1,720,969 research outputs found
Approccio diagnostico alla tosse
No full textLa tosse è un sintomo comune nel bambino e, sostanzialmente, rappresenta un meccanismo riflesso di difesa dell’organismo. Essa è caratterizzata da un'iniziale fase inspiratoria a cui segue un'espirazione forzata a glottide chiusa che consente l’espulsione all’esterno di eventuali secrezioni o corpi estranei presenti nell’albero tracheobronchiale ed è associata ad un suono caratteristico
The measurement of exhaled nitric oxide in routine practice.
No full textExhaled nitric oxide (NO) is considered the most easily available clinical test to indirectly assess the level of eosinophilic airway inflammation in asthma, and to predict the efficacy of anti-inflammatory treatment with inhaled corticosteroids (ICS). It is possible to measure the level of exhaled NO using online or offline methods. The most widely used online method employs techniques that enable NO in exhaled air to be measured in a single exhalation, calculating the value at the end-expiratory plateau. Because of the correlation between the level of exhaled NO with the level of eosinophilic inflammation in the airway of asthmatic patients, it has been proposed as a clinical marker in the practice of respiratory and allergy physicians with differing targets. In particular it is considered to be highly effective in the diagnosis of allergic asthma, to be capable of identifying those patients with a higher response probability to inhaled corticosteroids, and to a lesser extent, to be of value in contributing to the management of the disease. The possibility of easily taking measurements of FeNO in an office setting even by relatively young children, and the availability of a portable device, opens a significant perspective for the routine use of FeNO evaluation in daily practice
The use of inhaled corticosteroid in preschool wheezers: what's the point today?
Full text linkAbstract Among the preschool children who wheeze two different groups can be identify: children who have a viral infection and those who respond to multiple triggers, such as exercise or allergens. To distinguish between these different phenotypes of wheezing, and consequently choose therapy represents a major challenge for pediatricians. Transient wheezers conditions do not improve with maintenance treatment with ICS. On the other hand they are definitely useful in children with wheeze/asthma. Increasing evidence is in favor of the potential role of leukotriene receptor antagonists in preschool children with recurrent wheezing. Oral steroid has been demonstrated not to be indicated to control acute wheezing, unless severe disease is expected in non-atopic children. The early phenotyping of preschool wheezers, upon which the appropriate treatment should be based, represents a challenging issue in the paediatric practice.</p
Gli steroidi per via inalatoria nel trattamento del respiro sibilante in età prescolare
No full textL’uso di corticosteroidi per via inalatoria (ICS) in bambini con wheezing in età prescolare è ampiamente diffuso nella pratica pediatrica. L’obiettivo principale è la riduzione degli episodi di riacutizzazione, nel miglioramento dei sintomi e della funzionalità respiratoria. Gli ICS agiscono principalmente sui diversi meccanismi dell’infiammazione, sui processi di rimodellamento e sull’ipereattività bronchiale che si associa al fenotipo asmatico in quanto hanno come bersaglio l’infiammazione eosinofila che a quest’ultimo si associa. L’efficacia nell’impiego di tali farmaci nel bambino piccolo, che presenta wheezing ricorrente spesso associato a infezione virale, è, al contrario, molto dibattuta. La principale sfida nel trattamento del respiro sibilante in età prescolare resta la definizione del fenotipo in modo tale da poter attuare un trattamento farmacologico più idoneo a migliorare la clinica e la progressione di malattia del paziente
Un respiro... bollente (la temperatura dell’aria esalata)
No full textL’asma è una malattia infiammatoria delle vie aeree. Essendo il “calore” uno dei segni cardinali della flogosi, numerosi studi hanno valutato se la temperatura dell’aria esalata possa riflettere la risposta patologica delle vie aeree nell’asma bronchiale. È ipotizzabile che una notevole quantità di “calore” venga prodotta durante lo svolgimento delle diverse fasi dell’infiammazione e del rimodellamento delle vie aeree del soggetto con asma. L’insieme dei risultati ottenuti dagli studi fino ad oggi disponibili suggeriscono che la valutazione della temperatura dell’aria esalata possa rappresentare un indicatore composito di malattia in grado di riflettere non soltanto la componente infiammatoria ma anche quella relativa al rimodellamento delle vie aeree. Si può pertanto ipotizzare un ruolo pratico nella valutazione del controllo di malattia e nel monitoraggio della risposta alla terapi
Ebastine overdose in a child
Full text linkThe lack of side effects after acute ingestion of a high dose of ebastine in our child aging 44 months suggests an overall safety profile of ebastine; it could suggest less time of hospitalization for children who are subjected to this event
Exercise-induced bronchospasm or dyspnoea in obese children?
No full textExercise-induced bronchospasm or dyspnoea in obese children? a review of the literatur
Electronic nose in discrimination of children with uncontrolled asthma
No full textMeasuring biomarkers (e.g. volatile organic compounds [VOCs]) in exhaled breath is an attractive approach to monitor airway inflammation in asthma and other lung diseases. Olfactive technology by electronic nose (e-Nose) has been applied to identify VOCs in exhaled breath. We compared e-Nose respiratory patterns in a pediatric cohort with asthma classificate children with different asthma control. This cross-sectional study involved 38 children: 28 with asthma and 10 healthy controls . The asthmatic patients were categorized as having controlled (AC), partially controlled (APC) or uncontrolled asthma (ANC) based on level of asthma symptom control according to Global Initiative for Asthma (GINA). Clinical exams, exhaled breath collection for generating e-Nose VOC profiles, and spirometry were performed. Exhaled breath samples were obtained using a commercial electronic nose (Cyranose 320; Smith Detections, Pasadena, CA, USA). The discriminative ability of breathprints were investigated by principal component analysis and penalized logistic regression. The e-Nose was able to discriminate between the CON (controls) + AC and the ANC + APC group with an area under the curve [AUC] of 0.85 (95% confidence interval [CI] 0.72 to 0.98) and a cross-validated AUC of 0.80 (95% CI 0.70 to 0.85). Sensitivity and specificity calculated using the Youden index were 0.79 and 0.84, respectively. Exhaled biomarker patterns were easy to obtain with the device and were able to differentiate children with uncontrolled symptomatic asthma from asymptomatic controls
Il respiro disfunzionale nel bambino.
No full textIn età pediatrica pattern anomali della respirazione possono causare lo sviluppo di sintomi caratteristici e interferire con la qualità di vita
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