Pediatric Asthma. Fernando D. Mar,nez, M.D. Asthma and Airways Disease Research Center The University of Arizona
|
|
- Arron Griffith
- 6 years ago
- Views:
Transcription
1 Pediatric Asthma Fernando D. Mar,nez, M.D. Asthma and Airways Disease Research Center The University of Arizona
2 Disclosure Grant from Johnson and Johnson to study use of Amish dust to prevent asthma Advisor to PureTech in the development of microbe-based therapies
3 Three Challenges Can we prevent asthma? Are inhaled coritcosteroids effec,ve in preschoolers? Is there any role for Azithromycin in severe, wheezy preschoolers?
4 The Emergence of a Fundamental New Concept! The last 30 years have witnessed the advent of major shifts in our understanding of the origins of human phenotypes! It is now widely accepted that most chronic diseases have their origins during the first years of life! Interactions between genes and early environment determine developmental pathways that have long term influence on health and disease for a lifetime
5 Incidence of Asthma by Age in Rochester Minnesota Yunginger et al, ARRD 1992: 146:888
6 Natural Course of Asthma in the 1958 British Birth Cohort Each symbol represents 1% of children with complete data (N=5801) Strachan et al, BMJ 1996: 312:1195
7 Natural Course of Asthma in the 1958 British Birth Cohort Each symbol represents 1% of children with complete data (N=5801) Strachan et al, BMJ 1996: 312:1195
8 Morgan et al, Ped. Pulmonol 1988;5:232
9 Trajectories of Lung Func,on in Young Children With and Without Asthma by Age 7 Yrs Bisgaard et al, AJRCCM. 2012; 185:
10 Lung Function from Birth by Wheezing at Age Yrs 0.4 Z-Scores Adjusted FEV1/FVC (+/-se) * * No Wheeze Infrequent Wheeze Frequent Wheeze Age, years * * * p<0.01 Frequent vs No Wheeze p<0.01 Frequent vs. Infrequent *
11 Trajectories of Airway Func,on in Childhood Asthma No Asthma Rela,ve Level of Lung Func,on Mild Asthma Moderate/Severe Asthma Birth Age 5-7 Years School age Adult life Mar$nez and Vercelli Lancet 2013;382:
12 Frequent Wheezing by Siblings or Daycare in the First 6 Months of Life Ball et al, NEJM 2000;343:538
13
14 Exposure to Stables and/or Farm Milk in the First Year of Life. % Asthma ever Exposed Non-exposed * * Asthma attacks past 12 mo Riedler et al, Lancet Oct 6;358: * p<0.0001
15 Amish Huteritas
16
17 Amish Are Exposed to Considerably Higher Microbial Products in Their Homes Stein et al, NEJM 2016; 375:411
18 Proteobacteria are Significantly More Abundant in Amish Dust Stein et al, NEJM 2016; 375:411
19 Huaerites and Amish Children Have Different Propor,on of Eosinophils and Neutrophils Stein et al, NEJM 2016; 375:411
20 Huaerite and Amish Children are Immunologically Very Different Stein et al, NEJM 2016; 375:411
21 Gene Expression Profiles in Leukocytes From Amish and Huaerite Children Blue: Increased Expression in Amish Stein et al, NEJM 2016; 375:411
22 Amish (but not Huaerite) House Dust is Protec,ve 30 PBS Resistance (cm H20.s/ml) OVA OVA/Amish OVA/Hutterite p=0.03 p= Ach (µg/g mouse) Stein et al, NEJM 2016; 375:411
23 Concordance Between Home Microbiome and Personal Microbiome Lax et al, Science 2014; 345:2048
24 Three Dis,nct Neonatal Gut Microbiota Paaerns Wayne County Birth Cohort Fujimura et al, Nat Med 2016; 22:1187
25 Increased Risk of Atopy and Asthma in Neonatal Carriers of NGM3 Atopy MD asthma Fujimura et al, Nat Med 2016; 22:1187
26 Bacterial Taxonomic Comparison Between NGM3 and NGM1 Fujimura et al, Nat Med 2016; 22:1187
27 Sci Transl Med 2015; 7:39
28 The INFANT Study Fitzpatrick et al, JACI 2016; 138:1608
29 The INFANT Study Fitzpatrick et al, JACI 2016; 138:1608
30 The INFANT Study Fitzpatrick et al, JACI 2016; 138:1608
31 Yr 6 Asthma By RSV- And RV Wheezing Illness In Early Life Jackson et al, AJRCCM 2008; 178:667
32 Likelihood of NP Isola,on of Bacteria and Viruses During Wheezing Episodes (Age <3 Yr) Bacteria: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis Virus: picorna, RSV, corona, parainfluenza, influenza, human metapneumo, adeno, or boca Bisgaard et al, BMJ 2010;341:c4978
33 Risk of Persistent Wheeze at Age 5 by Pharyngeal Bacterial Coloniza,on as Newborns Hazard Ra,o: 2.40 (95% CI, 1.45 to 3.99) S. pneumoniae, H. influenzae, M. catarrhalis. Bisgaard et al, NEJM 2007;357:
34 An,bio,c Use in Preschool Children An,bio,c use in wheezing illnesses controversial Not recommended by na,onal guidelines Judicious use recommended in general in effort to prevent development of resistance However, very commonly prescribed in clinical prac,ce (1/6 visits for asthma)
35 The Effect of Azithromycin in Preven,ng Severe Lower Respiratory Tract Illnesses in Preschool Children: A Randomized Trial Leonard B. Bacharier, M.D., Theresa Guilbert, M.D., David Mauger, Ph.D., Sue Boehmer, M.A., and Fernando Mar$nez, M.D. NHLBI s AsthmaNet JAMA. 2015;314:
36 Research Ques,on Among preschool-aged children with recurrent wheezing episodes and 1 clinically significant wheezing episode in the year prior: Episode Preven$on: Is azithromycin, when administered at the ini,al and early signs of a respiratory tract illness, more effec,ve than placebo for preven,ng progression to severe lower respiratory tract symptoms?
