Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Background: In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods: Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results: The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions: We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research

FOXP3 expression and overall survival in breast cancer

PURPOSE: The transcription factor forkhead box P3 (FOXP3) up- or downregulates a large number of genes and has been recently reported to be expressed in tumor cells. We investigated the prognostic importance of FOXP3 expression in patients with breast cancer. PATIENTS AND METHODS: The expression patterns of FOXP3 were characterized by immunohistochemistry in primary breast carcinoma specimens from patients of the Milan 3 and 1 trials. Kaplan-Meier analysis and Cox proportional hazards regression modeling were used to assess the overall survival, distant metastasis-free survival, and local relapse cumulative incidence, according to the presence or absence of FOXP3 expression. RESULTS: FOXP3 expression in tumors was associated with worse overall survival probability and the risk increased with increasing FOXP3 immunostaining intensity. FOXP3 was also a strong prognostic factor for distant metastases-free survival but not for local recurrence risk. In multivariate analysis FOXP3 resulted an independent prognostic factor and the hazard ratio of FOXP3 expression and of lymph node positivity were similar. In the Milan 3 trial, the probability of 10-year survival in node-negative subgroup was 100% for FOXP3-negative and 82% for FOXP3-positive patients; in node-positive subgroup 82% for FOXP3-negative and 41% for FOXP3-positive patients. Even in the Milan 1 trial the lack of FOXP3 expression in node-positive subgroup was related to a significantly better prognosis than in FOXP3-positive patients (10-year survival probability, 89% v 59%). CONCLUSION: The data identify FOXP3 expression as a new independent prognostic factor in breast carcinoma, which might help to improve the selection of patients for appropriate therapy

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

none76noneDuse M.a,Santamaria F.,Verga M.C.,Bergamini M.,Simeone G.,Leonardi L.,Tezza G.,Bianchi A.,Capuano A.,Cardinale F.,Cerimoniale G.,Landi M.,Malventano M.,Tosca M.,Varricchio A.,Zicari A.M.,Alfaro C.,Barberi S.,Becherucci P.,Bernardini R.,Biasci P.,Caffarelli C.,Caldarelli V.,Capristo C.,Castronuovo S.,Chiappini E., ,Cutrera R.,De Castro G.,De Franciscis L.,Decimo F.,Iacono I.D.,Diaferio L.,Di Cicco M.E.,Di Mauro C.,Di Mauro C.,Di Mauro D.,Di Mauro F.,Di Mauro G.,Doria M.,Falsaperla R.,Ferraro V.,Fanos V.,Galli E.,Ghiglioni D.G.,Indinnimeo L.,Kantar A.,Lamborghini A.,Licari A.,Lubrano R.,Luciani S.,Macrì F.,Marseglia G.,Martelli A.G.,Masini L.,Midulla F.,Minasi D.,Miniello V.L.,del Giudice M.M.,Morandini S.R.,Nardini G.,Nocerino A.,Novembre E.,Pajno G.B.,Paravati F.,Piacentini G.,Piersantelli C.,Pozzobon G.,Ricci G.,Spanevello V.,Turra R.,Zanconato S.,Borrelli M.,Villani A.,Corsello G.,Di Mauro G.,Peroni D.Duse M., A; Santamaria, F.; Verga, M. C.; Bergamini, M.; Simeone, G.; Leonardi, L.; Tezza, G.; Bianchi, A.; Capuano, A.; Cardinale, F.; Cerimoniale, G.; Landi, M.; Malventano, M.; Tosca, M.; Varricchio, A.; Zicari, A. M.; Alfaro, C.; Barberi, S.; Becherucci, P.; Bernardini, R.; Biasci, P.; Caffarelli, C.; Caldarelli, V.; Capristo, C.; Castronuovo, S.; Chiappini, E.; Cutrera, R.; De Castro, G.; De Franciscis, L.; Decimo, F.; Iacono, I. D.; Diaferio, L.; Di Cicco, M. E.; Di Mauro, C.; Di Mauro, C.; Di Mauro, D.; Di Mauro, F.; Di Mauro, G.; Doria, M.; Falsaperla, R.; Ferraro, V.; Fanos, V.; Galli, E.; Ghiglioni, D. G.; Indinnimeo, L.; Kantar, A.; Lamborghini, A.; Licari, A.; Lubrano, R.; Luciani, S.; Macrì, F.; Marseglia, G.; Martelli, A. G.; Masini, L.; Midulla, F.; Minasi, D.; Miniello, V. L.; del Giudice, M. M.; Morandini, S. R.; Nardini, G.; Nocerino, A.; Novembre, E.; Pajno, G. B.; Paravati, F.; Piacentini, G.; Piersantelli, C.; Pozzobon, G.; Ricci, G.; Spanevello, V.; Turra, R.; Zanconato, S.; Borrelli, M.; Villani, A.; Corsello, G.; Di Mauro, G.; Peroni, D

Correction: Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases (Italian Journal of Pediatrics, (2021), 47, 1, (97), 10.1186/s13052-021-01013-8)

The original article contained an incorrect institution for Affiliation #22 which has since been corrected

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Background: In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods: Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results: The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions: We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research