Global strategy for the diagnosis and management of asthma in children 5 years and younger

Abstract

Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalions1. During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control it effectively. However, in children 5 years and younger, the clinical symptoms of asthma are variable and non‐specific. Furthermore, neither airflow limitation nor airway inflammation, the main pathologic hallmarks of the condition, can be assessed routinely in this age group. For this reason, to aid in the diagnosis of asthma in young children, a symptoms‐only descriptive approach that includes the definition of various wheezing phenotypes has been recommended2. In 1993, the Global Initiative for Asthma (GINA) was implemented to develop a network of individuals, organizations, and public health officials to disseminate information about the care of patients with asthma while at the same time assuring a mechanism to incorporate the results of scientific investigations into asthma care. Since then, GINA has developed and regularly revised a Global Strategy for Asthma Management and Prevention. Publications based on the Global Strategy for Asthma Management and Prevention have been translated into many different languages to promote international collaboration and dissemination of information.In this report, Global Strategy for Asthma Management and Prevention in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data on new therapies. Approaches to these issues will vary among populations in the world based on socioeconomic conditions, genetic diversity, cultural beliefs, and differences in healthcare access and delivery. Patients in this age group are often managed by pediatricians and general practitioners routinely faced with a wide variety of issues related to childhood diseases. Pediatr Pulmonol. 2011; 46:1–17. © 2010 Wiley‐Liss, Inc.

Interleukin-31 promotes helper T cell type-2 inflammation in children with allergic rhinitis

“…(e) *P < 0.01, IL-31 (10 ng/ml) vs. IL-31 (1 ng/ml), IL-31 (100 ng/ml) vs. IL-31+IL-17 (100 ng/ml); **P < 0.05, IL-31 (10 ng/ml) vs. IL-31 (100 ng/ml). criteria (28). Twenty children of similar age and gender with no history of allergic disease or wheezing were selected as the control group.…”

Traqueotomía en una unidad de tercer nivel del noroeste de México: descripción y análisis de casos

“…En un estudio local reciente, se aprecia que cuando se realiza en forma sostenida el tratamiento de un niño asmático con la medicación controladora (corticoides inhalados) y se correlaciona la mejoría clínica con algún marcador inflamatorio, como por ejemplo nitritos en el esputo inducido, se observa de manera significativa que el marcador inflamatorio disminuye sustancialmente luego del uso continuo del corticoide, aspecto que es más factible de lograr en un programa preventivo donde se remarca que el uso del inhalador (ICS) debe ser continuo (1,2,24,26) . Una ventaja adicional del ACT, es que el mismo se puede responder vía Web, versión que ya ha sido validada y que muestra un costo -efectividad superior a otras formas de monitorización como por ejemplo la medición de FENO; la posibilidad de responder online el cuestionario es interesante, ya que la página web respectiva (www.asthmacontroltest.…”

The Serum Level of Leptin in Patients with Obesity: Asthmatic and Non-Asthmatic Children

“…The study included 36 subjects referred to endocrine clinic for obesity and were classified into 2 groups of children with obesity with and without asthma according to GINA 2011 (10). Group 1 included 23 cases with obesity and asthma (cases) with a mean body mass index (BMI) of 24.3 kg/m 2 , and group 2 included 13 children with obesity (controls) and a mean BMI of 26.6 kg/m 2 , apparently healthy without a diagnosis of any disorders including asthma.…”