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Recent advances on diagnosis and management of childhood asthma and food allergies.

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Recent advances on diagnosis and management of childhood asthma and food allergies.

Ital J Pediatr. 2013 Dec 27;39(1):80

Authors: Hakimeh D, Tripodi S

Abstract
The epidemic of childhood allergic disorders has been associated to the decline of infectious disease. However, exposure to many triggers (airborne viruses, tobacco smoke, pollution, indoor allergens, etc.) contribute to the disease. Breast feeding practices, nutrition, dietary and obesity also play a multifaceted role in shaping the observed worldwide trends of childhood allergies. Guidelines for treatment are available, but their implementation is suboptimal. Then developed countries are slowing learning integrating the development of suitable guidelines with implementation plans. Awareness, psychosocial and family factors strongly influence asthma and food allergy control. Moreover, monitoring tools are necessary to facilitate self-management. By taking into consideration these and many other pragmatic aspects, national public health programs to control the allergic epidemic have been successful in reducing its impact and trace the need for future research in the area.

PMID: 24373684 [PubMed - as supplied by publisher]

Predictors of hospitalization for asthma in children: Results of a 1-year prospective study.

INTRODUCTION: Although hospital admissions for pediatric asthma constitute a significant problem in high-income countries, they are an even greater health problem in low- and middle-income countries (LMIC). However, previous studies that aimed to identify predictors of hospital admission for asthma in children have mainly been conducted in high-income countries, and these findings might not be applicable to LMIC. METHODS: In a prospective cohort study, we aimed to identify predictors of hospital admission for asthma, including measures of parental knowledge about asthma and maternal depression level, in a population of children aged 1-18 years living in urban Bogota, Colombia hospitalized for acute asthma symptoms, over a 6-month period. RESULTS: Out of the total of 101 included patients, 37 (36.6%) had at least one hospital admission for asthma during the year following admission. After controlling for the age of the patients, dog ownership in the previous 12 months, asthma severity variables in the previous 6 months, maternal allergic rhinitis, level of maternal education, and measures of parental knowledge about asthma and maternal depression level, we found that maternal smoking (IRR, 3.12; 95% confidence interval [95% CI], 1.12-8.68; P = 0.029) was the only independent predictor of hospital admissions due to asthma exacerbations in the year following admission to the study. CONCLUSIONS: In a population of asthmatic Latino children admitted to hospital for an asthma exacerbation, approximately one-third of the patients had at least one hospital admission for asthma during the year following admission, and maternal smoking was the only independent predictor of these hospitalizations. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.

Epidemiology of virus-induced wheezing/asthma in children.

Wheezing is a lower respiratory tract symptom induced by various viral respiratory infections. Epidemiological studies have revealed the phenotypes of wheezing in early childhood which have different risk factors for the development of asthma among school age children. The major viral species causing wheezing in children include respiratory syncytial virus, rhinovirus, human metapneumovirus and influenza viruses. It has been shown that the impact on the development of asthma is different between those virus species. Moreover, recent studies have also focused on the interaction between virus infection and other risk factors in the development of asthma, such as genetic factors or allergic sensitization. In this review, we summarize the previous findings and discuss how clinicians can effectively intervene in these viral infections to prevent the development of asthma.

Small Airway Targeted Therapy in Pediatric Asthma: Are We There Yet?

Asthma is characterized by inflammation of proximal and distal airways. As new formulations of extrafine aerosol particles have become available, targeting small airways for the management of asthma has been investigated. As new studies attempt to explore the correlation between small airway dysfunction and clinical outcomes in asthma, well-designed clinical trials are needed to compare targeted and standard therapy for asthma management especially in pediatric patients.

Volume doubling time for lung cancer screening

This Italian, retrospective cohort study used data collected during the Continuous Observation of Smoking Subjects (COSMOS) study. The aim was to measure volume doubling time (VDT) of incident lung cancers detected by low-density CT screening over 5 consecutive years as a means of identifying slow-growing cancers that might be overdiagnosed, and to evaluate clinical outcomes comparing these with faster growing lesions. Based on previous studies’ results, slow-growing or indolent tumours were deemed to have a VDT of >400 days.

COSMOS recruited 5203 high-risk volunteers with an adherence rate of 79% for all five scans. During the study, 175 cases (3.2% of participants) of primary lung cancer were identified; 55 prevalent (present on first scan) and 120 incident cases (found thereafter). Of the incident cases, 25.8% were found to be slow growing or indolent (VDT >400 days). There were 29 cases that underwent invasive procedures for benign disease, 13 of which had...

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