Since the introduction of topical inhaled corticosteroids (ICSs) for the treatment of asthma decades ago, there have been concerns about potential risks from systemic activity.1 This has been particularly true regarding ICS use in young children, in whom growth and development represent additional issues.2 Despite the ongoing development over the years of newer ICS molecules with pharmacokinetic properties that improve the therapeutic index (ratio of topical activity to systemic activity), such as decreased oral bioavailability, rapid systemic clearance, and lung retention (Fig 1), all ICSs still work by stimulating glucocorticoid receptors, which are found throughout the body.

Atopic dermatitis (AD) is a chronic, relapsing form of inflammatory skin disease, affecting approximately 10% of children in the United States.1 AD has been associated with sleep disturbances, along with various comorbid allergic conditions, resulting in poor quality of life. In the last decade, studies have demonstrated an epidermal skin barrier defect, caused by various genetic mutations, to be an additional predisposing factor.2 Early childhood caries (ECC), a chronic diet-mediated infectious oral disease, has been reported to be the most common chronic childhood disease in the United States.

Two recent articles by Koplin et al1 and Feenay et al2 discuss some features of the Learning Early About Peanut Allergy (LEAP) study.3 We express our worries about what we consider common misinterpretations of that study. Koplin et al write that the LEAP study “provided direct evidence in high-risk infants […] that delayed introduction of dietary peanut increases the risk of peanut allergy.” Feenay et al state that “early introduction of dietary peanut results in a marked reduction in the development of peanut allergy in high-risk infants.” They add that the “study intervention disagrees with current World Health Organization advice, which recommends that infants should be exclusively breast-fed for the first 6 months of life.”4 The former interpretation encourages health professionals to recommend introduction of complementary food before age 11 months, the latter between 4 and 6 months, not later.

Related Articles

New immunohistochemical markers in the differential diagnosisof nonsmall cell lung carcinoma.

Turk J Med Sci. 2016 Dec 20;46(6):1854-1861

Authors: Bir F, Çeliker D, Evyapan BF, Yaren A, Edirne T

Abstract
BACKGROUND/AIM: The aim of this study was to investigate Napsin-A, NTRK-1, NTRK-2, Desmoglein-3, and Desmocollin-3 in the differential diagnosis and prognosis of nonsmall cell lung cancer.
MATERIALS AND METHODS: The expression of Napsin-A, NTRK-1, NTRK-2, and Desmoglein-3 was examined by immunohistochemistry in 50 squamous cell carcinomas and 50 adenocarcinomas. Desmocollin-3 was investigated in 29 squamous cell carcinoma and 29 adenocarcinoma cases. Associations between expression profiles of Napsin-A, NTRK-1, NTRK-2, Desmoglein-3, and Desmocollin-3 in lung cancers and clinicopathological variables were analyzed.
RESULTS: Napsin-A staining was statistically significant in detecting adenocarcinomas versus squamous cell carcinomas. The sensitivity of Napsin-A for adenocarcinomas was 96% and the specificity was 100%. NTRK-2 and Desmocollin-3 staining were statistically significant in detecting squamous cell carcinomas versus adenocarcinomas. Desmoglein-3, Napsin-A, and NTRK-2 had no effect on survival. Disease-free survival time was significantly shorter in cases that were moderately positive with NTRK-1.
CONCLUSION: Our data suggest that Napsin-A, NTRK-2, and Desmocollin-3 are useful markers in the differentiation of nonsmall cell lung cancer.

PMID: 28081338 [PubMed - in process]