37 Major Inclusion Criteria months of age Recurrent significant wheezing in the past year (any of the following) >3 episodes, 1 of which was clinically significant*; OR >2 clinically significant* episodes; OR > 4 months of daily controller therapy AND >1 clinically significant* episode. *Clinically significant episode: requiring any of the following: (1) systemic cor,costeroids (oral or injectable), (2) unscheduled physician office visit, (3) ED visit, (4) urgent care visit, or (5) hospitaliza,on.
38 Onset of RTI symptoms APRIL Treatment Failure (APRIL Primary Outcome): Progression of Symptoms SYMPTOMS Begin APRIL Illness Kit: Azithromycin or Placebo
39 Primary Outcome Severe LRTI: AZM 39, Placebo 57 Cumula,ve risk of severe LRTI AZM 0.24, Placebo 0.40
40 Symptom Scores During Treated RTIs All RTIs Severe LRTIs
41 Development of AZM Resistance 81 subjects provided deep oropharyngeal samples at baseline and at final visit ( 14 days auer final dose of study medica,on) Number (%) of Subjects with an AZM- Resistant Organism AZM-treated Non-AZM-treated Baseline 5/41 (12.2) 4/45 (8.9) Final visit 8/40 (20.0) 7/41 (17.0) Number (%) of Subjects with Acquisi$on of an AZM-Resistant Organism AZM-treated (N=36) Non-AZM-treated (N=37) 6 (16.7) 4 (10.8)
42 Subgroup Analyses
43 The COPSAC Azithromycin Trial 1-3 year olds with recurrent asthma-like symptoms Each episode of asthma-like symptoms las,ng at least 3 days was randomly allocated to a 3-day course of azithromycin or placebo The primary outcome was dura,on of the respiratory episode auer treatment, verified by prospec,ve daily diaries Stockholm et al, Lancet Respir Med 2016; 4: 19 26
44 Primary Outcome Stockholm et al, Lancet Respir Med 2016; 4: 19 26
45
46
47 Conclusions Asthma begins in childhood, and environments rich in microbial exposures appear to be protec,ve In preschool children, ICS is the most effec,ve therapy in atopic children Azithromycin could be considered to prevent severe exacerba,ons in children not responsive to ICS
Recurrent Wheezing in Preschool Children. William Sheehan, MD Associate Professor of Pediatrics Division of Allergy and Immunology
Recurrent Wheezing in Preschool Children William Sheehan, MD Associate Professor of Pediatrics Division of Allergy and Immunology Disclosure I have nothing to disclose related to this talk. Background
More informationUnderstanding Early Wheezing in the Development of Airflow Limitation in Children
Understanding Early Wheezing in the Development of Airflow Limitation in Children Bradley Chipps, MD Capital Allergy & Respiratory Disease Center Sacramento, CA Western Society of Allergy, Asthma and Immunology
More information1/30/2016 RESPIRATORY INFECTIONS AND ASTHMA NO DISCLOSURES NO FINANCIAL INTEREST INFORMATION OBTAINED JACI AJRCCM
RESPIRATORY INFECTIONS AND ASTHMA NO DISCLOSURES NO FINANCIAL INTEREST INFORMATION OBTAINED JACI AJRCCM 1 2 year old male HISTORY -Daycare since 9 months of age -Recurrent symptoms since 10 months of age:
More informationThe Link Between Viruses and Asthma
The Link Between Viruses and Asthma CATHERINE KIER, MD Professor of Clinical Pediatrics Division Chief, Pediatric Pulmonary, and Cystic Fibrosis Center Director, Pediatric Sleep Disorders Center SUNY Stony
More informationEarly Administration of Azithromycin and Prevention of Severe Lower Respiratory Tract Illnesses in Preschool Children With a History of Such Illnesses
Early Administration of Azithromycin and Prevention of Severe Lower Respiratory Tract Illnesses in Preschool Children With a History of Such Illnesses M I R E N G U E N E C H E A - S O L A, M. D. U C S
More informationPotential public health impact of RSV vaccines. R. Karron December 2016
Potential public health impact of RSV vaccines R. Karron December 2016 1. RSV is The leading cause of hospitalization in infants and in many high-income countries; >2 million medical visits annually in
More informationTREAMENT OF RECURRENT VIRUS-INDUCED WHEEZING IN YOUNG CHILDREN. Dr Lại Lê Hưng Respiratory Department
