Tumor necrosis factor alpha as an asthma biomarker in early childhood

Research on biomarkers of asthma in early childhood could be explained by at least three reasons [...

Czynnik martwicy nowotworów alfa jako biomarker predykcyjny astmy we wczesnym dzieciństwie

Rozwój badań nad biomarkerami astmy we wczesnym dzieciństwie można uzasadnić trzema przyczynami [...

Pediatric Asthma Caregiver’s Quality of Life Questionnaire is a useful tool for monitoring asthma in children

PURPOSE: There is little agreement among researchers whether a caregiver’s QOL can be used to detect changes in asthma severity in children. We assessed correlation between QOL in parents and QOL in children with asthma as well as clinical parameters of asthma. We determined whether changes in caregiver’s QOL scores reflect changes in child’s QOL and their asthma control. METHODS: This was a 9-week period cohort study. One hundred and ten primary caregivers with 110 children were seen in the clinic at enrollment, at week #1, #5 and #9. At each visit, the parents completed the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ). RESULTS: One hundred and one children and 101 caregivers completed the study. We found a significant correlation between asthma diary score in children and QOL in parents (from r = −0.46 to r = −0.53). We also found significant positive correlation between PAQLQ and PACQLQ and significant association between changes in asthma control and PACQLQ score for both domains. We observed significant change in PACQLQ of caregivers whose children obtained asthma control. CONCLUSIONS: PACQLQ is a useful tool for monitoring asthma in children. The implementation of the PACQLQ would be helpful in involving parents in therapy of their children with asthma

Cytokine profiling in exhaled breath condensate after exercise challenge in asthmatic children with post-exercise symptoms

Introduction: Markers of exhaled breath condensate (EBC) correlate with lung function impairment, airway remodeling and different aspects of the disease such as exercise-induced bronchoconstriction (EIB). Aim of the study was to determine the cytokine profile in EBC of children with asthma after an exercise treadmill challenge in order to obtain clinically useful information about mechanisms of EIB; also, to assess correlations between cytokine concentrations in EBC and clinical characteristics of the patients. Material and methods: The study population consisted of 25 randomly selected children, aged 8 to 19 years, with asthma and EIB symptoms despite the use of control medications. Patients on the day of the study visit underwent fractional exhaled nitric oxide measurement (FeNO) and baseline spirometry, performed an exercise treadmill challenge (ETC), and EBC samples were obtained at the end of the ETC. Results: In asthmatic children with positive ETC, monocyte hemotactic protein-1 (MCP-1) and IL-16 adjusted to pre-EBC forced expiratory volume in 1 s (FEV1) were significantly higher compared to children with negative ETC (p = 0.022 and p = 0.017 respectively). After adjustment to pre-EBC FEV1 other cytokines (IL-4, IL-5, IL-6, IL-8, MIG, TNF-) were not related to post-exercise changes in FEV1. Conclusions: We observed a specific inflammatory profile in the airways of asthmatic children with bronchoconstriction induced by exercise. The concentration of cytokines in EBC depended on the post-exercise decrease in FEV1, which was measured by the area under the curve (AUC). MCP-1 and IL-16, adjusted to pre-EBC FEV1, were significantly higher in children with a positive exercise challenge compared to those with a negative one.This study was funded by grant 503-2056-1 from the Medical University of Lodz, Poland. ClinicalTrials.gov Identifier: NCT01798823. The study was approved by the Medical University of Lodz Ethics committee, Poland. Written consent from the patients and their parents was obtained

Czynnik martwicy nowotworów alfa jako biomarker predykcyjny astmy we wczesnym dzieciństwie

Rozwój badań nad biomarkerami astmy we wczesnym dzieciństwie można uzasadnić trzema przyczynami [...

Satisfaction with treatment of atopic dermatitis in children

Introduction . Atopic dermatitis is a frequent chronic skin disease in children. The major clinical manifestations include itching and dryness of the skin. The pathomechanism of skin changes results from an interaction of genetic and environmental factors as well as impairments of skin barrier function and immune response. Despite chronic treatment the disease is characterized by exacerbation and remission periods and lowers the quality of life of patients and their families. Objective. To evaluate treatment satisfaction in children with atopic dermatitis, identify components of medical care which contribute to treatment satisfaction, and evaluate the relationship between satisfaction and adherence to a doctor’s recommendations. Material and methods. One hundred and nineteen children (6 months to 12 years old, mean age 4.9 years) with atopic dermatitis were enrolled in the study. The doctor performed physical examinations and history taking and filled in questionnaires evaluating the course and exacerbation of the disease, the type of administered therapy and diagnostics. The patients’ parents completed two questionnaires: a questionnaire assessing satisfaction with the therapy (the type of recommended therapy, adherence to recommendations, contact with the doctor, obtained information, degree of psychological support, role of parents in taking decisions regarding the therapy) and a quality of life questionnaire. Results. The authors observed that 56% of parents were dissatisfied with the administered treatment, and 40% failed to adhere to at least one therapeutic recommendation. Parents of children with mild atopic dermatitis significantly more often stop using emollients. It was also observed that lack of treatment satisfaction in children with severe atopic dermatitis whose parents are insufficiently educated contributes to decreased adherence. The authors identified independent factors of lack of treatment satisfaction: failure to obtain enough psychological support (OR = 20.00), failure to obtain reliable information on the disease (OR = 5.91), failure to actively get engaged in the treatment procedure (OR = 5.31), dissatisfaction with the contact with the doctor (OR = 4.9), dissatisfaction with the diagnostics (OR = 4.93) and severe course of the disease (OR = 2.82). Conclusions . Elimination of risk factors of dissatisfaction with the treatment might potentially improve the adherence to chronic treatment in atopic dermatitis

