Pediatric Allergy Immunology and Pulmonology最新文献

{"title":"Inhaled Dry Powder Mannitol Treatment in Pediatric Patients with Cystic Fibrosis: Evaluation of Clinical Data in a Real-World Setting.","authors":"I. Duman, Gökçe Ünal, A. Yılmaz, A. Güney, Y. Durduran, S. Pekcan","doi":"10.1089/ped.2021.0127","DOIUrl":"https://doi.org/10.1089/ped.2021.0127","url":null,"abstract":"Background: Cystic fibrosis (CF) is a genetic disorder, in which defective clearance of airway secretions leads to progressive lung function loss. Inhaled mannitol is used to increase sputum and mucociliary clearance. There are little data from real-world studies on the effectiveness of mannitol in children. Our objective was to evaluate the spirometry and clinical results of mannitol in pediatric patients. Methods: We retrospectively reviewed the records of 30 children and adolescents with CF receiving inhaled mannitol who were already on recombinant human deoxyribonuclease (rhDNase) treatment. The change in forced expiratory volume in 1 second (FEV1) from baseline at 2-4 months was the primary outcome. Secondary measures were other spirometry results, body mass index (BMI), hospital admissions, sputum characteristics, and positive bacterial colonization. Results: Compared to baseline, we found significant improvement in percent predicted FEV1 at 2-4 months of treatment; 84.50 (58.00-99.00) vs. 96.00 (66.00-106.00) (P = 0.0007). The absolute change in FEV1 was +11.5% at 2-4 months, +6.5% at 5-7 months, and +4% at 8-12 months. Also, significant improvements in other spirometry results were observed. Adolescents had significantly lower FEV1 results, but the improvement in their lung function was sustained for a more extended period than children. Mannitol provided easier sputum removal, increased sputum volume, significant decline in hospitalizations, and significantly fewer patients with positive sputum cultures. A significant increase in BMI at 8-12 months was observed. Cough was the most frequent adverse effect. Conclusion: In a real-world setting, our results demonstrated that adding mannitol to rhDNase therapy is tolerable in pediatric patients with CF and may provide improved spirometry and clinical outcomes. In addition, our results showed that mannitol provided recovery in overall lung function at 2-4 months, which was sustained up to 12 months together with improved BMI, easier sputum removal, and a decline in bacterial colonization and hospital admissions. However, cough was the most frequent side effect.","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46849978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological State of Parents of Children with Primary Immunodeficiencies During the COVID-19 Pandemic.","authors":"Berhan Akdağ,&nbsp;Arif Önder,&nbsp;Özge Gizli Çoban,&nbsp;Dilara Fatma Kocacık Uygun,&nbsp;Aslı Sürer Adanır,&nbsp;Aybike Erdem,&nbsp;Enes Çelik,&nbsp;Zehra Ece Soğucak,&nbsp;Ayşen Bingöl","doi":"10.1089/ped.2021.0081","DOIUrl":"https://doi.org/10.1089/ped.2021.0081","url":null,"abstract":"<p><p><b><i>Background:</i></b> COVID-19 has affected humanity not only physically but also mentally. It was expected to have impact on high-risk groups such as the immunocompromised patients and parents/caregivers of them. Our study was aimed to investigate the COVID-19 related anxiety, post-traumatic stress levels, and sleep-related parameters of the parents of children with primary immunodeficiency. <b><i>Methods:</i></b> Parents of children with primary immunodeficiency and age and gender-matched control group completed questionnaires. <b><i>Results:</i></b> Anxiety and post-traumatic stress levels of the study group were found to be significantly higher than the control group. Furthermore, sleep time of the study group was significantly lower than the control group. The subjective sleep quality of the study group was also lower in the study group, but the difference did not reach a significant level. <b><i>Conclusions:</i></b> In the ongoing and other possible pandemic processes, professional support for the parents of these children is of great importance.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":"35 1","pages":"12-18"},"PeriodicalIF":0.