Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuff...Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ<sup>2</sup> = 14.62, df = 4, p value = 0.01, Type B χ<sup>2</sup> = 14.06, df = 4, p value = 0.01, Type C χ<sup>2</sup> = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.展开更多
Today the most important challenge facing the pediatrician is the increasing prevalence of chronic diseases. With this regard, pediatricians play a key role in the management of these conditions. The closeness with th...Today the most important challenge facing the pediatrician is the increasing prevalence of chronic diseases. With this regard, pediatricians play a key role in the management of these conditions. The closeness with the family, the knowledge of the clinical case and the care continuity allow the pediatrician to acquire a position of director of every case. When pathological events have a chronic feature, suddenly the quality of life of the whole family changes. For this reason the first communication of chronic disease is very important and the task of the pediatrician should be to provide a positive message to help the family in facing the difficulty of this new challenge. The bronchial asthma is the most common chronic disease worldwide. The incidence, the prevalence, and the mortality of the disease have increased in children over the past decades. These trends are particularly marked above all in preschool children. The success reached by Pediatricians is closely related to the compliance and the implementation of the therapy followed by the little patient and his family. With this regard authors, in this review, focus on the illustration of several strategies, based on the pediatrician’ skills and medicine documents, that can be used for the improvement of communication among pedia- trician-family and child, never forgetting the hu- man aspect of the same doctor, that should con- ciliate with the scientific knowledge in the taking care of a specific chronic disease.展开更多
Bronchial hyperresponsiveness(BHR) is an important but not asthma-specific characteristic and can be assessed by direct and indirect methods, based on the stimulus causing airway obstruction. BHR has been proposed as ...Bronchial hyperresponsiveness(BHR) is an important but not asthma-specific characteristic and can be assessed by direct and indirect methods, based on the stimulus causing airway obstruction. BHR has been proposed as a prognostic marker of asthma severity and persistence, and may also be used to control pharmacological management of asthma. The most recent data on the prevalence and development of BHR in childhood and its predictive value for subsequent asthma development in late adolescence and adulthood is discussed in this review. According to the BHR-related scientific articles written in the English language and indexed in the publicly searchable PubM ed database, the prevalence of BHR varies based upon the methods used to assess it and the population examined. In general, however, BHR prevalence is reduced as children grow older, in both healthy and asthmatic populations. While asthma can be predicted by BHR, the predictive value is limited. Reduced lung function, allergic sensitization, female sex, and early respiratory illness have been identified as risk factors for BHR. The collective studies further indicate that BHR is a dynamic feature related to asthma, but asymptomatic BHR is also common. Ultimately, the prevalence of BHR varies depending on the population, the environment, and the evaluation methods used. While both the methacholine challenge and the exercise test may predict asthma in adolescence or early adulthood, the predictive value is higher for the methacholine challenge compared to the exercise test. The collective data presented in the present study demonstrate how BHR develops through childhood and its relation to bronchial asthma.展开更多
