1,721,047 research outputs found
Exhaled nitric oxide in childhood asthma. A more reliable indicator of asthma severity than lung function measurement?
No full textThe level of exhaled nitric oxide (NO) has been demonstrated to reflect the degree of airway inflammation in patients with asthma and to be related to the severity of asthma, as well as to the efficacy of treatment. In contrast, lung function tests provide information about airway volumes and flows reflecting the level of airway obstruction, but do not allow any direct information about the degree of airway inflammation. Several studies have evaluated the relationships between the level of airway inflammation assessed by exhaled NO and the levels of airway obstruction and/or bronchial hyperresponsiveness in asthmatic adults and children. These studies highlight the complex pathophysiology of asthma and suggest that exhaled NO may have a promising role in addition to lung function measurement in the evaluation of asthma severity in children
ENVIRONMENTAL ALLERGENS AND CHILDHOOD ASTHMA
No full textExposure to allergens has been shown to lead to sensitization and to the subsequent development of airway hyperresponsiveness in genetically predisposed individuals. Increasing interest is being devoted to mechanisms for the prevention of allergen sensitization and asthma development. Primary prevention (avoiding the sensitization to allergens) requires a large effort as the majority of atopic sensitizations occur in children with no demonstrable risk at the birth. Secondary prevention (deterrence of disease expression despite prior IgE sensitization) requires methods for detecting the population at risk by means of large population screening. Tertiary prevention (minimizing the morbidity for those who already have the disease) may be achieved by allergen avoidance, which has been demonstrated to effectively decrease inflammation in symptomatic patients
Airway inflammation in elite swimmers
No full textExercise may increase ventilation up to 200 L/min for short periods of time in speed and power athletes, and for longer periods in endurance athletes, such as long-distance runners and swimmers. Therefore highly trained athletes are repeatedly and strongly exposed to cold air during winter training and to many pollen allergens in spring and summer. Competitive swimmers inhale and microaspirate large amounts of air that floats above the water surface, which means exposure to chlorine derivatives from swimming pool disinfectants. In the summer Olympic Games, 4% to 15% of the athletes showed evidence of asthma or used antiasthmatic medication. Asthma is most commonly found in endurance events, such as cycling, swimming, or long-distance running. The risk of asthma is especially increased among competitive swimmers, of which 36% to 79% show bronchial hyperresponsiveness to methacholine or histamine. The risk of asthma is closely associated with atopy and its severity among athletes. A few studies have investigated occurrence of exercise-induced bronchospasm among highly trained athletes. The occurrences of exercise-induced bronchospasm vary from 3% to 35% and depend on testing environment, type of exercise used, and athlete population tested. Mild eosinophilic airway inflammation has been shown to affect elite swimmers and cross-country skiers. This eosinophilic inflammation correlates with clinical parameters (ie, exercise-induced bronchial symptoms and bronchial hyperresponsiveness). Athletes commonly use antiasthmatic medication to treat their exercise-induced bronchial symptoms. However, controlled studies on their long-term effects on bronchial hyperresponsiveness and airway inflammation in the athletes are lacking. Follow-up studies on asthma in athletes are also lacking. What will happen to bronchial hyperresponsiveness and airway inflammation after discontinuation of competitional career is unclear. In the future, follow-up studies on bronchial responsiveness and airway inflammation, as well as controlled studies on both short- and long-term effects of antiasthmatic drugs in the athletes are needed
Effect of montelukast on exhaled NO in asthmatic children exposed to relevant allergens
No full textThe level of exhaled nitric oxide (FENO) is increased in house dust mite (HDM)-sensitized asthmatic children after exposure to HDM antigen, and inhaled steroids can prevent this increase. The aim of this study was to evaluate whether montelukast could prevent an increase in FENO levels in allergic asthmatic children after a brief period of exposure to relevant allergens. Sixteen children were evaluated at the residential house 'Istituto Pio XII' (Misurina, Bellunio, Italy) in the Italian Alps, a dust mite-free environment. FENO levels were evaluated before (t0) and immediately after (t1) the children were exposed to HDM allergens for 2 weeks in their homes at sea level. No significant difference in FENO was observed in the fluticasone-treated group of children after 2 weeks at sea level. In the group treated with montelukast, an increase in FENO was observed between t0 and t1, which failed to reach statistical significance. These preliminary data suggest that oral montelukast could be effective in preventing the relapse in airway inflammation in allergic asthmatic children who are occasionally exposed to relevant allergens for a short period of time
