Paediatric asthma and allergy最新文献_第8页

Antistatic treatment and the amount of salbutamol actuated have variable effect on drug delivery of six different valved holding chambers (VHC) 抗静电处理和沙丁胺醇驱动量对6种不同的有阀保持室(VHC)的药物传递有不同的影响。

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa961

P. Csonka, L. Lehtimäki

引用次数: 0

Maternal antibiotic use during pregnancy and asthma in children: population-based cohort study and sibling design 妊娠期间母亲抗生素使用与儿童哮喘:基于人群的队列研究和兄弟姐妹设计

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa4942

Xiaoqin Liu, Jianping Chen

{"title":"Maternal antibiotic use during pregnancy and asthma in children: population-based cohort study and sibling design","authors":"Xiaoqin Liu, Jianping Chen","doi":"10.1183/13993003.congress-2019.oa4942","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa4942","url":null,"abstract":"Objective: Antibiotic use during pregnancy may affect asthma risk in offspring. However, studies show conflicting results, and the observed association could be confounded by unmeasured covariates. We aimed to assess the association accounting for possible confounding factors. Methods: A population-based cohort study and sibling study using data from Danish national registers, which comprised 411,883 liveborn singletons during 2005–2011. The children were followed from 5 years of age until the first onset of asthma, emigration, death, or Dec 31, 2016, whichever came first. Maternal antibiotic use, infections, and asthma in the children were defined by data from the National Patient Register and Prescription Registry. We estimated hazard ratios (HRs) of asthma using proportional Cox regression models. Results: Approximately 36.5% of pregnant women redeemed at least one antibiotic prescription. Antibiotic use during pregnancy was associated with childhood asthma in cohort analyses (HR=1.23, 95% confidence interval (CI): 1.20–1.26), but not in sibling analyses (HR= 0.97, 95% CI: 0.91–1.03). In cohort analyses, the risk of offspring asthma was 1.16 (95% CI: 1.13–1.20) for antibiotics used for urogenital infections, 1.19 (95% CI: 1.10–1.29) for respiratory infections, 1.26 (95% CI: 1.14–1.39) for ear or eye infections, and 1.01 (95% CI: 0.75–1.35) for skin infections, respectively. All these associations disappeared in the sibling analyses. Conclusion: Prenatal exposure to antibiotic use during pregnancy is not associated with asthma in children. The association observed by previous studies could be due to familial confounding.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128369885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Long-term effects of a peer-led asthma self-management program for adolescents on peer leaders’ healthcare utilization 同伴领导的青少年哮喘自我管理项目对同伴领导医疗保健利用的长期影响

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa930

H. Rhee, T. Love, Donald Harrington, Leanne Walters

{"title":"Long-term effects of a peer-led asthma self-management program for adolescents on peer leaders’ healthcare utilization","authors":"H. Rhee, T. Love, Donald Harrington, Leanne Walters","doi":"10.1183/13993003.congress-2019.pa930","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa930","url":null,"abstract":"Background: Asthma affects nearly 3 million adolescents in the US alone. Attaining optimal asthma control in adolescent remains elusive, primarily due to poor disease self-management. Capitalizing on peer dynamics particularly relevant to adolescence, a peer-led asthma self-management program for adolescents (PLASMA) was developed and evaluated in three urban communities in the US. The purpose of this study is to examine the long-term effects of PLASMA on peer leaders’ healthcare utilization. Methods: Peer leaders (ages16-20 years) with physician-diagnosed asthma and nominated by clinicians or teachers for their quality as a leader completed an intense 12 hour training session and delivered a maualized PLASMA program to their adolescent peers at a camp setting. A self-report healthcare utilization form was completed at baseline and every three months after the intervention for 15 months. Generalized linear mixed-effect-model was conducted to test for significant changes in the number of times each type of healthcare service was used over time. Results: Of 42 completed the peer leader training session, 35 implemented the PLASMA program at the camp. We found significant reduction in the numbers of healthcare service use reported over the course of 15 months after the PLASMA program, specifically in asthma-related routine office visits (p=0.01), acute office visits (p Conclusion: PLASMA is a compelling alternative to conventional asthma education led by healthcare professionals, given its demonstrated effects on reducing acute office visits and school absenteeism in peer leaders.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132371385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fractional exhaled Nitric Oxide levels: an objective indicator for asthma severity 呼出一氧化氮分数水平:哮喘严重程度的客观指标

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5420

Nir Diamant, I. Amirav, Keren Armoni-Domani, U. Shapira, Reut Rital, Mika Rochman, Moria Beer, Moran Lavie

