1,721,011 research outputs found
New threats for pediatric respiratory health: beware of vaping
Full text linkElectronic cigarette (EC) was proposed on the market about 15 years ago as a harmless alternative to traditional combustion cigarettes (CC). Since then, EC and other electronic devices that deliver nicotine by simulating traditional smoking without combustion have achieved unexpected success, with around 80 million users worldwide by 2023. Such devices are commonly felt to be safer than CC, especially among adolescents, who are also the main target for aggressive marketing from the tobacco industry. Increasing evidence shows that e-liquids and vape contain toxicants and irritants and that acute and chronic vaping causes airway inflammation and bronchoconstriction and reduces responses to infections. Moreover, some studies have shown that second- and third-hand smoke, as well as in utero exposure, may cause detrimental effects to the airways and to health in general. Notably, the recent E-cigarette or Vaping use-Associated Lung Injury (EVALI) epidemic in the USA has shown that EC has higher acute toxicity than CC, while long-term effects are still not known. Since adolescents and children are often completely unaware of the health risks associated with vaping or of the potential presence of nicotine in e-liquids, pediatricians play a crucial role in educating them, in order to prevent vaping, as well as smoking. Pediatricians should always consider the possibility of vaping as the cause of unusual respiratory diseases, especially in adolescents. This narrative review paper briefly outlines the most recent data on EC and their effects on the airways, focusing on childhood and adolescence
Asthma, exercise and metabolic dysregulation in paediatrics
No full textAsthma is the most frequent chronic disease in childhood. Chest tightness, cough, wheezing and dyspnoea during or after exercise may be unique manifestations of asthma in up to 90% of subjects. Physical activity may be reduced by uncontrolled asthma symptoms and parental beliefs, impairing physical fitness of asthmatic children. Clinicians working in the field of allergy are aware of evidence supporting the benefits of physical activity for patients with asthma. Treatment of asthma is required in order to obtain its control and to avoid any limitation in sports and active play participation. As exercise performance in children with controlled asthma is not different from that of healthy controls, any exercise limitation cannot be accepted. Overweight and obesity may interfere with asthma and exercise, leading to dyspnoea symptoms. Evidences on the effect of insulin resistance on airway smooth muscle and on bronchial hyperactivity are presented. Conclusion: Exercise is part of the strategy to obtain the best control of asthma in childhood, but we have to optimise the asthma control therapy before starting exercise programming. Furthermore, it is crucial to give best attention on the effects of obesity and insulin resistance, because they could in turn influence patients’ symptoms
Therapeutic Effects of Vitamin D in Asthma and Allergy
Full text linkIn recent years, low vitamin D status has been proposed as a putative risk factor for allergic diseases. A growing body of literature reports low vitamin D levels in atopic patients and supports an association between vitamin D deficiency and risk of adverse asthma and allergies outcomes. Therefore, it has been speculated that vitamin D supplementation may either prevent or reduce the risk of allergic diseases. Birth cohort studies addressing the role of vitamin D intake during pregnancy have shown conflicting results regarding allergy outcomes in offspring. Currently, only a few studies have tried to supplement vitamin D in asthmatic patients, often as an add-on therapy to standard asthma controller medications, and results are not all consistent. There is emerging data to show that vitamin D can enhance the antiinflammatory effects of glucocorticoids and potentially be used as adjuvant therapy in steroid-resistant asthma. Recent in vivo data suggest that vitamin D supplementation may also reduce the severity of atopic dermatitis. This review examines the existing relevant literature focusing on vitamin D supplementation in the treatment of allergic diseases
The role of atopy in asthma development and persistence
No full textAsthma is the most common chronic disease in pediatric age. Childhood-onset asthma, as opposed to adult-onset asthma, is typically characterized by a personal and often a family history of atopy and related markers of type 2-mediated inflammation. However, the interplay between atopy and asthma development is more complex than a linear dose-response relationship
The good bugs: the use of probiotics in pediatrics
No full textPurpose of review There is growing evidence encouraging the use of probiotics in many conditions in children. However, given the wide number of probiotics available and contradictory data in the literature, the health-care provider is often faced with uncertainness about whether or not to use probiotics and which one(s) to choose. We here review current hypotheses regarding the efficacy and safety of probiotics and evaluate the available data on the use of probiotics in most common diseases in children. Considering that probiotics have strain-specific effects, we will focus on individual probiotic strains rather than on probiotics in general. Recent findings Strain-specific efficacy was clearly demonstrated with Lactobacillus rhamnosus GG and Saccharomyces boulardii I-745 in the treatment of acute infectious diarrhea, Lactobacillus reuteri DSM 17938 in infantile colics, Lactobacillus rhamnosus GG, and VSL#3 in irritable bowel syndrome. In addition, encouraging results are seen for use of probiotics in necrotizing enterocolitis, food allergy, and nonalcoholic fatty liver disease. However, the data available for constipation are to be considered somewhat equivocal. The clinical relevance of these findings indicates that healthcare providers need to take strain-specificity and disease specificity of probiotics into consideration when recommending probiotic for their patients
Potential effects of E-cigarettes and vaping in pediatric asthma
Full text linkAsthma is the most common chronic disease in childhood and exposure to tobacco smoke has been long recognized as a risk factor for its onset as well as for exacerbations and poor disease control. Since the early 2000s, electronic cigarettes have been marketed worldwide as a non-harmful electronic alternative to combustible cigarettes and as a device likely to help stop smoking, and their use is continuously rising, particularly among adolescents. However, several studies have shown that vape contains many different well-known toxicants, causing significant cytotoxic and pro-inflammatory effects on the airways in-vitro and in animal models. In humans, a variety of harmful lung effects related to vaping, ranging from bronchoconstriction to severe respiratory distress has been already reported
Asthma and viruses: is there a relationship?
No full textAsthma is a multifactorial disease in which many factors play a role in its development and exacerbations. Viral infections are known to be the main cause of asthmatic exacerbations and are often the first manifestation of asthma in preschool age. However, there is much evidence suggesting a role of viral infections even in asthma development. Respiratory Syncytial Virus (RSV). has been first associated with an increased risk to develop asthma, but recently new viruses have been proposed to be involved in asthma pathogenesis. Further studies will be needed to demonstrate a causative role of viral infections in asthma development, in order to implement preventive strategies in high-risk children
Acute dacryocystitis with giant lacrimal abscess: a case report
Full text linkWe report a case of a 4-year-old girl with acute dacryocystitis complicated with giant lacrimal abscess who underwent open dacryocystectomy as resolutive surgery
Breast milk: more than just nutrition!
No full textFrom an evolutionary and nutritional standpoint, exclusive human milk feeding for the first 6 months of life, with continued breastfeeding for 1 to 2 years of life, is recognized as the gold standard nourishment for the infant: it is a species-specific food, with a composition designed by nature to better respond to the biological and psychological needs of the newborn/infant. Human milk contains many hundreds of bioactive molecules that protect newborn against infection and inflammation and contribute to immune maturation, organ development, and healthy microbial colonization. Compared with formula feeding, breastfeeding has been associated with decreased morbidity and mortality in infants and to lower incidence of gastrointestinal infections and inflammatory, respiratory and allergic disease. Here, we briefly review the nutritional and functional composition of human milk and provide an overview of its varied bioactive factors
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