TREAMENT OF RECURRENT VIRUS-INDUCED WHEEZING IN YOUNG CHILDREN Dr Lại Lê Hưng Respiratory Department Literature review current through: Feb 2013. This topic last updated: Aug 14, 2012 INTRODUCTION Wheezing
More informationOutcome, classification and management of wheezing in preschool children Paul L.P. Brand
Outcome, classification and management of wheezing in preschool children Paul L.P. Brand Princess Amalia Children s Clinic Isala klinieken, Zwolle the Netherlands p.l.p.brand@isala.nl Valle de la Luna,
More informationMicrobiome and Asthma
제 12 차천식연구회 COPD 연구회공동심포지엄 Microbiome and Asthma 한양대학교병원호흡기알레르기내과 김상헌 Disclosure 내용 1 Lung Microbiome 2 Lung Microbiome and Asthma 3 Gut Microbiome and Asthma Microbiome and Microbiota human microbiome
More informationVIRUSES AND ASTHMA. They asked if the sneezle came after the wheezle, or if the first sneezle came first
VIRUSES AND ASTHMA They asked if the sneezle came after the wheezle, or if the first sneezle came first First documented viral-association of asthma attacks occurred during influenza epidemics at 4 th
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Bisgaard H, Hermansen MN, Buchvald F, et al. Childhood asthma
More informationPro/Con: Pets Prevent Allergies and Asthma
Slide 1 Pro/Con: Pets Prevent Allergies and Asthma Slide 2 Special thanks to: n Dr. Dennis Ownby n Dr. Matt Perzanowski n Dr. Erica von Mutius and Dr. Charlotte Braun-Fahrlander n Dr. Andy Liu n Colleagues
More informationHow Gut Microbes Alter the Risks of RSV Infection and Asthma in Mice and Men
How Gut Microbes Alter the Risks of RSV Infection and Asthma in Mice and Men Dennis R. Ownby MD Medical College of Georgia at Augusta University Disclosures No commercial financial relationships No discussion
More informationEARN 3 FREE CPD POINTS
EARN 3 FREE CPD POINTS asthma and allergy Leader in digital CPD for Southern African healthcare professionals Asthma and allergy: Influence of EARLY LIFE RISK EXPOSURE Professor Peter Sly Director: World
More informationVitamina D: un ormone multifunzione
Vitamina D: un ormone multifunzione Introduction And Infections Diego Peroni Clinica Pediatrica Universita di Ferrara Food Allergy Asthma Conclusions diego.peroni@unife.it Holick, M. F. J. Clin. Invest.
More informationControversial Issues in the Management of Childhood Asthma: Insights from NIH Asthma Network Studies
Controversial Issues in the Management of Childhood Asthma: Insights from NIH Asthma Network Studies Stanley J. Szefler, MD Helen Wohlberg and Herman Lambert Chair in Pharmacokinetics, Head, Pediatric
More informationAssessing wheeze in pre-school children
Assessing wheeze in pre-school children 8 Wheeze in children aged less than five years has many potential causes. Often it is regarded as the first sign of asthma, however, a substantial proportion of
More informationGood Bugs Bad Bugs: The Role of the Microbiome on Human Health
Good Bugs Bad Bugs: The Role of the Microbiome on Human Health S Shahzad Mustafa, MD Rochester Regional Health Clinical Associate Professor of Medicine University of Rochester School of Medicine and Dentistry
More informationManagement of wheeze in pre-school children. Prof Colin Robertson, Respiratory Medicine, Royal Children s Hospital, Melbourne
Management of wheeze in pre-school children Prof Colin Robertson, Respiratory Medicine, Royal Children s Hospital, Melbourne General Practitioner encounters for asthma Asthma in Australia, 2003 Emergency
More informationUpdate on Immunology 12/31/12. Disclosures. Outline. Outline. Outline. Pathophysiology of Allergic Disease. Allergy background Novel T cell subsets
Update on Immunology Mitchell H. Grayson, MD Associate Professor Medical College of Wisconsin Dec 2012 Disclosures Employer Medical College of Wisconsin Research support National Institutes of Health $100,000
More informationan inflammation of the bronchial tubes
BRONCHITIS DEFINITION Bronchitis is an inflammation of the bronchial tubes (or bronchi), which are the air passages that extend from the trachea into the small airways and alveoli. Triggers may be infectious
More informationWHEEZING IN INFANCY: IS IT ASTHMA?
