Background: In asthmatics, the concentration of hydrogen peroxide (H2O2) in exhaled breath condensate (EBC) has been found to be increased and to be related to airway inflammation. Objective: The aim of this study was to determine whether in children with acute exacerbation, exhaled H2O2 levels could be influenced by treatment and linked to airway obstruction. Methods: Twenty-two asthmatic children (mean age 9.4 years, range 6–14) with asthma exacerbation and 12 healthy children (mean age 11.7 years, range 7–15) were enrolled. Concentrations of exhaled H2O2 before and after standard treatment for asthma attack were compared with those of controls and with clinical observation. Asthmatic children and controls underwent spirometry and skin prick tests to common aeroallergens. Results: Exhaled H2O2 concentrations were significantly higher in children with asthma both before (median 0.273 µm; p < 0.001) and after pharmacologic treatment (median 0.303 µm; p = 0.001) compared to control values (median 0.045 µm). After treatment, exhaled H2O2 concentrations remained significantly higher in children with and without auscultatory wheezing than in controls (p = 0.034 and p < 0.001, respectively). EBC H2O2 levels in asthmatics before treatment did not differ from those after treatment. No correlation was found between H2O2 and forced expiratory volume in 1 s values. All asthmatics but one were atopics. Conclusions: In children with acute asthma exacerbation, exhaled H2O2 concentrations in EBC are significantly elevated. In the short-term follow-up, H2O2 levels remain at high levels and are not correlated with lung function or improvement in symptoms.
Acute rhinosinusitis (ARS) is one of the most common reasons for physician visits and for significant school absenteeism, although precise data on its prevalence and incidence are still lacking. RS is defined as acute if there are symptoms lasting <12 wk with complete resolution. Superinfection by bacteria following a viral infection is the most important mechanism of ARS. Diagnosis of ARS should be made on clinical grounds alone. Typically, acute bacterial RS is self-limited and goes through spontaneous recovery within 4 wk. Recognizing the occurrence of bacterial superinfections of the sinuses during a common viral respiratory infection is fundamental to making the decision to start an appropriate antibiotic treatment. Topical treatments such as saline irrigation, nasal decongestants, steroids, antihistamines, and fungicides are all in widespread pediatric use, but analyzing the literature gives poor evidence of efficacy, except for topical steroids. RS is a multifactorial condition that poses a diagnostic and management challenge to infectivologist and ear-nose-throat specialists as well as to pediatricians.
As gross differences have been described in the awareness of the disease and its management between allergists and nonallergists, allergists should interact with emergency doctors to improve education in this area.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.