{"title":"Fractional exhaled Nitric Oxide levels: an objective indicator for asthma severity","authors":"Nir Diamant, I. Amirav, Keren Armoni-Domani, U. Shapira, Reut Rital, Mika Rochman, Moria Beer, Moran Lavie","doi":"10.1183/13993003.congress-2019.pa5420","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5420","url":null,"abstract":"Background: FeNO (Fractional Exhaled Nitric Oxide) is a biomarker for eosinophilic inflammation and is used for diagnosis and monitoring of asthma. Abnormal FeNO [levels above 35 parts per billions (ppb)] indicates significant airway eosinophilia and steroid-responsive airway inflammation. Some children with asthma have extremely high FeNO, yet it is unknown if these levels represent a different asthma phenotype compared to those with mildly elevated FeNO. Aims: To investigate if FeNO levels correlate with clinical phenotype, comorbidity and Pulmonary Function Tests (PFT) in children with asthma and abnormal FeNO. Methods: Anthropometric data, day symptoms, night symptoms, controller/reliever treatment, comorbidity and PFT were correlated with FeNO level in asthma patients with abnormal FeNO. Results: 125 children and adolescents ages 4-18 years with abnormal FeNO were included. No correlation was found between FeNO and controller/reliever treatment, comorbidity and PFT. However, FeNO levels positively correlated with severity for both day and night symptoms (r=0.263 P=0.003 and r=0.211 P=0.021; respectively). Moreover, FeNO level of 80 ppb was found to be the best cutoff to differentiate between patients with mild vs severe day and night symptoms (P=0.01 and P=0.02, respectively). Conclusion: In asthma patients with abnormal FeNO, the levels of FeNO correlated with severity of symptoms. FeNO level of 80 ppb or above may serve as an objective indicator for severe asthma. In the era of personalized medicine these findings may aid in the clinical management of asthma patients.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115081863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Adverse events and cardiovasular effects of vilanterol in paediatric asthma: a systematic review 维兰特罗在儿童哮喘中的不良事件和心血管效应:一项系统综述

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa960

R. Austin, I. Sinha, D. Hawcutt

{"title":"Adverse events and cardiovasular effects of vilanterol in paediatric asthma: a systematic review","authors":"R. Austin, I. Sinha, D. Hawcutt","doi":"10.1183/13993003.congress-2019.pa960","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa960","url":null,"abstract":"Introduction: Ultra-long-acting β2-agonists (uLABAs) are a recent addition in asthma, but are yet to be included in paediatric guidelines. Given their pharmacology there are concerns around unknown adverse effects (AEs) in children. Aims: To review the safety of uLABA vilanterol (VI) use in paediatric patients, including specifically looking for cardiovascular (CVS) AEs. Methods: The Cochrane Database, clinicaltrials.gov, Medline, EMBASE, Pubmed, CINAHL were queried using keywords (‘asthma’ AND ‘vilanterol OR GW642444 OR Revlar Ellipta’ limited to Results: Three papers were included capturing 510 patients aged 5-11 years. Fourteen trials including patients ≥12 years old were excluded as paediatric data was not reported separately. VI dose (6.25-25mcg) and comparator varied (placebo, fluticasone furoate) therefore quantitative analysis was not performed. Abnormal ECGs were seen in 2(1.6%) placebo patients and in 10(2.5%) VI patients; there was no dose correlation, with those on lower VI doses having more episodes of abnormal ECG. None of these episodes were adverse events or required patients to be removed from the study. The ECG abnormalities were not specified and not clear if they were pre- or post-dose. Other CVS parameters were unremarkable. Follow-up period was of short duration. Adverse events occured in 29% of the VI group, 24% of the placebo group and 8% on comparator drugs. Conclusion: With only 510 children recruited, the power to detect rare or uncommon side effects is insufficient. We have highlighted the limitations of CVS monitoring in these studies. This area requires urgent attention and further study in our paediatric patients.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134231073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Routine clinical use of Electronic Monitoring Devices (EMD) to measure inhaler adherence in children with Difficult Asthma (DA) 临床常规使用电子监测装置(EMD)测量难治性哮喘患儿吸入器依从性

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5427

S. Frost, J. Bennett, B. Davies, Isobel Brookes, P. Kenia, S. Rao, P. Nagakumar

{"title":"Routine clinical use of Electronic Monitoring Devices (EMD) to measure inhaler adherence in children with Difficult Asthma (DA)","authors":"S. Frost, J. Bennett, B. Davies, Isobel Brookes, P. Kenia, S. Rao, P. Nagakumar","doi":"10.1183/13993003.congress-2019.pa5427","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5427","url":null,"abstract":"Poor adherence to inhaled steroids is a well-recognised factor for poor asthma control. Although use of EMDs to assess adherence is advocated by BTS-SIGN asthma guidelines, their use has been predominantly within research studies (Chan: 2015). Moreover, most commercially available EMD’s in children do not measure the actuation of the drug. A retrospective analysis of the data from EMD monitoring (Smartinhaler®) over a 2 year period was reviewed to asscertain experience of the use of EMD’s to measure inhaled steroid adherence within routine clinical settings. All patients were attending the regional paediatric DA service, on high dose asthma therapies, & for consideration of novel therapies. 40 patients were monitored at median age 12. 7 yr (range 7, 16 yr). The median duration of monitoring = 2.1 month (range 1, 6months). The FEV1 at the start of the monitoring = 84% (range 45, 109%). 23 (57.5%) had adherence In 17 (42.5%) patients, EMD data showed adherence >80%. Further data analysis showed possible poor inhaler technique in 7/17 patients. Only 10 (23.8%) children showed adherence >80% & apparent good inhaler technique. The FEV1 improved by 4.8% (p=0.2) during the monitoring period. Also 3 of the young people wished to continue the use of EDM. Smartinhaler® can be used in routine clinical practice to objectively assess adherence in paediatric DA patients. Clinicians should be aware that the device stores data that can uncover poor inhaler technique/ repeated actuations, providing valuable information for tailoring interventions to patients. The role of EMDs regular clinical practice as a strong monitoring tool needs further exploration.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"44 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132969973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Proteomic analysis of blood serum of children with bronchial asthma 支气管哮喘患儿血清蛋白质组学分析