WHEEZING IN INFANCY: IS IT ASTHMA? Jittlada Deerojanawong Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Wheezing is common symptoms throughout infancy and childhood
More informationEnvironmental exposures in asthma: opportunities for prevention. Tim K. Takaro, MD, MPH. Faculty of Health Sciences Simon Fraser University
Environmental exposures in asthma: opportunities for prevention Tim K. Takaro, MD, MPH. Faculty of Health Sciences Simon Fraser University Conflict of Interest Nothing to declare Thank you funders! Private
More informationAsthma update Michigan Asthma Education Day Harvey L. Leo, MD
Asthma update 2017 Michigan Asthma Education Day Harvey L. Leo, MD Disclosures I have the following financial relationship with the manufacturers of any commercial product(s) and/or provider of commercial
More informationCynthia S. Kelly, M.D. Professor of Pediatrics Eastern Virginia Medical School Division Director Allergy Children s Hospital of The King s Daughters
Cynthia S. Kelly, M.D. Professor of Pediatrics Eastern Virginia Medical School Division Director Allergy Children s Hospital of The King s Daughters Disclosures Speakers bureau of Novartis and Genentech
More informationMikrobiom und Ernährung. Ruth Ferstl
Mikrobiom und Ernährung Ruth Ferstl 18.09.2017 Gemeinsamkeiten? Zellen: - 10% Mensch - 90% Bakterien Gene: - 1% Mensch - 99% Bakterien Everything that we eat, drink, touch, and breathe is reflected in
More informationPneumonia Aetiology Why is it so difficult to distinguish pathogens from innocent bystanders?
Pneumonia Aetiology Why is it so difficult to distinguish pathogens from innocent bystanders? David Murdoch Department of Pathology University of Otago, Christchurch Outline Background Diagnostic challenges
More informationLong-term studies of the natural history of asthma in childhood
Clinical reviews in allergy and immunology Series editors: Donald Y. M. Leung, MD, PhD, and Dennis K. Ledford, MD Long-term studies of the natural history of asthma in childhood Hans Bisgaard, MD, DMSc,
More informationRespiratory Tract Infec1ons Long Term Care. Dr Karsten Hammond Infec1ous Diseases 28 March 2015
Respiratory Tract Infec1ons Long Term Care Dr Karsten Hammond Infec1ous Diseases 28 March 2015 Disclosures I have no financial rela1onships to disclose 82 yo Female In LTC for two years, total care from
More informationAsthma and the Airway Microbiome: New Insights and Hypotheses
Asthma and the Airway Microbiome: New Insights and Hypotheses Yvonne J. Huang, MD Division of Pulmonary and Critical Care Medicine Department of Internal Medicine University of Michigan, Ann Arbor 3 rd
More informationWheeze and asthma in the very young
EARN 3 FREE CPD POINTS asthma Leader in digital CPD for Southern African healthcare professionals Wheeze and asthma in the very young Insights on diagnosis and current care Professor Felix Ratjen Head:
More informationPredicting, Preventing and Managing Asthma Exacerbations. Heather Zar Department of Paediatrics & Child Health University of Cape Town South Africa
Predicting, Preventing and Managing Asthma Exacerbations Heather Zar Department of Paediatrics & Child Health University of Cape Town South Africa Asthma exacerbations Predicting exacerbation recognising
More informationRisk Factors for Recurrent Early Wheezing in Childhood: Viral Infections
Risk Factors for Recurrent Early Wheezing in Childhood: Viral Infections Robert F. Lemanske, Jr., M.D. Professor of Pediatrics and Medicine University of Wisconsin Madison, WI Jackson & Lemanske, Immunology
More informationAllergy and Immunology Review Corner: Chapter 75 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al.
Allergy and Immunology Review Corner: Chapter 75 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al. Chapter 75: Approach to Infants and Children with Asthma
More informationObjectives. The Present and Future of Asthma: Birth Cohorts & Public Health Devon A. Greene, MD, MPH June 11, What is Asthma.
The Present and Future of : Birth Cohorts & Public Health Devon A. Greene, MD, MPH June 11, 2014 Objectives Become familiar with the evidence from available long-term studies on the natural history of
More informationIdentifying and managing the infant and toddler at risk for asthma
Clinical pearls Identifying and managing the infant and toddler at risk for asthma Theresa W. Guilbert, MD Madison, Wis Key words: Infants, children, asthma, wheezing, inhaled corticosteroids, leukotriene
More informationWhat s Hot in Pediatric Infectious Diseases Soren Gantt UBC Peds ID
What s Hot in Pediatric Infectious Diseases 2015-16 Soren Gantt UBC Peds ID ZIKA VIRUS!!! What is ZIKV? ZIKV is a flavivirus, related to dengue, yellow fever, West Nile and Japanese encephalitis Discovered
More informationManagement of asthma in preschool children with inhaled corticosteroids and leukotriene receptor antagonists Leonard B. Bacharier
Management of asthma in preschool children with inhaled corticosteroids and leukotriene receptor antagonists Leonard B. Bacharier Department of Pediatrics, Division of Allergy and Pulmonary Medicine, Washington
More informationIdentifying Biologic Targets to Attenuate or Eliminate Asthma Exacerbations
Identifying Biologic Targets to Attenuate or Eliminate Exacerbations exacerbations are a major cause of disease morbidity and costs. For both children and adults, viral respiratory infections are the major
More informationAsthma in Pediatric Patients. DanThuy Dao, D.O., FAAP. Disclosures. None
Asthma in Pediatric Patients DanThuy Dao, D.O., FAAP Disclosures None Objectives 1. Discuss the evaluation and management of asthma in a pediatric patient 2. Accurately assess asthma severity and level
More informationWhat is the best way to treat recurrent wheeze in pre-school children?