目的分析肺部康复训练在沙丁胺醇治疗重度支气管哮喘急性发作患儿中对气道炎症因子和肺功能的影响,为临床治疗重度支气管哮喘急性发作提供治疗依据。方法选取郑州大学第三附属医院2021年9月至2023年2月收治的102例重度支气管哮喘急性发...目的分析肺部康复训练在沙丁胺醇治疗重度支气管哮喘急性发作患儿中对气道炎症因子和肺功能的影响,为临床治疗重度支气管哮喘急性发作提供治疗依据。方法选取郑州大学第三附属医院2021年9月至2023年2月收治的102例重度支气管哮喘急性发作患儿进行前瞻性研究,采用随机数字表法将其分为两组(参照组、治疗组),每组51例。参照组男32例、女19例;年龄5~12(7.32±1.85)岁;病程2~18(12.30±1.28)个月;体质量12~27(21.65±2.08)kg。治疗组男28例、女23例;年龄6~13(7.94±1.16)岁;病程2~17(11.89±2.31)个月;体质量11~28(22.32±2.17)kg。入院后两组患儿均予以布地奈德抗感染治疗,参照组采用沙丁胺醇治疗,治疗组采用沙丁胺醇联合肺部康复训练,两组患儿治疗周期均为1个月。比较两组患儿临床效果,临床症状(呼吸困难、咳嗽、喘息、哮鸣音、湿啰音)消失时间,治疗前及治疗后1个月炎症因子水平[白细胞介素-4(interleukin-4,IL-4)、IL-18、IL-1β、嗜酸性粒细胞(eosinophils,EOS)]、肺功能[用力呼出50%肺活量时的瞬间呼气流量(forced expiratory flow at 50%,FEF50%)、呼气峰值流量(peak expiratory flow,PEF)、第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)、用力肺活量(forced vital capacity,FVC)]。统计学方法采用t检验、χ^(2)检验。结果治疗组经治疗后临床总有效率比参照组高[96.08%(49/51)比82.35%(42/51)](χ^(2)=4.993,P<0.05)。与参照组[(5.23±1.03)d、(4.32±1.30)d、(2.36±0.26)d、(6.22±1.63)d、(5.89±1.07)d]比较,治疗组呼吸困难、咳嗽、喘息、哮鸣音、湿啰音消失时间[(2.25±0.69)d、(2.03±0.85)d、(2.23±0.32)d、(5.63±1.10)d、(3.62±1.04)d]均较短,差异均有统计学意义(t=17.166、10.529、2.252、2.143、10.864,均P<0.05)。治疗1个月后,治疗组血清IL-4、IL-18、IL-1β、EOS水平均比参照组低[(25.30±3.96)ng/L比(28.30±3.47)ng/L,(92.03±7.36)ng/L比(100.65±8.66)ng/L,(2.03±0.26)ng/L比(2.89±0.32)ng/L,(1.06±0.39)%比(2.84±0.52)%],差异均有统计学意义(t=4.069、5.417、14.896、19.557,均P<0.05)。治疗1个月后,治疗组FEF50%、PEF、FEV1、FVC水平均比参照组高,差异均有统计学意义(均P<0.05)。结论重度支气管哮喘急性发作患儿在沙丁胺醇治疗时采用肺部康复训练可使临床效果得到提升,缩短临床呼吸困难、咳嗽等症状消失时间,缓解气道炎症反应,促进患儿肺功能恢复,从而加快患儿康复。展开更多
文摘Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ<sup>2</sup> = 14.62, df = 4, p value = 0.01, Type B χ<sup>2</sup> = 14.06, df = 4, p value = 0.01, Type C χ<sup>2</sup> = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.
文摘Today the most important challenge facing the pediatrician is the increasing prevalence of chronic diseases. With this regard, pediatricians play a key role in the management of these conditions. The closeness with the family, the knowledge of the clinical case and the care continuity allow the pediatrician to acquire a position of director of every case. When pathological events have a chronic feature, suddenly the quality of life of the whole family changes. For this reason the first communication of chronic disease is very important and the task of the pediatrician should be to provide a positive message to help the family in facing the difficulty of this new challenge. The bronchial asthma is the most common chronic disease worldwide. The incidence, the prevalence, and the mortality of the disease have increased in children over the past decades. These trends are particularly marked above all in preschool children. The success reached by Pediatricians is closely related to the compliance and the implementation of the therapy followed by the little patient and his family. With this regard authors, in this review, focus on the illustration of several strategies, based on the pediatrician’ skills and medicine documents, that can be used for the improvement of communication among pedia- trician-family and child, never forgetting the hu- man aspect of the same doctor, that should con- ciliate with the scientific knowledge in the taking care of a specific chronic disease.