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39797178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Utility of Intermittent Inhaled Corticosteroids in Preschoolers with Viral-Triggered Wheeze.","authors":"Jefferson Antonio Buendía,&nbsp;Diana Guerrero Patiño,&nbsp;Juan Esteban Giraldo Ramírez","doi":"10.1089/ped.2021.0143","DOIUrl":"https://doi.org/10.1089/ped.2021.0143","url":null,"abstract":"<p><p><b><i>Background:</i></b> Evidence has demonstrated that adding intermittent inhaled corticosteroids (ICS) to treatment with short-acting b2-agonists (SABAs) in children 5 years of age and younger who experience intermittent viral-induced wheezing (VIW) reduces the risk of severe exacerbations. However, there is concern about whether the extra benefit offered by this drug outweighs the additional cost. This study aimed to evaluate the cost-effectiveness of intermittent ICS in children 5 years of age and younger who experience intermittent VIW. <b><i>Methods:</i></b> We constructed a probabilistic Markov model to estimate the cost and quality-adjusted life-years (QALYs) of intermittent ICS compared with SABA reliever therapy in preschoolers with viral-triggered wheezing in Colombia. Multiple sensitivity analyses were conducted. Cost-effectiveness was evaluated at a willingness-to-pay value of $5,180. <b><i>Results:</i></b> In an analysis of the Markov cohort model, we estimated a gain of 0.2 QALYs per patient per year on intermittent ICS compared with SABA and a reduction of cost per patient of USD $37 per year. This position of dominance negated the need to calculate an incremental cost-effectiveness ratio. Deterministic and probabilistic sensitivity analyses, our base case results were robust to variations of all assumptions and parameters. <b><i>Conclusion:</i></b> Adding intermittent ICS to treatment with SABAs in children 5 years of age and younger who experience intermittent VIW was found to be cost effective. These results could improve the use of health care resources, especially in settings with limited economic resources.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"36-42"},"PeriodicalIF":0.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specific Granule Deficiency Due To Novel Homozygote <i>SMARCD2</i> Variant.","authors":"Zeynep Kihtir,&nbsp;Kıymet Çelik,&nbsp;Funda Tayfun Küpesiz,&nbsp;Osman Alphan Küpesiz,&nbsp;Dilara Fatma Kocacik Uygun,&nbsp;Sema Arayici,&nbsp;Hakan Ongun,&nbsp;İpek Acarbulut,&nbsp;Celal Sağlam,&nbsp;Gülay Ceylaner,&nbsp;Ayşen Bingöl","doi":"10.1089/ped.2021.0070","DOIUrl":"https://doi.org/10.1089/ped.2021.0070","url":null,"abstract":"<p><p><b><i>Background:</i></b> Specific granule deficiency (SGD) is a rare immunodeficiency associated with <i>CCAT/enhancer-binding protein epsilon (CEBPE)</i> gene variants. It can cause severe recurrent infections and is lethal without successful stem cell transplantation. Few cases with SGD of both type 1 and type 2 have been described in the literature. In this study, we present the first report of a case with a novel homozygous <i>c.511 C > T (p.Gln171Ter)</i> mutation in the <i>SMARCD2</i> gene of SGD type 2, which was successfully treated with bone marrow transplantation. <b><i>Case:</i></b> A male infant presented to our neonatal intensive care unit on the second day of life with an icteric appearance and mild hypotonia. He was evaluated for immunodeficiency as the cause of delayed cord separation and refractory neutropenia. At 6 weeks of age, SGD type 2 with a new variant was diagnosed and successfully treated by bone marrow transplantation. <b><i>Conclusion:</i></b> SGD is an immunodeficiency disease that is quite rare. However, we believe that SGD diagnosis and associated new variants can be detected more frequently with the widespread use of all whole-exome sequencing techniques.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"43-46"},"PeriodicalIF":0.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Bronchodilation Testing Routinely Useful in All Asthmatic Children?","authors":"Maria Angela Tosca,&nbsp;Irene Schiavetti,&nbsp;Maria Binelli,&nbsp;Michele Miraglia Del Iudice,&nbsp;Giorgio Ciprandi","doi":"10.1089/ped.2021.0222","DOIUrl":"https://doi.org/10.1089/ped.2021.0222","url":null,"abstract":"<p><p><b><i>Background:</i></b> The reversibility of bronchial obstruction is needed to diagnose asthma. Bronchodilation (BD) testing is, therefore, used in asthma work-up. This study explored the benefit of performing BD testing in asthmatic children without bronchial obstruction. <b><i>Methods:</i></b> The study included 60 subjects with asthma and normal lung function, 13 (21.7%) females and 47 (78.3%) males; the mean age was 11.5 years, 26 were adolescents, and 34 were children. Lung function, symptoms, use of asthma medications, type 2 inflammation, and asthma control were assessed in all subjects. <b><i>Results:</i></b> Eleven (18%) subjects positively responded to BD testing. Fifty-five percent of subjects were uncontrolled based on Global Initiative for Asthma (GINA) criteria. The multivariate analysis identified 2 factors associated with a positive response to BD testing: FEV₁ [odds ratio (OR) = 0.91) and ACT (OR = 0.79). <b><i>Conclusions:</i></b> This study showed that BD testing could give additional helpful information in clinical practice. In addition, uncontrolled asthma, based on GINA criteria, was prevalent in children with normal lung function.