What is the best way to treat recurrent wheeze in pre-school children? Miles Weinberger MD Professor of Pediatrics www.uihealthcare.com/allerpulm Lower airway obstruction Asthma vs bronchiolitis? Both
More informationAsthma: an international perspective
Asthma: an international perspective Dr Paul D. Robinson MBChB, MRCPCH, FRACP, PhD Staff Specialist, Department of Respiratory Medicine The Children s Hospital Westmead Paediatric Medical Association Allergy
More informationERJ Express. Published on September 20, 2011 as doi: /
ERJ Express. Published on September 20, 2011 as doi: 10.1183/09031936.00193310 Febrile respiratory illnesses in infancy & atopy are risk factors for persistent asthma & wheeze. Authors List Merci M H Kusel
More informationUsing Patient Characteristics to Individualize and Improve Asthma Care
Using Patient Characteristics to Individualize and Improve Asthma Care Leonard B. Bacharier, M.D. Associate Professor of Pediatrics Clinical Director, Division of Allergy, Immunology, & Pulmonary Medicine
More informationAsthma and COPD in older people lumping or splitting? Christine Jenkins Concord Hospital Woolcock Institute of Medical Research
Asthma and COPD in older people lumping or splitting? Christine Jenkins Concord Hospital Woolcock Institute of Medical Research Concord Hospital Woolcock Institute of Medical Research Joe has asthma What
More informationManaging the wheezing infant. Alessandro Fiocchi. Chair, WAO Special Committee on Food Allergy. Milano, Italy
Managing the wheezing infant Alessandro Fiocchi Chair, WAO Special Committee on Food Allergy Milano, Italy Asthma and viral infections Dubai, December 8 th, 2010 Conflict of interest Speakers Bureau: none
More informationReducing unnecessary antibiotic use in respiratory tract infections in children
Reducing unnecessary antibiotic use in respiratory tract infections in children -a secondary care perspective Dr Conor Doherty (Consultant in paediatric infectious diseases and immunology GGC) Current
More informationPractical Approach to Managing Paediatric Asthma
Practical Approach to Managing Paediatric Asthma Dr Andrew Tai FRACP, PhD Paediatric Respiratory and Sleep Specialist Women's and Children's Hospital, Adelaide Approaching the patient Check the diagnosis
More information7/7/2015. Somboon Chansakulporn, MD. History of variable respiratory symptoms. 1. Documented excessive variability in PFT ( 1 test)
Definition of Asthma GINA 2010: Chronic inflammatory disorder of the airways Airway hyper-responsiveness Recurrent wheezing, breathlessness, chest tightness, coughing Variable, reversible airflow obstruction
More informationDiet and the Gut Microbiome
Diet and the Gut Microbiome Jean Kerver, PhD, MSc, RD March 15, 2018 COMMUNITY CAMPUSES & CLINICAL SITES Jean Kerver, PhD, MSc, RD kerverje@msu.edu 1 Diet and the Gut Microbiome Does the type and amount
More informationTITOLO RELAZIONE Vitamina D ed infezioni respiratorie ricorrenti. DOCENTE Prof. Peroni Diego
TITOLO RELAZIONE Vitamina D ed infezioni respiratorie ricorrenti DOCENTE Prof. Peroni Diego Ruolo dell'ipovitaminosi D nelle infezioni respiratorie Diego Peroni U.O. Pediatria Università di Pisa Le basi
More informationVaccine Development for Respiratory Viruses in Children. James E. Gern MD Professor of Pediatrics and Medicine University of Wisconsin Madison USA
Vaccine Development for Respiratory Viruses in Children James E. Gern MD Professor of Pediatrics and Medicine University of Wisconsin Madison USA Speaker Disclosure In accordance with the policy of the
More informationCOASTING NEWS. SPRING 2007
COASTING NEWS. SPRING 2007 Gymfinity The fourth Annual GYMFINITY Activity needs to be cancelled for this Sunday, March 11, 2007. Unfortunately, Gymfinity had a scheduling conflict, and the COAST staff
More informationDeveloping the potential of prebiotics and probiotics as immune health ingredients
Developing the potential of prebiotics and probiotics as immune health ingredients ARTHUR OUWEHAND ACTIVE NUTRITION DUPONT NUTRITION & HEALTH 20 th November 2014, The gut microbiome The gut microbiota
More informationPersonalized medicine in childhood asthma. Dr Mariëlle Pijnenburg, Erasmus MC Sophia, Rotterdam, NL
Thank you for viewing this presentation. We would like to remind you that this material is the property of the author. It is provided to you by the ERS for your personal use only, as submitted by the author.
