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1.
Article in Chinese | WPRIM | ID: wpr-930505

ABSTRACT

The prevalence of anaphylaxis, which is underdiagnosed and undertreated, has been increasing recently.It was reported that about one fourth of anaphylaxis patients were children and there were some critical gaps in the initial treatment of anaphylaxis, including epinephrine use, when compared to the guidelines.Since most of anaphylaxis cases happen outside of medical institutions, and could recur unexpectedly, it is important for children with anaphylaxis to get long-term management.In order to improve management of anaphylaxis, a written China Children′s Anaphylaxis Emergency Action Plan (CCAEAP) is developed.It is a tool for children and parents/caregiver to recognize the symptoms and signs of anaphylaxis as early as possible and take proper action immediately, including using a predefined dose of intramuscular epinephrine and accessing to emergency department.

2.
Article in Chinese | WPRIM | ID: wpr-930491

ABSTRACT

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

3.
Article in Chinese | WPRIM | ID: wpr-930480

ABSTRACT

The diagnosis of food allergy in children is one hotspot attracting people′s attention in recent years.The incidence of it shows an increasing trend which exposes problems in the understanding of children′s food allergy in China, especially in the misdiagnosis and missed diagnosis.To further standardize the diagnosis and treatment of food allergy in children, based on the current domestic, foreign guidelines and relevant research evidence, the guideline recommends 16 clinical hot-button issues in the 4 aspects of diagnosis, treatment, prognosis, and prevention.Finally, a diagnosis flowchart has been formulated.The guideline aims to improve the standard diagnosis and treatment of food allergies in children in China.

4.
Article in Chinese | WPRIM | ID: wpr-930479

ABSTRACT

Exercise is medicine.Exercise is not only the cornerstone of children′s normal growth and development, but also the necessary condition of physical and mental health.Moreover, exercise contributes to the management of childhood asthma.Exercise prescription is an effective method for children with asthma, but there is no much experience in China, we should continuously explore and optimize it.Therefore, the level of physical activity could be improved in children with asthma.

5.
Article in Chinese | WPRIM | ID: wpr-930463

ABSTRACT

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) and hospitalizations in infants under 1 year of age, seriously jeopardizing infants′ health.Most hospitalizations (up to 80%) due to RSV-LRTI occur in otherwise healthy infants born at term.At present, no effective treatment and preventative measure against RSV is available domestically.Passive immunization with fully human long-acting monoclonal antibody Nirsevimab offers immediate protection for all infants experiencing their first RSV season with one shot, thus ushering in a new era of prevention of RSV infection among infants.

6.
Article in Chinese | WPRIM | ID: wpr-930459

ABSTRACT

With the emergence of new respiratory virus, it is more apparent for the vulnerability of population to respiratory viral infection.Non-pharmaceutical interventions (NPIs) for respiratory virus infection have become the main way to prevent corona virus disease 2019.Some studies had proven its effectiveness.In addition, the NPIs also significantly reduced the incidence and hospitalization rate of other respiratory disease in children.NPIs for respiratory virus infection in children have its particularity and challenge.In daily life, it is important to guide children how to do the NPIs, so as to protect susceptible children and reduce the disease burden in children′s health system.Therefore, the aerosol transmission, the specificity of the NPIs in children, and the impact on childhood respiratory diseases are described in this article, to improve the prevention of common respiratory diseases in children.

7.
Article in Chinese | WPRIM | ID: wpr-930430

ABSTRACT

Acute respiratory tract infection is the most common infectious disease in children, which seriously threatens children′s health.Rapid and accurate etiological diagnosis is of great significance for the clinical treatment and control of these diseases.Pathogen nucleic acid test was applied and became the main method of respiratory tract infection diagnosis for its high sensitivity and specificity.To regulate the application of pathogen nucleic acid amplification test in respiratory tract infection in children, improve the diagnosis level, expert consensus on nucleic acid amplification test of respiratory pathogens in children was prepared to guide the application and promote pathogens diagnosis ability.