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":"8-11"},"PeriodicalIF":0.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgment of Reviewers 2021.","authors":"","doi":"10.1089/vio.2021.29029.ack","DOIUrl":"https://doi.org/10.1089/vio.2021.29029.ack","url":null,"abstract":"","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48806877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Serum Vitamin D Level on Allergic Rhinitis Symptoms in Children.","authors":"Zeynep Haziroglu Okmen,&nbsp;Mehmet Halil Celiksoy,&nbsp;Erdem Topal","doi":"10.1089/ped.2021.0161","DOIUrl":"https://doi.org/10.1089/ped.2021.0161","url":null,"abstract":"<p><p><b><i>Background:</i></b> Allergic rhinitis (AR) is a chronic disease that is becoming increasingly common worldwide and has a negative impact on school performance, work performance, and quality of life. The aim of this study was to investigate the effect of vitamin D on the symptoms of AR in children. <b><i>Methods:</i></b> Serum vitamin D levels of children with AR and age-matched healthy controls were compared using the high-pressure liquid chromatography method. The relationship between serum vitamin D levels and symptoms and severity of AR was then examined. <b><i>Results:</i></b> The study included 137 patients diagnosed with AR (76 males, 61 females; median age: 11 years). Serum vitamin D levels were lower in the patient group than in the control group (<i>P</i> = 0.001), lower in all aeroallergen groups (mites, pollen, and multiple inhalants) than in the healthy control group (<i>P</i> = 0.001), and lower in both the perennial AR group and the seasonal AR group than in the control group (<i>P</i> = 0.001). Spearman correlation analysis showed that there was no correlation between symptom score and vitamin D level (<i>r</i>_s = -0.099; <i>P</i> = 0.25). <b><i>Conclusions:</i></b> We found no correlation between serum vitamin D level and symptoms and severity of AR. Serum vitamin D levels were lower in children with AR than in healthy children.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":"34 4","pages":"132-140"},"PeriodicalIF":0.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8817683/pdf/ped.2021.0161.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39854190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Th17 Lymphocytes in Children with Asthma: Do They Influence Control?","authors":"Verónica Moreno-Córdova, Roberto Berra-Romani, Lilian K Flores Mendoza, Julio Reyes-Leyva","doi":"10.1089/ped.2021.0067","DOIUrl":"10.1089/ped.2021.0067","url":null,"abstract":"<p><p><b><i>Background:</i></b> Allergic asthma was considered as an inflammation mediated by specific CD4⁺ helper lymphocytes (Th2); however, this paradigm changed in 2005, when a third group of helper cells called Th17 cells were identified. Th17 lymphocytes are the main source of interleukin (IL)-17A-F, IL-21, and IL-22; however, their physiological role in children is unclear. This study aimed to determine the percentage of Th17 cells and IL-17A in pediatric patients diagnosed with asthma and to associate it with disease control using a validated questionnaire. <b><i>Methods:</i></b> This cross-sectional, prospective, comparative study included 92 asthma-diagnosed children 4-18 years of age. The Asthma Control Test was used as an assessment measure to classify patients as controlled (<i>n</i> = 30), partially controlled (<i>n</i> = 31), and uncontrolled (<i>n</i> = 31). Th17 cells and IL-17A were analyzed by flow cytometry. Patients receiving inhaled steroid therapy as monotherapy or associated with a long-acting bronchodilator were included. <b><i>Results:</i></b> The mean percentage of Th17 cells in the participants was 4.55 ± 7.34 (Controlled), 5.50 ± 8.09 (Partially Controlled), and 6.14 ± 7.11 (Uncontrolled). There was no significant difference between the 3 groups (<i>P</i> = 0.71). The mean percentage of IL-17A in all the participants was 9.84 ± 9.4 (Controlled), 10.10 ± 10.5 (Partially Controlled), and 11.42 ± 8.96 (Uncontrolled); no significant difference between the 3 groups (<i>P</i> = 0.79) was observed. Th17 lymphocyte levels were similar among the 3 groups and the same trend was observed with IL-17A. A significant correlation between Th17 or IL-17A and the degree of asthma control (Th17, <i>P</i> = 0.24; IL-17A, <i>P</i> = 0.23) was not found. <b><i>Conclusions:</i></b> The percentages of both Th17 lymphocytes and IL-17A found in children with asthma were not significantly different in the 3 groups, which suggests that they do not play an important role in asthma control. Our findings may contribute to the knowledge related to non-Th2 inflammation in children. Clinical-Trials.gov ID: 2015-2102-85.