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4506

O. Semernik, A. Lebedenko, V. Gunko

引用次数: 0

Association of Blood Eosinophil and Neutrophil with Asthma Control in Children 儿童血嗜酸性粒细胞和中性粒细胞与哮喘控制的关系

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5421

J. Goyal, Prawin Kumar, Sachin Singh

{"title":"Association of Blood Eosinophil and Neutrophil with Asthma Control in Children","authors":"J. Goyal, Prawin Kumar, Sachin Singh","doi":"10.1183/13993003.congress-2019.pa5421","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5421","url":null,"abstract":"Background: Blood eosinophils are marker of eosinophilic airway inflammation and blood neutrophil count may be associated with disease severity and poor asthma control. It has been observed that children with high blood eosinophil counts respond better to inhaled corticosteroids (ICS). Aims and objective: The objective of this study was to determine the association between blood eosinophil and neutrophil count with asthma control. Methods: This retrospective cohort study used medical record data of children who attended pediatric chest clinic (PCC) at tertiary care center in India in last 2 years. We recorded baseline demographic profile, blood eosinophil and neutrophil count. Asthma control was assessed as per GINA guideline on follow up. ICS duration and PEFR were also recorded. Result: A total of 742 children attended PCC in last two years out of which baseline blood eosinophil and neutrophil counts were done in 116 children with asthma. In this study, the median (IQR) blood eosinophil count was 4% (1.3-6.9) and the median blood neutrophil count was 53.5% (42.2-66.4). Eosinophil count was significantly high in children with well controlled asthma [median eosinophil count 4.4 % (IQR 1.7–8.1) vs 3.45 % (0.1-6.2)] [p=0.04]; while neutrophil counts were higher in children with partly/uncontrolled asthma as compared to well controlled asthma [median neutrophil count 59.4 % (IQR 59-69.4) vs 50.4% (38.9-65)] [p=0.02]. Conclusion: Baseline high blood eosinophil counts were associated with better asthma control while baseline high neutrophil counts were associated with poor asthma control.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122064924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Patterns of drug utilisation over age in asthmatic children 哮喘儿童超龄用药模式

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5426

E. Baan, A. Heeremans, Leila Karimi, G. Brusselle, M. Sturkenboom, J. C. Jongste, L. Lahousse, H. Janssens, K. Verhamme

{"title":"Patterns of drug utilisation over age in asthmatic children","authors":"E. Baan, A. Heeremans, Leila Karimi, G. Brusselle, M. Sturkenboom, J. C. Jongste, L. Lahousse, H. Janssens, K. Verhamme","doi":"10.1183/13993003.congress-2019.pa5426","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5426","url":null,"abstract":"Background: Children start using drugs for asthma at different ages, and many stop using these after different periods of time. Aim: To study patterns of asthma drug use by age using group-based trajectory models in children. Methods: A retrospective cohort study (2007-2016) in asthmatic children, 5-17 years old in 2 primary care databases: IPCI (NL) and THIN (UK). Asthma was defined as ≥1 asthma disease code and ≥2 prescriptions of respiratory drugs in 1 year. Prescriptions were retrieved by ATC code from patient records. We used group-based trajectory analysis to model 4 trajectories of drug use of any asthma drug (ATC code R03) over age. Drug use was defined as ≥30 days covered by a prescription in a year. Baseline patient characteristics were compared between trajectory groups using χ2-test. Results: We found trajectories of early users, early moderate users, late users and late moderate users with median age of asthma onset of 7, 8, 11 and 13 years, respectively. In both databases early users were significantly more often boys (63-65% in early users vs 41-49% in other groups), had more often eczema (41-48% vs 25-44%) and gastro-esophageal reflux disease (2-4% vs 1-3%) and less often rhinitis, depression or obesity compared to other groups. Conclusion: Within a pediatric primary care population, we found different patterns of drug use over age, associated with various comorbidities. This helps understanding the diversity within pediatric asthma.","PeriodicalId":114886,"journal":{"name":"Paediatric asthma and allergy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130505515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinically Appropriate Testing of Valved Holding Chambers with Facemask - Impact of Substitution 带面罩的有瓣保持室的临床适当试验-替代的影响

Paediatric asthma and allergy Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa963

M. Nagel, J. Suggett, V. Avvakoumova, A. Bracey

引用次数: 0