8.
Article in Chinese | WPRIM | ID: wpr-930405

ABSTRACT

Objective:A case of cystic fibrosis admitted in the Respiratory Department of Beijing Children′s Hospital, Capital Medical University in June 2018 and underwent lung transplantation later was analyzed retrospectively.A 10-year-old girl had intermittent productive cough for more than 4 years with clubbed-finger.The lung high resolution CT (HRCT) showed bronchiectasis and mucus impaction, and the nasal sinus HRCT showed sinusitis.She had cystic fibrosis transmembrane conductance regulator ( CFTR) gene complex heterozygous mutation and positive sweat test.The immunoglobulin E (IgE) level and eosinophil count increased, and aspergillus fumigatus-specific IgE was positive.She was diagnosed as cystic fibrosis, allergic bronchopulmonary aspergillosis and sinusitis.Anti-infection, glucocorticoid and symptomatic treatment were given.During the following 21 months, the child had repeated respiratory difficulties and respiratory failure.Her lung function declined.Bilateral lung transplantation was performed in March 2020.She had a good recovery at more than 1 year and 3 months postoperatively.

9.
Article in Chinese | WPRIM | ID: wpr-907972

ABSTRACT

Anaphylaxis is a hypersensitivity reaction that is rapid in onset, multi-system involved and can be fatal.Adrenaline is the first-line treatment of anaphylaxis.Adrenaline autoinjector is an important device in emergent situation.In European Academy of Allergy and Clinical Immunology anaphylaxis guideline updated in 2021, adrenaline autoinjector is systemically described and recommended.The following interpretation is focused on adrenaline autoinjector, including advantages, indications for prescription, pharmacokinetic data, dose and long-term management, aimed to enhance understanding of this device and standardize future application.

10.
Article in Chinese | WPRIM | ID: wpr-907971

ABSTRACT

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.

11.
Article in Chinese | WPRIM | ID: wpr-907970

ABSTRACT

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.

12.
Article in Chinese | WPRIM | ID: wpr-907952

ABSTRACT

The World Health Organization published guidelines on physical activity, sedentary behavior, and sleep for children under 5 years old in 2019 and then published guidelines on physical activity and sedentary behavior for children and adolescents aged 5-17 years in 2020 for the purpose of improving the physical activity level of people around the world.The physical activity guidelines for children under the age of 5 and the physical activity recommendations for children aged 5-17 in the 2020 guidelines are interpreted, summarized the suggestions on children in physical activity, and provided help for pediatricians with suggestions on physical activity in children.

13.
Article in Chinese | WPRIM | ID: wpr-907933

ABSTRACT

Guideline or consensus for the vaccination of children with special conditions like immunocompromised children may be more suitable for pediatricians.However, the vaccination of children in China is mainly performed by general practitioners or child health care practitioners in community health service centers.They need to master the screening knowledge of contraindications and precautions for the vaccination of children, and make the decision to referral to specialists.Based on the technical guidelines for Immunization of National Health Commission of the People′s Republic of China, Best Practices Guidance of the Advisory Committee on Immunization Practices and contraindications and precautions proposed by the Immunization Action Coalition, 20 suggestions for primary screening of children with vaccination contraindications and referral recommendations for primary care providers were developed by experts from the Integration of Medicine and Prevention in Children of Health Commission of Shenzhen Municipality.

