Therapy of bronchial asthma in children: age-related aspects

Abstract

Bronchial asthma (BA) is a disease that is one of the most frequent chronic diseases of childhood. Characteristic clinical symptoms of BA are wheezing, cough, difficulty in breathing, shortness of breath and, of course, recurrent episodes of bronchial obstruction. They require mandatory clarification of family and individual allergoanamnesis, assessment of symptoms, differential diagnosis with other diseases that may occur with BA. The Global Initiative for the Treatment and Prevention of Bronchial Asthma (GINA 20202021) preserves and develops the ageappropriate approach to verification of diagnosis and therapy selection, which is supported in the Russian National Program "Bronchial Asthma in Children" and in the Russian clinical guidelines "Bronchial Asthma 2021 When the diagnosis of BA is made, therapy should be started as early as possible. Administration of low-dose inhaled glucocorticosteroids (IGCS) immediately after the diagnosis allows not only to control the inflammatory process, which is the basis of BA, but also to reduce the severity of exacerbations. IGCS are the most effective drugs for children of any age, they ensure control of the disease and reduce the risk of AD exacerbations.

Approaches to the treatment of bronchial asthma in children: leukotriene receptor antagonists

“…Согласно современным рекомендациям, при легкой интермиттирующей и персистирующей БА альтернативой ИГКС являются АЛТР (монтелукаст) [2,4,9]. Это первая медиатор-специфическая терапия БА.…”

Development and implementation in outpatient practice of an electronic computer program “Diagnostics of bronchial asthma in children”

“…Однако практически ни один из этих показателей в отдельности (включая уровень IgE) не может служить достаточно достоверным дифференциальнодиагностическим критерием обструктивного бронхита и БА [1, 9,14,23]. В то же время очень важной задачей является своевременное назначение ребёнку базисной противовоспалительной терапии, что позволяет уменьшить риск ремоделирования респираторного тракта [1,2,7,24].…”

“…Такие пациенты формируют группу риска по БА и требуют тщательного наблюдения для первичной профилактики заболевания. В этом случае педиатр может назначить противовоспалительную терапию ингаляционными глюкокортикоидами в низких дозах или блокаторами лейкотриеновых рецепторов на 4-8 нед с обязательным мониторированием состояния пациента на фоне лечения через 1 и 3 мес [1,11,24]. Все авторы подтверждают соответствие своего авторства международным критериям ICMJE (все авторы внесли существенный вклад в разработку концепции, проведение исследования и подготовку статьи, прочли и одобрили финальную версию перед публикацией).…”

The importance of environmental factors in the development of pneumonia in children

“…Most researchers associate to a large extent with environmental pollution (atmospheric air, water, soil with chemical compounds). In Uzbekistan, studies have not been conducted to identify the prevalence of pneumonia and other bronchopulmonary pathologies, on risk factors and the impact of air pollution on an increase in the incidence of the disease among children living in rural and industrial regions [3,[4][5][6][7][8][9][10][11][12][13]. The main sources of indoor air pollution, in addition to outdoor air and new building materials, are tobacco smoking, the use of gas stoves for cooking and room heating, and gas water heaters.…”

“…One of the urgent scientific problems is the formation of mechanisms of immune and molecular genetic development of community-acquired pneumonia in young children, the identification of prognostic risk factors of the disease, the improvement of diagnostic criteria through modern innovative clinical diagnostic research methods, the development of effective methods of treatment and rehabilitation of the disease. Pneumonia of viral-bacterial etiology also requires study [10,[13][14][15][16][17][18][19][20][21][22][23][24].…”