Prevalence and Predictors of Uncontrolled Asthma in Children Referred for Asthma and Other Atopic Diseases.

Background: Uncontrolled asthma in children is still highly prevalent despite the availability of effective asthma treatment. We investigated 1) the prevalence of uncontrolled asthma among children referred for asthma and referred for atopic diseases other than asthma (ie food allergy, allergic rhinitis or atopic dermatitis) to secondary care; and 2) the predictors associated with uncontrolled asthma.

Methods: All children (4 to 18 years) referred for asthma or atopic diseases other than asthma to 8 secondary care centers in The Netherlands were invited to an electronic portal (EP).

Episodic viral wheeze and multiple-trigger wheeze in preschool children are neither distinct nor constant patterns. A prospective multicenter cohort study in secondary care.

Objectives: To evaluate whether episodic viral wheeze (EVW) and multiple-trigger wheeze (MTW) are clinically distinguishable and stable preschool wheezing phenotypes.

Methods: Children of age 1 to 4 year with recurrent, pediatrician-confirmed wheeze were recruited from secondary care; 189 were included. Respiratory and viral upper respiratory tract infection (URTI) symptoms were recorded weekly by parents in an electronic diary during 12 months.

Asthma medication in children who are overweight/obese: justified treatment?

Background: The prevalence of asthma and obesity have increased over the last decades. A possible association between these two chronic illnesses has been suggested, since the prevalence of asthmatic symptoms rises with increasing Body Mass Index (BMI). However, asthma is only one of several possible causes of shortness of breath in obese children.

Screening children for pulmonary arteriovenous malformations: Evaluation of 18 years of experience.

Background: Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disease with multi-systemic vascular dysplasia. Early diagnosis through screening is important to prevent serious complications. How best to screen children of affected parents for pulmonary arteriovenous malformations (PAVMs) is often subject to debate.

Sensitization predicts asthma development among wheezing toddlers in secondary healthcare.

Introduction: Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain.

Respiratory tract infections and asthma control in children.

Introduction: Asthma control is considered the major goal of asthma management, while many determinants of control are difficult to modify. We studied the association between respiratory infection episodes (RTIs) of various types and asthma control.

Methods: Cross-sectional data were used from children aged 4-18 years with physician-diagnosed asthma who participated in a web-based electronic portal for children with asthma, allergies or infections.

Diagnostic properties of C-reactive protein for detecting pneumonia in children.

Background: The diagnostic value of C-reactive protein (CRP) level for pneumonia in children is unknown. As a first step in the assessment of the value of CRP, a diagnostic study was performed in children at an emergency department (ED).

Methods: In this cross-sectional study, data were retrospectively collected from children presenting with suspected pneumonia at the ED of Antonius Hospital Nieuwegein in The Netherlands between January 2007 and January 2012.

The expert network and electronic portal for children with respiratory and allergic symptoms: rationale and design.

Data on baseline characteristics of children with asthma to predict individual treatment responses are lacking. We aimed to set up a data-collection system which can easily fill this gap in clinical practice.A web-based application was developed, named 'Portal for children with respiratory and allergic symptoms', hereafter called Electronic Portal (EP).

[Diagnosis of fetal alcohol spectrum disorders].

Prenatal alcohol exposure may cause decreased growth of the child, congenital abnormalities, specific facial characteristics, and, most importantly, mental retardation and behavioural disorders, all known as fetal alcohol spectrum disorders (FASD). A significant number of pregnant women in the Netherlands drink alcohol, but the prevalence of FASD in our country is unknown. Repeated and high peak blood alcohol concentrations, for example in the case of binge drinking by the mother, result in more severe abnormalities; a safe limit for alcohol consumption in pregnancy cannot be defined.

Atopic disease and exhaled nitric oxide in an unselected population of young adults.

Background: Several studies have reported elevated levels of fractional exhaled nitric oxide (FeNO) in atopic patients, particularly in asthmatic patients, suggesting that FeNO is a marker of bronchial inflammation. However, the independent influence of different atopic entities (eczema, allergic rhinitis, and asthma) on FeNO has never been studied in the general population.

Objective: To study the influence of a questionnaire-based diagnosis of atopic diseases and IgE and lung function measurements on FeNO levels.

[Wheezing and cough related to congenital airway abnormalities in young infants].

Two girls developed symptoms of wheezing which started shortly after birth. The symptoms did not respond to bronchodilators. At the age of 5 months, the first infant developed severe respiratory distress with decreased left-sided breathing sounds on auscultation.

Prediction of asthma in young adults using childhood characteristics: Development of a prediction rule.

Objective: To develop an easily applicable prediction rule for asthma in young adulthood using childhood characteristics.

Methods: A total of 1,055 out of 1,328 members of a Dutch birth cohort were followed from 2 to 21 years of age. Univariate and multivariate logistic regression analyses were used to evaluate the predictive value of childhood characteristics on asthma at 21 years of age.

Persistence of upper respiratory tract infections in a cohort followed from childhood to adulthood.

Objective: To assess (1) prevalences of recurrent URTIs (rURTIs) and relapsing/persistent rURTIs and associated medical consumption between 0 and 21 years of age and (2) whether rURTIs experienced in early life predispose to upper airway disease later in life.

Methods: A cohort of all children born in Nijmegen, The Netherlands, between September 1982 and September 1983, was assessed repeatedly from 2 to 21 years of age with questionnaires regarding infections of the upper respiratory tract (URTIs), use of antibiotics, ENT operations and known risk factors for URTIs.

Results: One hundred and sixty-one of the 693 cohort member (23%) suffered from relapsing rURTIs between 0 and 21 years of age, whereas only 7 (1%) suffered from persistent rURTIs throughout this period.

Recurrent childhood upper respiratory tract infections do not reduce the risk of adult atopic disease.

Background: Children of large families and those attending day care are at increased risk of respiratory tract infections, which in turn may protect against the development of allergic disease. Longitudinal studies investigating these associations beyond childhood are, however, scarce.

Objective: To investigate the association between childhood recurrent upper respiratory tract infections (URTI) and asthma, allergic rhinitis (AR) and eczema in adulthood.

Adenoidectomy and/or tonsillectomy in childhood is not associated with atopic disease later in life.

Objective: To investigate the association between adenoidectomy and/or tonsillectomy in childhood and asthma, allergic rhinitis (AR), and eczema in adolescence.

Methods: Longitudinal birth cohort study of 1328 members born in the city of Nijmegen. Information on ear-nose-throat surgery was documented at 2, 4, and 8 years of age.