14.
Article in Chinese | WPRIM | ID: wpr-907879

ABSTRACT

Objective:To summarize the clinical features of children with autosomal dominant hyper-IgE syndrome (AD-HIES) and the differential diagnosis of hyper-IgE syndrome and allergic diseases as well.Methods:All clinical data, including general information, clinical features, and genetic changes, from 7 children with AD-HIES who were diagnosed in Beijing Children′s Hospital Affiliated to Capital Medical University from April 2016 to June 2020 were analyzed retrospectively.The diagnostic criteria are based on the National Institutes of Health′s (NIH)′s hyper-IgE syndrome score and combined with the results of gene detection, shown as follows: (1) NIH score over 40, with signal transducer and activator of transcription 3 gene ( STAT3) pathogenic mutation; (2) NIH score between 20 and 40, with reported STAT3 pathogenic mutation; (3) NIH score less than 20 points was excluded. Results:There were 3 males and 4 females.The onset age of 7 cases was within 2 months after birth, and the mean age at diagnosis was 3 years old.All seven cases had recurrent skin or lung infections, with 4 cases having skin and lung infections, 1 case of skin abscesses at the BCG vaccination site, and 2 cases without skin infection suffering from recurrent pneumonia.The mean onset age of skin abscess in 5 cases was 1.5 years, and pus culture of 3 cases were Staphylococcus aureus.Four cases developed bullae and 6 cases had lung infections.Four cases had otitis media, and oral thrush was seen in 4 cases.One case of skin and lung infection developed liver abscess and sepsis.Seven cases had eczema, which was disco-vered in the neonatal period for 6 cases.Four cases had the symptoms of eczema for the first visit.Two cases had food allergy, and 1 case had recurrent wheezing within 1 year old.The serum IgE level and blood eosinophil count in 7 children were elevated.All children had heterozygous pathogenic mutations in STAT3.Six patients had de novo mutations.There were 6 different mutation sites.The 4 mutation sites were reported: c.1145G>A, c.1144C>T, and c. 1699A>G were missense mutations, and c. 1139+ 5G>A was splicing mutation.Two mutation sites had not been reported: c.1031A>C was missense mutation, and c. 2050G>T was nonsense mutation.The pathogenic grade of them were likely pathogenic, and the NIH score of 2 cases were above 40 score, which was consistent with the clinical diagnosis of hyper-IgE syndrome. Conclusions:Eczema is a common and early clinical manifestation of hyper-IgE syndrome, along with elevated IgE levels and eosinophil counts that need to be differentiated from allergic diseases.On the contrary, it often had recurrent skin abscesses or pneumonia, which was prone to bullae.The clinical manifestations of young children were atypical, and genetic testing was helpful for early diagnosis.

15.
Article in Chinese | WPRIM | ID: wpr-907878

ABSTRACT

Objective:To analyze the long-term prognosis and prognostic factors of allergic bronchopulmonary aspergillosis(ABPA) in children suffering from cystic fibrosis (CF).Methods:An observational study was performed.All children who were admitted to the Department of Respiratory, Beijing Children′s Hospital, Capital Medical University from August 2014 to June 2018, with more than 2 years of followed up for the diagnosis of CF accompanied by ABPA were involved.Results:Three children met the inclusion criteria, with 2 boys and 1 girl, and their diagnostic age were 14, 8 and 9 years old, respectively.The follow-up duration ranged from 2 to 6 years.All the 3 cases were treated with systemic corticosteroids and antifungal agent.In case 1, the initial dose of prednisone was 0.75 mg/(kg·d), and the course of treatment was more than 5 years.The corticosteroid-dependent patient suffered from expectoration and chest pain, and radiographic findings indicated exacerbation, while his lung function was normal.Treating with initial dose of prednisone 2 mg/(kg·d) for 9 months, case 2 had normal serum immunoglobulin E(IgE) concentration, but his pulmonary artery was infiltrated by lesions, thus leasing to lobectomy.In case 3, the initial dose of prednisone was 0.6 mg/(kg·d), and the course of treatment was 18 months.And she developed persistent hypoxemia, and decreased pulmonary function, so lung transplantation was necessary 2 years after diagnosis.Conclusions:Systemic glucocorticoid combined with antifungal therapy is the main treatment for CF with ABPA, but there are individual differences in the efficacy.The level of serum total IgE is not always consistent with lung function and chest images.The overall prognosis is poor, and it is infeasible to evaluate the prognosis by single factor.