More informationThe problem with an0bio0cs. Oct CCST Council Mee0ng Mar0n J. Blaser, MD New York University
The problem with an0bio0cs Oct 27 2015 CCST Council Mee0ng Mar0n J. Blaser, MD New York University Br J Exp Pathol 1929;79:780. J Clin Invest 1945;24:589. Top 8 prescrip0ons in US children, 2010 Prescrip0on
More informationUPPER RESPIRATORY TRACT INFECTIONS. IAP UG Teaching slides
UPPER RESPIRATORY TRACT INFECTIONS 1 INTRODUCTION Most common problem in children below 5 years. In this age group they get about 6 8 episodes per year. It includes infections of nasal cavity, throat,
More informationINTRODUCTION TO UPPER RESPIRATORY TRACT DISEASES
Upper Respiratory Tract Infections Return to Syllabus INTRODUCTION TO UPPER RESPIRATORY TRACT DISEASES General Goal: To know the major mechanisms of defense in the URT, the major mechanisms invaders use
More informationA Clinical Index to Define Risk of Asthma in Young Children with Recurrent Wheezing
A Clinical Index to Define Risk of Asthma in Young Children with Recurrent Wheezing JOSÉ A. CASTRO-RODRÍGUEZ, CATHARINE J. HOLBERG, ANNE L. WRIGHT, and FERNANDO D. MARTINEZ Respiratory Sciences Center,
More informationEvolution of asthma from childhood. Carlos Nunes Center of Allergy and Immunology of Algarve, PT
Evolution of asthma from childhood Carlos Nunes Center of Allergy and Immunology of Algarve, PT allergy@mail.telepac.pt Questionnaire data Symptoms occurring once or several times at follow-up (wheeze,
More informationAsthma: a major pediatric health issue Rosalind L Smyth
Asthma: a major pediatric health issue Rosalind L Smyth University of Liverpool, Institute of Child Health, Alder Hey Children s Hospital, Liverpool L12 2AP, UK Corresponding author: Rosalind L Smyth (e-mail:
More informationEpidemic of Asthma in Pittsburgh
Epidemic of Asthma in Pittsburgh Deborah A. Gentile, MD Associate Professor of Medicine Temple University School of Medicine Director of Clinical Research Division of Allergy, Asthma, Immunology Department
More informationGut Lung Axis Implication of the Gut Microbiota beyond its niche
Gut Lung Axis Implication of the Gut Microbiota beyond its niche Reema Subramanian PhD Candidate (4 th year) Supervisor: Prof. Margaret Ip Department of Microbiology, CUHK Joint Graduate Student Seminar
More informationMicrobiomes of the Built Environment: Homes
Microbiomes of the Built Environment: Homes Tiina Reponen, PhD, Professor Center for Health Related Exposure Assessment Department of Environmental Health University of Cincinnati Microbiomes of the Built
More informationWeb appendix: Supplementary data
Web appendix: Supplementary data Azad MA, Coneys JG, Kozyrskyj AL, Field CJ, Ramsey CD, Becker AB, Friesen C, Abou-Setta AM, Zarychanski R. Probiotic supplementation during pregnancy or infancy for the
More informationTips on managing asthma in children
Tips on managing asthma in children Dr Ranjan Suri Consultant in Respiratory Paediatrics Bupa Cromwell Hospital Clinics: Friday (pm) Asthma in Children Making the diagnosis Patterns of childhood asthma
More informationAsthma from birth to age 23: incidence and relation to prior and concurrent atopic disease
Thorax 1992;47:537-542 537 Asthma from birth to age 23: incidence and relation to prior and concurrent atopic disease Department of Public Health Sciences, St George's Hospital Medical School, London SW17
More informationRunning Head: BREAST-FEED! Stop the Wheeze 1. Stop the Wheeze, Breast-Feed! Allie Thomas and Stephanie Keys University of North Carolina at Asheville
Running Head: BREAST-FEED! Stop the Wheeze 1 Stop the Wheeze, Breast-Feed! Allie Thomas and Stephanie Keys University of North Carolina at Asheville Running Head: BREAST-FEED! Stop the Wheeze 2 Asthma
More informationDistinction and Overlap. Allergy Dpt, 2 nd Pediatric Clinic, University of Athens
Asthma Phenotypes: Distinction and Overlap Nikos Papadopoulos Allergy Dpt, 2 nd Pediatric Clinic, University of Athens Asthma as a syndrome From the Iliad to ADAM 33 and back again Bronchoconstriction,
More informationAsthma Publications: Year in Review
Asthma Publications: Year in Review Elisa Thompson, APRN, CNP, AE-C Oklahoma Allergy and Asthma Clinic Gregory Metz, MD, AE-C Oklahoma Allergy and Asthma Clinic Clinical Associate Professor of Medicine,
More informationAsthma: Classification, Management, Prevention and New Treatments
Asthma: Classification, Management, Prevention and New Treatments Cori Daines, MD, Professor Pediatric Pulmonary Medicine University of Arizona April 28, 2018 I have no relevant financial relationships
More informationThe Enigma of the Infant Microbiome
The Enigma of the Infant Microbiome 3 rd Microbiome R&D and Business Collaboration Forum Europe London, April 2016 David J. Kyle, CEO, Evolve Biosystems Inc Microbiome diversity is a good thing. Modern
More informationParental antibiotics and childhood asthma : a population-based study. Örtqvist, A.K.; Lundholma, C.; Fang, F.; Fall, T.; Almqvist, C.
