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primary and specialist healthcare provider in the evaluation and management of gastroesophageal reflux ( GER) and gastroesophageal reflux disease ( GERD) in the pediatric age group infants, children and adolescents. ... They were written by a joint
37 White, 3 not given Moderate to-severe asthma Patients presented to urban, pediatric ED Pulmonary index ( PI) score of > 8 out of 15; mean 10.2 at entry Beta2-agonist, ... Albuterol nebulized in heliox in the initial ED treatment of pediatric asthma:
July 2007 2 Evidence Table 19. Managing Exacerbations: Magnesium Sulfate Study Population Citation ( Sponsor) Study Design Study N ( Number Evaluable) Population Characteristics Asthma Severity at Baseline ( if reported) Magnesium by Nebulizer
pubmed.gov - 11/2/11
To determine the risk, by age group, of serious asthma-related events with long-acting (2)-adrenergic receptor agonists marketed in the United States for asthma.|The US Food and Drug Administration performed a meta-analysis of controlled clinical trials comparing the risk of LABA use with no LABA use for patients 4 to 11, 12 to 17, 18 to 64, and older than 64 years old. The effects of age on a composite of asthma-related deaths, intubations, and hospitalizations (asthma composite index) and the effects of concomitant inhaled corticosteroid (ICS) use were analyzed.|One hundred ten trials with 60 954 patients were included in the meta-analysis. The composite event incidence difference for all ages was 6.3 events per 1000 patient-years (95% confidence interval [CI]: 2.2-10.3) for using LABAs compared with not using LABAs. The largest incidence difference was observed for the 4- to 11-year age group (30.4 events per 1000 patient-years [95% CI: 5.7-55.1]). Differences according to age
Subcutaneous immunotherapy and pharmacotherapy in seasonal allergic rhinitis: a comparison based on meta-analyses.
pubmed.gov - 10/1/11
Allergen-specific subcutaneous immunotherapy (SCIT) of seasonal allergic rhinitis (SAR) is usually considered a "second-line," slow-acting, disease-modifying treatment.|We sought to test whether SCIT is as effective as antisymptomatic treatment in the control of symptoms in patients with SAR in the first year of treatment.|We reviewed meta-analyses with 5 or more randomized, double-blind, placebo-controlled trials of SCIT or antisymptomatic treatment in patients with SAR. We then selected trials measuring the total nasal symptom score (TNSS), the total symptom score (TSS), or both during the first pollen season after treatment initiation. Efficacy was determined as the percentage reduction in TSSs and TNSSs obtained with active treatment compared with placebo (relative clinical impact [RCI]) and the standardized mean difference (SMD) of treatment verses placebo (effect size [ES]).|The weighted mean RCI of SCIT on TNSSs (-34.7% 6.8%) was higher than those of mometasone (-31.7%
Specific oral tolerance induction in food allergic children: is oral desensitisation more effective than allergen avoidance?: a meta-analysis of published RCTs.
pubmed.gov - 3/1/11
To determine whether specific oral tolerance induction (SOTI) is more effective than avoidance in inducing tolerance in children aged 0-18 years who have immunoglobulin E (IgE)-mediated food allergy.|MEDLINE (1950 to July 2009), EMBASE (1980 to July 2009) and all EBM Reviews: Cochrane Database of Systematic Reviews, ACP Journal Club, Database of Abstracts of Reviews of Effects, Cochrane Methodology Register, Health Technology Assessment and NHS Economic Evaluation Database (from start date to November 2008). The online table of contents (November 2003 to July 2009) of the Journal of Allergy and Clinical Immunology, Pediatric Allergy and Immunology and Allergy were also searched, and reference lists of retrieved articles were scrutinised for relevant studies.|Randomised controlled trials (RCT) were included providing they enrolled children with IgE-mediated food allergy diagnosed using the criterion standard tool (double-blind placebo-controlled food challenge) before randomisation and
pubmed.gov - 3/1/11
There has been marked expansion in the literature and practice of pediatric sleep medicine; however, no recent evidence-based practice parameters have been reported. These practice parameters are the first of 2 papers that assess indications for polysomnography in children. This paper addresses indications for polysomnography in children with suspected sleep related breathing disorders. These recommendations were reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine.|A systematic review of the literature was performed, and the American Academy of Neurology grading system was used to assess the quality of evidence. RECOMMENDATIONS FOR PSG USE: 1. Polysomnography in children should be performed and interpreted in accordance with the recommendations of the AASM Manual for the Scoring of Sleep and Associated Events. (Standard) 2. Polysomnography is indicated when the clinical assessment suggests the diagnosis of obstructive sleep apnea syndrome (OSAS)
pubmed.gov - 1/1/11
Genome-wide association studies of pooled DNA samples were shown to be a valuable tool to identify candidate SNPs associated to a phenotype. No such study was up to now applied to childhood allergic asthma, even if the very high complexity of asthma genetics is an appropriate field to explore the potential of pooled GWAS approach.|We performed a pooled GWAS and individual genotyping in 269 children with allergic respiratory diseases comparing allergic children with and without asthma. We used a modular approach to identify the most significant loci associated with asthma by combining silhouette statistics and physical distance method with cluster-adapted thresholding. We found 97% concordance between pooled GWAS and individual genotyping, with 36 out of 37 top-scoring SNPs significant at individual genotyping level. The most significant SNP is located inside the coding sequence of C5, an already identified asthma susceptibility gene, while the other loci regulate functions that are