1,721,050 research outputs found
Bronchiolitis: from empiricism to scientific evidence.
No full textBronchiolitis is the most common viral infection of the lower respiratory tract in infants in their first year of life, with an incidence peak between 3 and 9 months of age. The clinical profile of bronchiolitis results from the inflammatory obstruction of the small airways. The etiological agent involved is respiratory syncytial virus (RSV) in more than 50% of cases. The first international guidelines on the management of children with bronchiolitis have recently been published. The first was produced by a special subcommittee created by the American Academy of Pediatrics (AAP) with the support of a few important international associations that deal with respiratory diseases including the American Thoracic Society and the European Respiratory Society; the second was drawn up by the Scottish Intercollegiate Guidelines Network (SIGN). This review sets out to update the management of children with bronchiolitis by discussing the salient points relating to diagnosis, treatment and prevention on the basis of the recommendations in these documents
The Epithelial Barrier Hypothesis in Food Allergies: The State of the Art
Full text linkRecently, the “epithelial barrier hypothesis” has been proposed as a key factor in the development of allergic diseases, such as food allergies. Harmful environmental factors can damage epithelial barriers, with detrimental effects on the host immune response and on the local microbial equilibrium, resulting in chronic mucosal inflammation that perpetuates the dysfunction of the epithelial barrier. The increased epithelial permeability allows allergens to access the submucosae, leading to an imbalance between type 1 T-helper (Th1) and type 2 T-helper (Th2) inflammation, with a predominant Th2 response that is the key factor in food allergy development. In this article on the state of the art, we review scientific evidence on the “epithelial barrier hypothesis”, with a focus on food allergies. We describe how loss of integrity of the skin and intestinal epithelial barrier and modifications in gut microbiota composition can contribute to local inflammatory changes and immunological unbalance that can lead to the development of food allergies
Indications and outcomes of exercise challenge tests performed in children before and during COVID-19 pandemic
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Nasal nitric oxide is low early in life in two infants with primary ciliary dyskinesia
No full textNasal nitric oxide levels are low in patients with primary ciliary dyskinesia, but it is not known whether this defect is already present in the first months of life. The current authors measured nasal nitric oxide in two infants with situs inversus and primary ciliary dyskinesia, diagnosed by electron microscopy at 4 and 6 months of age, and in five healthy control infants. Nasal nitric oxide values in the primary ciliary dyskinesia infants (85 and 115 parts per billion (ppb)) were markedly lower than in the healthy controls (mean: 295 ppb, range: 225-379 ppb). This is the first report to show that nasal nitric oxide values are already low in early life in primary ciliary dyskinesia children, supporting the hypothesis that a reduced production of nasal nitric oxide is an intrinsic feature of this disease. The current authors suggest that the nasal nitric oxide test may be a useful, noninvasive method for screening young children for primary ciliary dyskinesia in clinical practice
Exercise tolerance after anaemia correction with recombinant human erythropoietin in end-stage renal disease.
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Clinical application of nasal nitric oxide measurement.
No full textNitric oxide is present in high concentration in the upper respiratory tract. The main source of this gaseous molecule is the paranasal sinus epithelium. The physiological role of this mediator is to contribute to local host defense, modulate ciliary motility and serve as an aerocrine mediator in helping to maintain adequate ventilationperfusion matching in the lung. Abnormal values of nasal NO (nNO) have been reported in different pathological conditions of the respiratory tract. Reduced nNO values have been recorded in subjects with acute and chronic sinusitis, cystic fibrosis and nasal polyps. Particularly low concentrations have been described in children with primary ciliary dyskinesia, so nNO measurement has been proposed as a reliable screening test for this chronic lung disease
A comparison of two noninvasive methods in the determination of the anaerobic threshold in children.
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