16.
Article in Chinese | WPRIM | ID: wpr-907875

ABSTRACT

Objective:To investigate the physical activity level and sedentary time of school-age children with bronchial asthma (asthma).Methods:Asthmatic children aged 6 to 17 years old who used Chinese Children′s Asthma Action Plan on smartphones from March to May 2021 were included in the study.International Physical Activity Questionnaire (IPAQ) was employed to assess exercise level, and Health Behavior in School-Aged Children (HBSC) was employed to evaluate sedentary behavior.The Childhood Asthma Control Test (C-ACT), and the Asthma Control Test (ACT) were employed to assess asthma control status.Clinical information was collected, including age, gender, body mass index (BMI), respiratory symptoms after exercise and adherence to medication.Results:A total of 265 valid questionnaires were collected, with a median age of 9.4 (7.5, 11.6) years old.The rate of ACT/C-ACT score ≥ 20 was 74.0% (196 cases). There were 52 cases with high, 110 cases with medium and 103 cases with low activity levels.There was no significant correlation between activity level and gender, BMI, regular drug use or educational level of parents ( P>0.05). The number of children with sedentary time ≥2 hours was 204 on weekdays and 233 on weekends, respectively, and the number on weekends was significantly higher (87.9% vs.77.0%, χ2=10.967, P=0.001). There were 160 cases (60.4%) with respiratory symptoms after exercise, with the most common symptoms including cough(72 cases), wheezing(53 cases), dyspnea(43 cases), chest pain(16 cases) and chest tightness(15 cases). Despite the symptoms, 79.6%(211 cases)of all children had the subjective intention to participate in physical activities.The incidence of post-exercise symptoms in children with ACT/C-ACT scores ≥20 was significantly lower than that in children with ACT/C-ACT≤19 (37.8% vs.72.5%, χ2=10.967, P<0.001). Conclusions:Most school-age children with bronchial asthma had low to moderate levels of physical activity, and the sedentary time is long.Children with poorly controlled asthma are more likely to develop respiratory symptoms after exercise.Standardized and individualized exercise prescriptions should be further formulated to guide children with asthma to carry out reaso-nable physical exercise.

17.
Article in Chinese | WPRIM | ID: wpr-907869

ABSTRACT

Eczema and elevated blood immunoglobulin E are not only characteristics of atopic dermatitis, but may also be a manifestation of skin-related monogenic diseases and certain syndromes or inborn error of immunity, such as hyper IgE syndrome, Wiskott-Aldrich syndrome, immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome, Omenn syndrome, atypical DiGeorge syndrome, Comèl-Netherton syndrome, severe dermatitis-multiple allergies-metabolic wasting syndrome, and prolinase deficiency.These monogenic diseases are present as severe eczema or eczema-like rash in childhood, and some of them may have an elevated IgE phenotype from infancy.Besides eczema-like rash and elevated IgE, these monogenic diseases also have other associated phenotypes.Therefore, acquaintance with the phenotypic characteristics of these diseases contributes to better identification in clinical practice.Early identification and effective management of these diseases conduce to the improvement in the prognosis.In this paper, the phenotypes of these diseases would be summarized from a clinical perspective in an attempt to provide a basis for clinicians to identify and further manage these diseases.

18.
Article in Chinese | WPRIM | ID: wpr-907868

ABSTRACT

Asthma is the most common chronic respiratory disease in children.Currently, asthma symptoms can be well controlled under initial treatment.For moderate and severe asthma that cannot be controlled by initial treatment, biological therapy is a new option.Among them, the anti-IgE antibody (Omalizumab) is the earliest biological agent to be marketed for the treatment of asthma, followed by a large number of novel monoclonal antibodies targeting different sites.In this paper, the immune mechanism, classification and the development history of biological therapy of asthma were summarized, and the trends of biological therapy of asthma were prospected.

19.
Article in Chinese | WPRIM | ID: wpr-907866

ABSTRACT

Severe asthma imposes a significant burden on patients, families, and healthcare systems.Management is difficult, due to disease heterogeneity, co-morbidities, complexity in care pathways and differences between national or regional healthcare systems.Better understanding of the mechanisms has enabled a stratified approach to the management of severe asthma, supporting the use of targeted treatments with biologicals.However, there are still many issues that require further clarification.These include selection of a certain biological, the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen.

20.
Article in Chinese | WPRIM | ID: wpr-907239

ABSTRACT

Maintaining normal physical activity level is one of the goals of asthma treatment in children with asthma.In order to better understand the relationship between asthma and exercise, it is necessary to summarize the related studies on exercise in children with asthma.This paper overviews the related researches on the benefits of exercise to patients with asthma, the current situation of exercise in children with asthma, exercise-induced bronchoconstriction, and the formulation of exercise prescription in children with asthma, so that clinicians can have a deeper understanding of exercise-related content in children with asthma, in order to better guide children with asthma in exercise.

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