1,721,225 research outputs found
Focus on biological therapies in pediatric allergy
No full textBiological therapies targeting specific cytokines and receptors provide successful treatment options for pediatric patients with allergic diseases. Defining their indications, dosing, and safety profiles is essential for optimizing outcomes and improving the quality of life for children with allergic chronic conditions
A polycentric, randomized, double blind, parallel-group, placebo-controlled study on Lertal®, a multicomponent nutraceutical, as add-on treatment in children with allergic rhinoconjunctivitis: phase I during active treatment
No full textAllergic rhinoconjunctivitis (AR) treatment is usually pharmacological in children, but medications are merely symptomatic, may not be completely effective, and may have relevant side effects. Thus, doctors and parents look at complementary medicine, including nutraceuticals. Lertal®, an oral nutraceutical, contains extract of Perilla, quercetin, and Vitamin D3 It has been reported that adults with AR diminished allergic symptoms and medication use during Lertal® therapy. Therefore, the current polycentric, randomized, double blind, parallel-group, placebo-controlled study aimed to evaluate the efficacy and safety of Lertal® as an add-on treatment in children with AR. In this study, 146 children (94 males and 52 females, mean age 9.1±1.88) were randomly assigned to Lertal® + standard treatment or Placebo + standard treatment and were visited at baseline (W0), and after 2 (W2) and 4 weeks (W4). Standard treatment consisted of continuous antihistaminic schedule. The primary endpoint was the Total Symptom Score (TSS - last 12 hours) change from the baseline to the end of the 4-week treatment. Both groups significantly (p less 0.0001 for both) reduced TSS (last 12 hours) after 4 weeks (% change: - 63.6% in Lertal®-group and - 60.7% in Placebo-group; p= n.s. intergroup analysis). Notably, 24 children had symptom worsening between W2 and W4: 8 in the Lertal®-group and 16 in the Placebo-group, with significant intergroup difference (p less than 0.05). All of them were poly-allergic subjects exposed to multiple allergens. There was no relevant adverse event. The present study documented that Lertal®, as add-on treatment, was able to significantly prevent the occurrence of clinical worsening and was safe in AR poly-allergic children
The relevance of symptom perception in the management of severe asthma in adolescents
No full textSevere asthma is a compelling challenge in clinical practice. Adolescence represents a relevant aspect of this issue. We report a series of adolescents with severe asthma and evaluated before and after a one-year standardized guideline-oriented treatment. We explored the relevance of symptom perception, including nasal and bronchial complaints, assessed by visual analog scale (VAS) and the perception of asthma control measured by the asthma control test (ACT). The current study demonstrated that adolescents perceived a significant improvement in their symptoms (p < 0.0001) and asthma control (p < 0.001) after adequate treatment. In conclusion, the management of severe asthma in adolescents should be carefully addressed to also consider the patient's perception
Paediatric severe chronic spontaneous urticaria: Successful management through conventional drug therapy
No full textChronic spontaneous urticaria (CSU) can occur in children and the clinical management is quite challenging. Here, we described a paediatric clinical case of CSU successfully managed by conventional therapy, including systemic steroids, cetirizine, anti-leukotriene drug and dietary restriction (for histamine-releasing foods). This patient showed neither atopy nor any allergic sensitisation; moreover, the autologous serum skin test resulted negative. This category of patients with no comorbidity and no evidence of atopy might benefit from the conventional drug management; however, a protracted course of steroid treatment with very slow and gradual tapering may be needed. This approach was successful and safe in our clinical case, but a careful follow-up, due to the potential side effects of steroids, should be recommended
Unrecognised diaphragmatic hernia in a refugee child: An incidental diagnosis
No full textA 4-year-old boy from Syria was evaluated at the emergency department because of an upper airway viral illness. His physical examination showed a significant intensity reduction of all heart sounds in the absence of any other pathological signs. As the child was affected with Down's syndrome and had suffered thoracic and abdominal trauma because of bombardments, a diaphragmatic hernia was immediately suspected and was confirmed through a simple chest X-ray. A careful clinical examination is crucial in refugee children and adolescents, as several medical and surgical disorders could have escaped previously
The gender effect in children and adolescents with asthma: practical outcomes from the "ControL'Asma" study
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