This is an author produced version of a paper accepted by Journal of Allergy and Clinical Immunology. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal
More informationThe case for extra fine particle ICS:! to cover the entire lung!
The case for extra fine particle ICS: to cover the entire lung Richard J. Martin, M.D. Chairman Department of Medicine National Jewish Health The Edelstein Chair in Pulmonary Medicine Professor of Medicine
More informationDecreased lung function precedes severe respiratory syncytial virus infection and post-respiratory syncytial virus wheeze in term infants
ORIGINAL ARTICLE PAEDIATRIC PULMONOLOGY Decreased lung function precedes severe respiratory syncytial virus infection and post-respiratory syncytial virus wheeze in term infants Kim Zomer-Kooijker 1, Cuno
More informationBronchial asthma. E. Cserháti 1 st Department of Paediatrics. Lecture for english speaking students 5 February 2013
Bronchial asthma E. Cserháti 1 st Department of Paediatrics Lecture for english speaking students 5 February 2013 Epidemiology of childhood bronchial asthma Worldwide prevalence of 7-8 and 13-14 years
More informationEmerging Respiratory Infections NZ Amanda McNaughton Respiratory Physician CCDHB Wellington
Emerging Respiratory Infections NZ 2015 Amanda McNaughton Respiratory Physician CCDHB Wellington Respiratory Infection: overview Influenza virus Clinical picture Emerging infection New Zealand Influenza
More informationVinita Rane Supervisor: Maryza Graham
Old bug, new tricks Vinita Rane Supervisor: Maryza Graham 6 week old female Initial presentation (outside Monash): Unwell since 3/52 old Cough, associated with cyanotic episodes Coryza Lethargy Vomiting
More informationInfluenza A (H1N1)pdm09 in Minnesota Epidemiology
Influenza A (H1N1)pdm09 in Minnesota Epidemiology Infectious Disease Epidemiology, Prevention and Control Division PO Box 64975 St. Paul, MN 55164-0975 Number of Influenza Hospitalizations by Influenza
More informationNasal and Sinus Microbiome: the potential for microbiota-targeted therapeutics
Nasal and Sinus Microbiome: the potential for microbiota-targeted therapeutics Katherine P. Lemon, M.D., Ph.D. Microbiome Transplantation Working Group December 3, 2015 & Boston Children s Hospital Microbes
More informationYou Can Observe a Lot By Just Watching. Wayne J. Morgan, MD, CM
You Can Observe a Lot By Just Watching Wayne J. Morgan, MD, CM Disclosures Genentech Epidemiological Study of Cystic Fibrosis, Scientific Advisory Group CF Foundation Data Safety Monitoring Board Registry/Comparative
More informationAn Update in COPD John Hurst PhD FRCP
An Update in COPD John Hurst PhD FRCP Reader in Respiratory Medicine / Honorary Consultant University College London / Royal Free London NHS Foundation Trust j.hurst@ucl.ac.uk What s new in COPD papers
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE 1 Guideline title SCOPE Bronchiolitis: diagnosis and management of bronchiolitis in children. 1.1 Short title Bronchiolitis in children 2 The remit The
More informationEPIDEMIOLOGICAL INVESTIGATIONS IN UNDERSTANDING HEALTH IMPACTS OF HUMAN BUILT ENVIRONMENT INTERACTIONS
EPIDEMIOLOGICAL INVESTIGATIONS IN UNDERSTANDING HEALTH IMPACTS OF HUMAN BUILT ENVIRONMENT INTERACTIONS JOANNE E. SORDILLO, SCD HARVARD MEDICAL SCHOOL, BRIGHAM AND WOMEN S HOSPITAL CHANNING DIVISION OF
More informationOseltamivir (Tamiflu ) for Acute Influenza. John Collins Spring 2014 BME 270
Oseltamivir (Tamiflu ) for Acute Influenza John Collins Spring 2014 BME 270 Key Points About Oseltamivir for Treating Acute Influenza Infections Influenza = RNA virus (replicates genome by RNA- dependent
More informationMolecular mechanisms in atopic eczema - why do they ma6er in the clinic?
