RHINASTHMA-Adolescents: a new quality of life tool for patients with respiratory allergy
Background: Specific instruments for health-related quality of life (HRQoL) assessment in adolescents with rhinoconjunctivitis or asthma are available. None of them evaluates rhinitis and asthma together, although they often coexist. Our aim was to validate a HRQoL questionnaire for adolescents with rhinoconjunctivitis, asthma, or both. Methods: A pool of 38 items covering the main symptoms and problems related to respiratory allergy was generated based on literature review, clinical experience, and unstructured interviews to 54 adolescents. The items were randomly listed and presented to 88 consecutive outpatients (44 M; mean age 15.2 3.1). Patients had to indicate which item they had expe…
Efficacy of Buffered Hypertonic Saline Nasal Irrigation for Nasal Symptoms in Children with Seasonal Allergic Rhinitis: A Randomized Controlled Trial
<b><i>Background:</i></b> Saline nasal irrigation is labelled as an add-on treatment in patients with allergic rhinitis (AR). The primary aim of this study was to compare the efficacy of 21-day use of buffered hypertonic saline (BHS) versus normal saline solution (NSS) on reducing nasal symptoms in children with seasonal AR (SAR). Comparing their efficacy on nasal cytology counts (NCC), quality of life, and sleep quality was the secondary aim. <b><i>Methods:</i></b> In this 21-day,<b> </b>open-label, randomized controlled study, 36 SAR children (aged 6-13 years) with a Total 5 Symptom Score (T5SS) ≥5 received twice-daily BHS or NSS…
Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases
Abstract Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infecti…
Catching allergy by a simple questionnaire
Background Identifying allergic rhinitis requires allergy testing, but the first-line referral for rhinitis are usually primary care physicians (PCP), who are not familiar with such tests. The availability of easy and simple tests to be used by PCP to suggest allergy should be very useful. Methods The Respiratory Allergy Prediction (RAP) test, based on 9 questions and previously validated by a panel of experts, was evaluated in this study. Results An overall number of 401 patients (48.6% males, age range 14–62 years) with respiratory symptoms was included. Of them, 89 (22.2%) showed negative results to SPT, while 312 (77.8%) had at least one positive result to SPT. Cohen’s kappa coefficient…
Verde e allergie
La qualità dell’ambiente urbano è sempre più oggetto di attenzione sia da parte degli amministratori che dei cittadini. Il verde, inteso come l’insieme delle diverse tipologie di impianti presenti nelle città, costituisce un fondamentale elemento per misurare la qualità dell’ambiente urbano. Le sue modificazioni storiche, la sua progettazione e manutenzione assumono rilievo importante soprattutto se si considera la presenza di specie allergeniche che possono condizionare la vita di un’importante fetta della popolazione presente. Tra le diverse soluzioni praticabili per ridurre l’esposizione dei pazienti allergici al polline iniziano a diffondersi anche le moderne tecnologie, come app dedica…
Comparative Effect of Beclomethasone Dipropionate and Cetirizine on Acoustic Rhinometry Parameters in Children With Perennial Allergic Rhinitis: A Randomized Controlled Trial.
Background and objectives The effect of intranasal corticosteroids and oral antihistamines on acoustic rhinometry parameters has not been directly compared. The primary objective was to compare the effect of a 21-day course of treatment with nasal beclomethasone dipropionate (nBDP) with that of cetirizine (CTZ) on nasal patency measured using acoustic rhinometry in children with perennial allergic rhinitis (PAR). The secondary objective was to compare the effect of both drugs on nasal cytology, symptom severity, sleep quality, and quality of life. Methods In this 21-day, open-label, randomized controlled study, 34 children with PAR (age 6-14 years) with a Total 5-Symptom Score (T5SS) ≥5 rec…
Effetti dannosi sul bambino del fumo di sigaretta di 1ª - 2 ª e 3 ª mano
Il fumo di tabacco costituisce un problema ancora attuale e di notevole rilevanza per il grande impatto sulla salute pubblica. Milioni di bambini sono esposti ai danni devastanti del fumo passivo. Questo contribuisce all’inquinamento degli ambienti chiusi apportando significative concentrazioni di nicotina, sostanze irritanti, tossiche e cancerogene, tanto da risultare il principale inquinante degli ambienti chiusi. Oltre al cosiddetto ‘fumo di seconda mano’, miscela costituita dal fumo derivante direttamente dalla sigaretta accesa e da quello esalato dai polmoni dei fumatori, recentemente è stata individuata una nuova forma di esposizione a fumo passivo, denominata ‘fumo di terza mano’. Qu…
Environmental risk factors and lung diseases in children: From guidelines to health effects
Abstract During the last decades research all over the world has highlighted the deleterious effects of outdoor and indoor pollution on respiratory health of adults and children. The World Health Organization (WHO) “ Air quality guidelines for Europe ” played a fundamental role in providing information and guidance to authorities involved in the air pollution field and they are considered the key source on which the European Commission's directive on air quality is based. Children appear to be most vulnerable to the harmful effects of outdoor pollutants, which can cause both acute exacerbations, as well as chronic respiratory symptoms and diseases. Possible mechanisms include the induction …
Endotyping allergic rhinitis in children: A machine learning approach.