文摘Bronchial hyperresponsiveness(BHR) is an important but not asthma-specific characteristic and can be assessed by direct and indirect methods, based on the stimulus causing airway obstruction. BHR has been proposed as a prognostic marker of asthma severity and persistence, and may also be used to control pharmacological management of asthma. The most recent data on the prevalence and development of BHR in childhood and its predictive value for subsequent asthma development in late adolescence and adulthood is discussed in this review. According to the BHR-related scientific articles written in the English language and indexed in the publicly searchable PubM ed database, the prevalence of BHR varies based upon the methods used to assess it and the population examined. In general, however, BHR prevalence is reduced as children grow older, in both healthy and asthmatic populations. While asthma can be predicted by BHR, the predictive value is limited. Reduced lung function, allergic sensitization, female sex, and early respiratory illness have been identified as risk factors for BHR. The collective studies further indicate that BHR is a dynamic feature related to asthma, but asymptomatic BHR is also common. Ultimately, the prevalence of BHR varies depending on the population, the environment, and the evaluation methods used. While both the methacholine challenge and the exercise test may predict asthma in adolescence or early adulthood, the predictive value is higher for the methacholine challenge compared to the exercise test. The collective data presented in the present study demonstrate how BHR develops through childhood and its relation to bronchial asthma.
文摘目的分析肺部康复训练在沙丁胺醇治疗重度支气管哮喘急性发作患儿中对气道炎症因子和肺功能的影响,为临床治疗重度支气管哮喘急性发作提供治疗依据。方法选取郑州大学第三附属医院2021年9月至2023年2月收治的102例重度支气管哮喘急性发作患儿进行前瞻性研究,采用随机数字表法将其分为两组(参照组、治疗组),每组51例。参照组男32例、女19例;年龄5~12(7.32±1.85)岁;病程2~18(12.30±1.28)个月;体质量12~27(21.65±2.08)kg。治疗组男28例、女23例;年龄6~13(7.94±1.16)岁;病程2~17(11.89±2.31)个月;体质量11~28(22.32±2.17)kg。入院后两组患儿均予以布地奈德抗感染治疗,参照组采用沙丁胺醇治疗,治疗组采用沙丁胺醇联合肺部康复训练,两组患儿治疗周期均为1个月。比较两组患儿临床效果,临床症状(呼吸困难、咳嗽、喘息、哮鸣音、湿啰音)消失时间,治疗前及治疗后1个月炎症因子水平[白细胞介素-4(interleukin-4,IL-4)、IL-18、IL-1β、嗜酸性粒细胞(eosinophils,EOS)]、肺功能[用力呼出50%肺活量时的瞬间呼气流量(forced expiratory flow at 50%,FEF50%)、呼气峰值流量(peak expiratory flow,PEF)、第1秒用力呼气容积(forced expiratory volume in the first second,FEV1)、用力肺活量(forced vital capacity,FVC)]。统计学方法采用t检验、χ^(2)检验。结果治疗组经治疗后临床总有效率比参照组高[96.08%(49/51)比82.35%(42/51)](χ^(2)=4.993,P<0.05)。与参照组[(5.23±1.03)d、(4.32±1.30)d、(2.36±0.26)d、(6.22±1.63)d、(5.89±1.07)d]比较,治疗组呼吸困难、咳嗽、喘息、哮鸣音、湿啰音消失时间[(2.25±0.69)d、(2.03±0.85)d、(2.23±0.32)d、(5.63±1.10)d、(3.62±1.04)d]均较短,差异均有统计学意义(t=17.166、10.529、2.252、2.143、10.864,均P<0.05)。治疗1个月后,治疗组血清IL-4、IL-18、IL-1β、EOS水平均比参照组低[(25.30±3.96)ng/L比(28.30±3.47)ng/L,(92.03±7.36)ng/L比(100.65±8.66)ng/L,(2.03±0.26)ng/L比(2.89±0.32)ng/L,(1.06±0.39)%比(2.84±0.52)%],差异均有统计学意义(t=4.069、5.417、14.896、19.557,均P<0.05)。治疗1个月后,治疗组FEF50%、PEF、FEV1、FVC水平均比参照组高,差异均有统计学意义(均P<0.05)。结论重度支气管哮喘急性发作患儿在沙丁胺醇治疗时采用肺部康复训练可使临床效果得到提升,缩短临床呼吸困难、咳嗽等症状消失时间,缓解气道炎症反应,促进患儿肺功能恢复,从而加快患儿康复。