Molecular mechanisms in atopic eczema - why do they ma6er in the clinic? Sara Brown Professor of Molecular & Gene0c Dermatology Wellcome Trust Senior Fellow in Clinical Research Professor of Molecular
More informationRecent advances in the management of pre-school wheeze
Recent advances in the management of pre-school wheeze A Bush Abstract Pre-school wheeze is very common and often difficult to treat. Most children do not require any investigations, only a detailed history
More informationHealth professionals. 8Asthma. and Wheezing in the First Years of Life. A guide for health professionals
Health professionals 8Asthma and Wheezing in the First Years of Life A guide for health professionals Asthma and Wheezing in the First Years of Life An information paper for health professionals The aim
More informationDiscrimination, Psycho-Social Stress and the Relationship to Non-Atopic Neutrophilic Asthma and Other Asthma Phenotypes
Discrimination, Psycho-Social Stress and the Relationship to Non-Atopic Neutrophilic Asthma and Other Asthma Phenotypes November 3, 2017 Neeta Thakur, MD MPH Neeta.Thakur@ucsf.edu OVERVIEW Asthma as a
More informationPreschool Wheeze. AC Jeevarathnum 04/03/16. Paediatric Pulmonologist Steve Biko Academic Hospital
Preschool Wheeze AC Jeevarathnum Paediatric Pulmonologist Steve Biko Academic Hospital MBBCh FcPaed(SA) MMED Dip Allergy(SA) Cert Pulm(Paed)(SA) European Respiratory Diploma 04/03/16 Overview Introduction
More informationEarly-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma
Early-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma Merci M. H. Kusel, MBBS, PhD, a Nicholas H. de Klerk, MSc, PhD, a Tatiana Kebadze,
More informationPaediatric Update. Pre-School Wheeze: Decrees and pleas for the under three s. Julian Vyas Respiratory Paediatrician STARSHIP HOSPITAL
Pre-School Wheeze: Decrees and pleas for the under three s Julian Vyas Respiratory Paediatrician STARSHIP HOSPITAL 8th July 2015 No Conflicts of Interest to Declare what is wheeze? Definition: A wheeze
More informationThe McMaster at night Pediatric Curriculum
The McMaster at night Pediatric Curriculum Community Acquired Pneumonia Based on CPS Practice Point Pneumonia in healthy Canadian children and youth and the British Thoracic Society Guidelines on CAP Objectives
More informationFactors Influencing Gender Differences in the Diagnosis and Treatment of Asthma in Childhood: The Tucson Children s Respiratory Study
Pediatric Pulmonology 41:318 325 (2006) Original Articles Factors Influencing Gender Differences in the Diagnosis and Treatment of Asthma in Childhood: The Tucson Children s Respiratory Study Anne L. Wright,
More informationThe burden of asthma on the US Healthcare system and for the State of Texas is enormous. The causes of asthma are multifactorial and well known.
The burden of asthma on the US Healthcare system and for the State of Texas is enormous. The causes of asthma are multifactorial and well known. There are also indications that rural counties have a higher
More informationAcute Wheezing Emergencies: From Young to Old! Little Wheezers in the ED: Managing Acute Pediatric Asthma
Acute Wheezing Emergencies: From Young to Old! Little Wheezers in the ED: Managing Acute Pediatric Asthma Talk Outline Case Delivery of bronchodilators Meter-dose inhalers and spacers Continuous nebulization
More informationAsthma and Its Many Unmet Needs: Directions for Novel Therapeutic Approaches
Asthma and Its Many Unmet Needs: Directions for Novel Therapeutic Approaches William W. Busse,, M.D. University of Wisconsin School of Medicine and Public Health Madison, WI, USA Disclosure Slide Employment
More informationMaternal food consumption during pregnancy and the longitudinal development of childhood asthma
Maternal food consumption during pregnancy and the longitudinal development of childhood asthma Saskia M. Willers, Alet H. Wijga, Bert Brunekreef, Marjan Kerkhof, Jorrit Gerritsen, Maarten O. Hoekstra,
More informationCHILD DAY CARE AND INFECTIONS: IS THERE A WAY TO MINIMIZE THEM?
CHILD DAY CARE AND INFECTIONS: IS THERE A WAY TO MINIMIZE THEM? Diego L. Van Esso. Primary Health Care Center Pare Claret Catalan Institute of Health Barcelona. Spain Paris, 19th of february 2011 THE NAME
More informationPerinatal Nutrition. Disclosure Statement. Annual Meeting of the NASPGHAN. Keynote Lecture: Nutrients in the Perinatal Environment: Lessons Learned
Annual Meeting of the NASPGHAN Chicago, ILL October 10-13, 2013 Keynote Lecture: Nutrients in the Perinatal Environment: Lessons Learned Allan Walker, M.D. Boston, MA Disclosure Statement Dr. Allan Walker
More information