1,721,067 research outputs found
Pediatric body composition in clinical studies: which methods in which situations?
No full textThere is currently much interest in the subject of pediatric obesity. Accurate
measures of body composition are required given the potential influence of
variables such as growth, metabolic rate, physical activity, and physical
fitness. Because boys and girls have a different growth pattern, gender is a
fundamental consideration when measuring children and assessing body composition.
The central aim of this paper is to review methods of pediatric body composition
assessment that can provide new insights for clinical practice
Anaphylaxis in adolescents.
No full textAbstract
PURPOSE OF REVIEW:
The frequency of hospitalization for anaphylaxis has increased over the last 20 years across Europe, Australia, and North America, particularly, for food and medication triggers. Adolescents show the highest risk for morbidity and fatality from food-induced anaphylaxis, yet there is little high-quality evidence addressing the reasons for this disproportionate vulnerability.
RECENT FINDINGS:
Recent data seem to suggest a possible increasing burden of food-induced anaphylaxis among adolescents. Trends in anaphylaxis mortality are stable in North America and the United Kingdom, but not in Australia where the incidence of fatal anaphylaxis has recently doubled. The age distribution of fatal anaphylaxis varies according to the nature of the culprit trigger, with data suggesting an age-related predisposition to fatal food anaphylaxis in adolescents and young adults. Adolescence represents a critical phase of transition when rapid and substantial physical, emotional, and social changes occur. Therefore, adolescents show challenges in self-management that are different from other age groups, contributing to a higher risk of poor anaphylaxis outcomes.
SUMMARY:
The purpose of this review is to summarize recent data on epidemiology and elicitors of anaphylaxis in adolescents and to address currently known barriers and potential facilitators to self-management of anaphylaxis in this vulnerable age group
Asthma, exercise and metabolic dysregulation in paediatrics.
No full textAbstract
Asthma 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
Predictive features for persistence of atopic dermatitis in children.
No full textAllergen exposure plays an important role in atopic dermatitis (AD). Because
immunological mechanisms underlying asthma and AD have great similarities, we
evaluated whether features such as allergen sensitization, immune response,
disease severity and duration or allergen exposure could be considered predictive
for AD persistence. Seventy-one AD children (age range 14-158 months) were
enrolled and followed for 3 consecutive years for AD severity using the SCORAD
index (SI). At enrollment, reactivity to inhalant and food allergens using the
skin prick test (SPT) and house dust mite (HDM) atopy patch test (APT), and HDM
allergens in house dust were evaluated. After 3 years, 38 children outgrew their
AD (AD- group), while in 33 AD persisted (AD+ group). At enrollment, AD+ children
had a higher SI, higher rate of positivity to SPT and APT for mites (p = 0.001),
and higher environmental exposure to HDM allergens (p = 0.035). The AD+ children
developed more respiratory symptoms in comparison to AD- children (p < 0.001).
None of the AD- children presented APT positivity. In our study population,
positivity of SPT and APT for HDM, environmental allergen exposure levels and
severity of the disease at enrollment presented a significant predictive power
towards AD persistence. Subjects with positive skin reactivity to HDM should be
considered at risk of AD persistence and of possible development of allergic
respiratory disorders
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
Double-blind trial of house-dust mite immunotherapy in asthmatic children resident at high altitude.
No full textTwenty-three Dermatophagoides pteronyssinus (Dpt)-sensitive asthmatic children
aged 7-14 years entered a double-blind, placebo-controlled trial of standardized
immunotherapy (IT) (Alpare) while resident at high altitude. Dpt sensitivity was
evaluated by skin prick tests at different allergen concentrations at the
enrollment and after 6 and 12 months of treatment. Bronchial hyperreactivity was
evaluated at the same time points, and on each occasion, histamine challenge and,
the following day, Dpt bronchial challenge were performed. All patients,
irrespective of active treatment, improved clinically and in lung function with
increased PC20 and Dpt-PD20. Alpare-treated patients had a significantly
decreased sensitivity on Dpt skin testing (P < 0.009) and felt that their asthma
had improved (P < 0.001) compared with placebo-treated subjects, but there was no
difference between the treatment groups in lung function or bronchial challenge
response. IT neither increased nor decreased bronchial histamine sensitivity. Our
results indicate that Dpt IT benefits asthmatic children, but improvement by
allergen avoidance at high altitude is even greater
Refractory Chronic Spontaneous Urticaria Treated With Omalizumab in an Adolescent With Common Variable Immunodeficiency
No full textChronic spontaneous urtcaria (CSU) can represent the leading sign of a wide spectrum of systemic diseases, including primary immunodeficiencies. We describe the case of a young adult female with coexisting CSU and common variable immunodeficiency (CVID) successfully treated with omalizumab. The patient, with a history of recurrent respiratory infections during childhood, was referred to clinical attention due to the development of refractory CSU. During the diagnostic workup for the research of secondary causes of urticaria, an immunological assessment was performed, showing markedly reduced levels of IgG and IgM, poor antibody response against vaccinating antigens in absence of a T cellular deficiency. Therefore, the diagnosis of CVID was posed. Despite the immunoglobulin replacement and a trial with intravenous immunoglobulin at immunomodulatory dosage, the patient continued to experience severe urticaria, with significant impairment in the quality of life. After 2 years from the diagnosis of CVID, a treatment with omalizumab was started, showing complete remission of cutaneous symptoms after the first injection. The drug was well-tolerated, and the patient did not experience adverse effects during a 12-months follow-up
Childhood Asthma Control Test in asthmatic children with dysfunctional breathing.
No full textNon disponibil
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