Valutazione dei livelli di leptina nel siero e nel condensato dell’aria esalata di bambini asmatici e obesi: uno studio pilota
No full textLa leptina è un ormone di derivazione adipocitaria del peso molecolare di 16 kDa. Essa è principalmente coinvolta nella regolazione del peso attraverso la modulazione del centro dell’appetito e del dispendio energetico corporeo. La leptina agisce come un lipostato: all’aumentare del grasso a livello adipocitario, essa viene prodotta e secreta a livello ematico per poi agire sul centro dell’appetito a livello ipotalamico con un meccanismo di feedback negativo. Sebbene inizialmente sia stato dimostrato che la mancanza di leptina favorisse lo sviluppo di obesità, studi recenti hanno dimostrato inoltre che il soggetto obeso presenta livelli di leptina sierica più elevati rispetto al normopeso, sottolineando la possibile leptino-resistenza in questo gruppo di soggetti. Studi recenti hanno evidenziato il possibile coinvolgimento della leptina nei processi infiammatori. Il recettore della leptina è infatti espresso anche sulla superficie cellulare di macrofagi alveolari, linfociti T e cellule epiteliali bronchiali, suggerendo un possibile ruolo di questa proteina nella cascata infiammatoria delle vie aeree. Il recettore della leptina è stato isolato sia sulle cellule bronchiali sia a livello del parenchima polmonare, sottolineando il suo possibile ruolo nella produzione del surfactante e nello sviluppo e remodelling a livello polmonare. Attualmente non sono disponibili studi sul ruolo della leptina nell’infiammazione delle vie respiratorie di pazienti con asma
Uno strano caso di asma difficle
No full textC. F. dai due anni di vita ha iniziato a presentare frequenti episodi di bronchite asmatiforme. Dall’età di 5 anni gli episodi si sono presentati in forma più lieve e hanno necessitato esclusivamente di terapia aerosolica domiciliare. All’età di otto anni è stato sottoposto a valutazione pneumo-allergologica con diagnosi di asma non allergico. Le prove di funzionalità respiratoria hanno iniziato a presentare un quadro persistentemente ostruttivo scarsamente responsivo al test di broncodilatazione. Ha eseguito terapia con salmeterolo/fluticasone, montelukast e salbutamolo con scarso beneficio. Successivamente ha eseguito tomografia computerizzata del torace che evidenziava la presenza di bronchiectasie ai lobi superiore e medio
di sinistra. Giungeva pertanto alla nostra osservazione per approfondimento diagnostico. Eseguiva tracheobroncoscopia, che mostrava la presenza di un restringimento bronchiale, da broncomalacia al lobo superiore sinistro. Alla luce del quadro clinico, è stato posizionato stent a livello dell’occlusione bronchiale con miglioramento della sintomatologia. È importante sottolineare come non sempre una storia di asma ricorrente con una spirometria persistentemente ostruttiva sia asma
Symptomatic vascular rings: a case misdiagnosed as difficult asthma in a school-age girl
No full textN/
Structured Light Plethysmography: new method to evaluate expiratory flow limitation in asthmatic children
No full textStructured Light Plethysmography (SLP) is a new non-invasive method that captures and records real-time functional images of chest movement, allowing a better understanding of patient espiratory function. The system measures breathing motion using a grid of light, tracked by a digital vision system of 2 high-speed cameras. Chest movement during breathing is analyzed and displayed in terms of regional movement parameters as well as a 3D-reconstruction. In addition to showing the breathing pattern of the patient on avolume-time graph and in a dynamic 3D-representation, the tidal breathing flow/volume graph is available for immediate identification of inspiratory or expiratory flow limitation. The regional subdivision are also available with both graphical curves and numerical parameters, that can easily show and identify respiratory-related issues or abnormal contribution to the tidal volume of the different regions of the chest. It doesn’t require patient collaboration like spirometry; so it could be an alternative to evaluate pre-school children
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