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":"34 4","pages":"147-152"},"PeriodicalIF":1.1,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8817680/pdf/ped.2021.0067.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39765089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary C-Reactive Protein and Mean Platelet Volume in the Diagnosis and Follow-Up of Community-Acquired Pneumonia in Infants.","authors":"Ahmed Omran,&nbsp;Hala Abohadid,&nbsp;Mai H S Mohammad,&nbsp;Sherien Shalaby","doi":"10.1089/ped.2021.0077","DOIUrl":"https://doi.org/10.1089/ped.2021.0077","url":null,"abstract":"<p><p><b><i>Background:</i></b> Community-acquired pneumonia (CAP) in infants is a major cause of morbidity and mortality, especially in developing countries. Increased salivary C-reactive protein (CRP) levels have been demonstrated in neonatal pneumonia and other diseases. We investigated the applicability of CRP and mean platelet volume (MPV) in the diagnosis and follow-up of CAP in infants. <b><i>Methods:</i></b> This prospective observational study included 45 infants admitted for CAP. We measured serum and salivary CRP levels via ELISA, while MPV was measured using an automated blood cell counter. <b><i>Results:</i></b> Both salivary and serum CRP values were significantly different in the studied population between admission and follow-up (<i>P</i> = 0.001 and <i>P</i> < 0.0001, respectively). The same was observed for MPV (<i>P</i> < 0.0001). We found significant positive correlations between serum and salivary CRP (<i>r</i> = 0.652, <i>P</i> < 0.0001) and between serum CRP and MPV (<i>r</i> = 0.495, <i>P</i> = 0.001), as well as between salivary CRP and MPV (<i>r</i> = 0.439, <i>P</i> = 0.003). Receiver operating curve analysis showed that salivary CRP at a cutoff value of 3.2 ng/L had a sensitivity of 97.2% and specificity of 90%, while MPV at a cutoff value of 8.4 fL showed 91% sensitivity and 90% specificity. <b><i>Conclusions:</i></b> The present study showed that both salivary CRP and MPV are reliable diagnostic markers of CAP in infants.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":"34 4","pages":"141-146"},"PeriodicalIF":0.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8817682/pdf/ped.2021.0077.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39942071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diurnal Variations in Skin Prick Testing.","authors":"Elisa Ochfeld,&nbsp;Brian Cheng,&nbsp;Nina Bowsher,&nbsp;Anna Fishbein","doi":"10.1089/ped.2021.0055","DOIUrl":"https://doi.org/10.1089/ped.2021.0055","url":null,"abstract":"<p><p><b><i>Background:</i></b> Prior research suggests that skin prick testing (SPT) might be larger in the afternoon, with unclear clinical significance. <b><i>Methods:</i></b> This retrospective chart review analyzed SPT results from patients between June 2008 and June 2017, organized into 4 time groups for analysis (Group 1: 7:00 AM -10:29 AM, Group 2: 10:30 AM -11:59 AM, Group 3: 12:00 PM -2:29 PM, and Group 4: 2:30 PM -8:15 PM). <b><i>Results:</i></b> In total, 12,982 (<i>n</i>) patient test results had positive histamine and were included in final analysis. Histamine wheal size was not significantly increased in the PM compared with AM (<i>P</i> = 0.89). Food allergen and aeroallergen wheal sizes were not significantly increased in PM. Histamine erythema size was increased in the PM compared with AM (<i>P</i> ≤ 0.01). Food allergen and aeroallergen erythema sizes trended toward an increase in the PM. <b><i>Conclusions:</i></b> There were not significant differences in SPT wheal size based on time of day for histamine, food allergens, or aeroallergens. SPT can be reliably performed at any time of day.</p>","PeriodicalId":54389,"journal":{"name":"Pediatric Allergy Immunology and Pulmonology","volume":"34 4","pages":"125-129"},"PeriodicalIF":0.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742273/pdf/ped.2021.0055.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39662046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}