The impact of cystic fibrosis course on the physical activity of children with cystic fibrosis

Wstęp. Chorzy na mukowiscydozę mają mniejszą wydolność wysiłkową w porównaniu ze zdrową populacją. Cel pracy. Celem badania była ocena wpływu przebiegu choroby na aktywność fizyczną dzieci chorych na mukowiscydozę. Materiał i metody. Badaniem objęto 20 dzieci chorych na mukowiscydozę w wieku 8–18 lat, w tym 11 dziewczynek i 9 chłopców. W celu zbadania wpływu przebiegu choroby na aktywność fizyczną dzieci chorych na mukowiscydozę wykorzystano kwestionariusz, jakim była anonimowa ankieta skierowana do chorych. W pracy posłużono się również wynikami badań spirometrycznych, z których wykorzystano wartości pomiaru FEV1. Wyniki. Wykazano, że czynności dnia codziennego, takie jak mycie, ubieranie, sprzątanie, spożywanie posiłków jedynie w nielicznych przypadkach sprawiają trudności badanym dzieciom chorym na mukowiscydozę. Ograniczenia te dotyczyły głównie pacjentów w zaawansowanym stadium choroby. Badane dzieci chore na mukowiscydozę nie uprawiały sportów wysiłkowych, wykonywały zaś ćwiczenia ogólnorozwojowe. Wnioski. Ze względu na częste hospitalizacje i przyjmowane leki oraz obniżoną wydolność fizyczną mukowiscydoza miała negatywny wpływ na uczestnictwo badanych dzieci w lekcjach wychowania fizycznego w szkole. Im większa była roczna częstość hospitalizacji i antybiotykoterapii u badanych pacjentów chorych na mukowiscydozę, tym mniejsza była ich aktywność fizyczna i ogólna sprawność. Problemy Pielęgniarstwa 2011; 19 (1): 39–46Introduction. Patients with cystic fibrosis (CF) have decreased physical efficiency compared to healthy population. Aim of the study. The aim of the study was to assess the impact of the CF course on physical activity in children with diagnosed CF. Material and methods. Participants were 20 children with CF, aged 8–18 years old, 11 girs and 9 boys. We used anonymous questionnaire directed to patients in order to assess the impact of the CF course on physical activity in children with diagnosed CF. We also used spirometric lung function parameter, namely FEV1. Results. We showed that every day activitiesnamely washing, dressing up, cleaning up, eating only in numerous cases seem troublesome for studied children with CF. These limitations were related to patients in advanced stage of CF. Studied children with CF did not practice heavy exercises but rather general developmental exercises. Conclusions. Due to frequent hospitalisations, drugs taken and decreased physical efficiency cystic fibrosis showed negative impact on the attendance of patients to physical exercise lesssons in school. Higher annual number of hospitalisations and annual number of antibiotic courses were correlated with were the lower physical activity and general efficiency of the patients were. Nursing Topics 2011; 19 (1): 39–4

Food allergy is associated with recurrent respiratory tract infections during childhood

Introduction : To find out whether children with food allergy have an increased risk of recurrent upper and lower respiratory tract infections and of asthma. Aim: To describe the clinical profile of children diagnosed with food allergy referred to the Allergy Clinic. Material and methods : We conducted a retrospective study to assess the patients’ demographic, anthropometric and clinical data. The analysis included data of all children by the age of 10 years (registered with the Allergy Clinic between 2012 and 2013) in whom IgE mediated food allergy had been diagnosed during 18 months of observation. Results : We included 280 children into the analysis. Recurrent respiratory tract infections (rRTI), asthma and gastrointestinal (GI) symptoms were observed in 153 (54.6%), 96 (34.3%), 39 (13.9%), respectively, with a significant increasing trend across age-subgroups. In children from 1 to 2 years old, sensitization to -lactoglobulin increased the risk of rRTI (OR = 3.91; 95% CI: 1.03–14.87). In older children sensitization to allergens other than milk or egg decreases the risk of rRTI (OR = 0.25; 95% CI: 0.10–0.62); sensitization to egg decreased the risk of asthma diagnosis (OR = 0.09; 95% CI: 0.01–0.75). We did not identify food allergens which change the risk of GI symptoms in children. This finding was consistent throughout all age-subgroups. Conclusions : Sensitization to -lactoglobulin increased the risk of rRTI in children under 2 years of age nearly four times. The presence of sensitization to food allergens above 3 years of age did not increase the risk of developing clinical presentation of food allergy other than atopic dermatitis

Innowacyjny inhalator AirFluSal Forspiro ― skuteczność, profil bezpieczeństwa i użyteczność dla pacjentów z astmą oskrzelową i przewlekłą obturacyjną chorobą płuc

  Przedstawiono aktualne dane Forspiro® — nowego inhalatora suchego proszki (DPI) wraz z procesem rejestracji hybrydowej tego urządzenia inhalacyjnego. Omówiono badania oceniające skuteczność i profil bezpieczeństwa kombinacji propionianu flutikazonu z salmeterolem z inhalatora Forspiro® u chorych na astmę i przewlekłą obturacyjną chorobę płuc. Wskazano na dostosowanie inhalatora Forspiro® do potrzeb i preferencji pacjentów oraz łatwość jego stosowania. Inhalator Forspiro® posiada wiele unikatowych i innowacyjnych cech, które sprawiają, iż ta konstrukcja zbliża się do „inhalatora idealnego”.  bra