Introduction: The diversity of allergic rhinitis (AR) phenotypes is particularly evident in childhood, suggesting the need to analyze and identify new approaches to capture such clinical heterogeneity. Nasal cytology (NC) is a very useful diagnostic tool for identifying and quantifying nasal inflammation. Data-driven approaches such as latent class analysis (LCA) assign subjects to classes based on their characteristics. We hypothesized that LCA based on NC, including the assessment of neutrophils, eosinophils, and mast cells, may be helpful for identifying AR endotypes in children. Methods: A total of 168 children were enrolled. Sociodemographic characteristics and detailed medical history…
Barriers and incentives for Italian paediatricians to become smoking cessation promoters: a GARD-Italy Demonstration Project
Background: Paediatricians rarely devote any time to screening and treatment for parental tobacco use. The present project is part of a Global Alliance against Chronic Respiratory Diseases (GARD)-Italy Demonstration Project, aimed to increase the skills of primary care physicians and paediatricians as "promoter of smoking cessation". The aims of this study were: (I) to identify latent classes of barriers and incentives for smoking cessation counseling among paediatricians using latent class analysis (LCA); (II) to investigate risk factors for inclusion into the identified classes. Methods: In 2018, 1,500 Italian paediatricians were invited to complete an online survey on passive smoke expos…
Nasal budesonide efficacy for nasal nitric oxide and nasal obstruction in rhinitis
Nasal nitric oxide (nNO) is a noninvasive tool that may be helpful in evaluating the inflammatory status in the upper airways [1]. Previous studies report that nNO is elevated in children with Allergic Rhinitis (AR) [2], especially in perennial sensitized subjects [3], and that it may be affected by topical administration of intranasal steroids (INSs) [4]. This article is protected by copyright. All rights reserved.
Vitamin D, allergies and asthma: focus on pediatric patients
In recent years, the interest of the scientific world towards vitamin D gradually increased, and several studies have been conducted to dissect its possible role in modulating the development/course of allergic diseases. Also, Vitamin D supplementation has been assessed as a beneficial approach for treating allergies in some, but not all studies. We reviewed herein the available and relevant literature concerning the possible links between Vitamin D, its supplementation and allergic diseases. A literature search was made independently by the Authors, identifying articles for a narrative review. As per literature, Vitamin D plays a key role in calcium and phosphate metabolism, and it is esse…
Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic
AbstractThe COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular…
About molds
I funghi provocano talora disturbi dell’apparato respiratorio e sebbene alcuni semplici provvedimenti possano rivelarsi determinanti per prevenirne lo sviluppo in ambiente domestico, la loro ubiquità fa sì che essi si sviluppino sia outdoor che indoor. Un fattore predisponente allo sviluppo di asma bronchiale è la sensibilizzazione allergica, mentre l’inquinamento ambientale gioca un altro ruolo di rilievo anche nelle altre patologie legate all’esposizione a muffe: l’aspergillosi broncopolmonare allergica, la rinosinusite, la sick building syndrome e la sindrome da polveri organiche tossiche. L’immunoterapia specifica, in virtù del suo ormai accertato potere desensibilizzante, rappresenta u…
Endotyping Seasonal Allergic Rhinitis in Children: A Cluster Analysis.
BackgroundSeasonal Allergic Rhinitis (SAR) is a heterogeneous inflammatory disease. We hypothesized that a cluster analysis based on the evaluation of cytokines in nasal lavage (NL) could characterize distinctive SAR endotypes in children.MethodsThis cross-sectional study enrolled 88 children with SAR. Detailed medical history was obtained by well-trained physicians. Quality of life and sleep quality were assessed through standardized questionnaires [Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and Pittsburgh Sleep Quality Index (PSQI) respectively]. Children were grouped through K-means clustering using Interleukin (IL)-5, IL-17, IL-23, and Interferon (INF)-γ in NL.R…
Cabbage and fermented vegetables: from death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19
International audience; Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT1 R) axis associated with oxidative stress. This leads to insulin resistance …