerbation is a critical step to implement strategies preventing these seasonal events...
March 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
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