The fraction of exhaled nitric oxide (FeNO) has gained interest as a non-invasive tool to measure airway inflammation in asthma since it reflects allergic inflammation. Recent controlled clinical studies have, however, questioned its role in the management of asthma in children. To assess the clinical value of FeNO in paediatric asthma management, a meta-analysis was performed on the controlled studies of childhood asthma management guided by repeated FeNO measurements, and relevant publications on the confounders of FeNO were reviewed. The data suggests that utilising FeNO to tailor the dose of inhaled corticosteroids in children cannot be recommended for routine clinical practice since there is a danger of excessive inhaled corticosteroid doses in children without meaningful changes in clinical outcomes. Many disease and non-disease related factors (most importantly atopy, height/age and infection) affect FeNO levels which can easily confound the interpretation.
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http://dx.doi.org/10.1016/j.prrv.2011.11.002 | DOI Listing |
Background: In patients with asthma, bronchoconstriction and airway inflammation both contribute to airway narrowing and airflow limitations, which lead to symptoms and exacerbations. Short-acting beta 2-agonist (SABA)-only rescue therapy addresses only bronchoconstriction and is associated with increased morbidity and mortality. Current asthma management guidelines recommend concomitant treatment of symptoms and inflammation with a fast-acting bronchodilator and inhaled corticosteroid (ICS) as rescue therapy for patients 12 years of age.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
University of Bristol, Bristol, United Kingdom.
Background: Digital health interventions targeting behavior change are promising in adults and adolescents; however, less attention has been given to younger children. The proliferation of wearables, such as smartwatches and activity trackers, that support the collection of and reflection on personal health data highlights an opportunity to consider novel approaches to supporting health in young children (aged 5-11 y).
Objective: This review aims to investigate how smartwatches and activity trackers have been used across child health interventions (for children aged 5-11 y) for different health areas, specifically to identify the population characteristics of those being targeted, describe the characteristics of the devices being used, and report the feasibility and acceptability of these devices for health-related applications with children.
J Asthma
January 2025
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Caregivers of children with asthma can become overwhelmed by the burden of care provision. Guided by the socioecological framework, we examined individual and system-level factors associated with caregiver health-related quality of life (HRQoL) among preschool children (aged two to six years) enrolled in a multilevel home- and school-based asthma educational intervention in Baltimore, Maryland. Primary outcome was caregiver HRQoL measured at baseline and six months.
View Article and Find Full Text PDFPediatr Pulmonol
January 2025
Department of Pediatrics, Hasbro Children's Hospital, Providence, Rhode Island, USA.
Objectives: To examine the extent to which asthma symptom concordance (ASC) or discordance (ASD) is associated with sleep outcomes in children with persistent asthma. Also, to investigate whether the association between ASC and sleep outcomes varies as a function of children's level of asthma control and severity.
Methods: A retrospective data analysis of Project NAPS (Nocturnal Asthma and Performance in School), an observational study which examined asthma and sleep outcomes in children with persistent asthma.
EClinicalMedicine
February 2025
Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, Marburg, Germany.
Unlabelled: Non-communicable diseases (NCDs) characterised by type 2 inflammation, including asthma, allergic rhinitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis, food allergies and eosinophilic esophagitis, are increasing in prevalence worldwide. Currently, there is a major paradigm shift in the management of these diseases, towards the concept of disease modification and the treatment goal remission, regardless of severity and age. Remission as a treatment goal in chronic inflammatory NCDs was first introduced in rheumatoid arthritis, and then adopted in other non-type 2 inflammatory diseases.
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