Utility and efficiency of methacholine challenge testing in evaluating pediatric asthma: unraveling the diagnostic conundrum.

This study investigated the clinical utility and efficiency of MCT at a tertiary center in evaluating pediatric asthma. Methods: Retrospective chart review was done for all MCT done at a tertiary center over a six year period (2011-2017). Demographics, referring provider, referral diagnosis, current symptoms with and without exercise, and baseline spirometry were collected. Pretest probability of asthma was assigned by author (RB) who was blinded to MCT results and PC20. Post-test probability of asthma was assigned based on pretest probability, MCT result (+/-), and PC20. Three assigned asthma probability categories were "unlikely" "likely", and "very likely". Results: Of 172 subjects (91 Females, age range 5-21 years), 64.9% of MCT results (n = 111)) were negative and 35.1% (n = 60)) were positive. One was inconclusive. Those who tested positive were shorter, lighter, younger and had lower forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio than those who tested negative (p 
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research

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Conclusion There is still a great opportunity to improve the utility of IOS by developing more computer-aided robust classifiers, specifically for the asthmatic children population as the classification studies performed to date (1) are limited in number, (2) include features derived from tests that are not optimally suitable for children, (3) are solely bi-class (mostly asthma and non-asthma) and therefore fail to include different degrees of peripheral obstruction for disease prevention and control and (4) lack of validation in cases that focus on multi-class classification of the different degrees of peripheral airway o...
Source: Biomedizinische Technik/Biomedical Engineering - Category: Biomedical Engineering Tags: Biomed Tech (Berl) Source Type: research
Abstract Introduction: Few investigations have related objective assessments of indoor air pollutants to respiratory health in farmers, in spite of the many rural environmental hazards to which they are exposed. Chemical air pollution has been particularly neglected. Objective: We investigated the relationships of indoor exposure to particulate matter (PM) and volatile organic compounds (VOCs) to respiratory health in farmers. Methods: Nineteen VOCs (5 families) and PM (from ultrafine to total suspended particles (TSP)) were objectively assessed in dwellings and workplaces in 109 French farmers du...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Multidiscip Respir Med Source Type: research
Conclusion The obesity-asthma link is mainly driven by visceral fat, independent of total fat mass. Hence, abdominal fat might contribute to asthma development. PMID: 31597047 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Am J Respir Crit Care Med Source Type: research
CONCLUSIONS: These findings extend a previous cross-sectional model test using a more comprehensive model and longitudinal data and highlight the importance of considering within-group differences for diagnosis and treatment of children coming from the vastly heterogeneous Latino umbrella group. TRIAL REGISTRATION: Trial number NCT01099800. PMID: 31586174 [PubMed - as supplied by publisher]
Source: Annals of Behavioral Medicine - Category: Psychiatry & Psychology Authors: Tags: Ann Behav Med Source Type: research
Conclusion: This case highlights the need to include paradoxical response to SABAs in the differential of a patient with poorly controlled asthma. It also provides an example of successful treatment of a pediatric patient with a class of medications previously reserved for adults with chronic obstructive pulmonary disease. PMID: 31573361 [PubMed - as supplied by publisher]
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
ConclusionsIgE against rAsp f1 and f2 (using receiver-operating characteristic–derived cutoffs) were found to be the most useful in differentiating ABPA from ASA. Because this study was conducted at a single center, our results require further validation.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Authors: Ciprandi G, Cirillo I Abstract Introduction: The forced expiratory flow between 25% and 75% of forced vital capacity (FEF25-75) is a spirometry parameter that may be useful in many clinical settings. Values
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
AbstractIntroductionFew investigations have related objective assessments of indoor air pollutants to respiratory health in farmers, in spite of the many rural environmental hazards to which they are exposed. Chemical air pollution has been particularly neglected.ObjectiveWe investigated the relationships of indoor exposure to particulate matter (PM) and volatile organic compounds (VOCs) to respiratory health in farmers.MethodsNineteen  VOCs (5 families) and PM (from ultrafine to total suspended particles (TSP)) were objectively assessed in dwellings and workplaces in 109 French farmers during a week. To take into a...
Source: Multidisciplinary Respiratory Medicine - Category: Respiratory Medicine Source Type: research
ConclusionThe results demonstrate that the MST distance strongly correlates with VO2peak, measured through CPET, and the main physiological variable responses were similar between both tests. Our results provide additional data for the use of the MST to assess exercise capacity in children and adolescents with STRA.
Source: Frontiers in Physiology - Category: Physiology Source Type: research
BackgroundAspirin desensitization and treatment benefits most patients with aspirin ‐exacerbated respiratory disease (AERD), although some patients fail therapy. Our objective was to assess whether recent endoscopic sinus surgery (ESS) improved aspirin treatment outcomes in AERD patients who initially failed aspirin therapy.MethodsOutcomes of aspirin desensitization and treatment in AERD patients prospectively enrolled were assessed preoperatively and at 4, 12, and 24 weeks after ESS by determining changes in Asthma Control Test (ACT) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores and respiratory fun...
Source: International Forum of Allergy and Rhinology - Category: Allergy & Immunology Authors: Tags: ORIGINAL ARTICLE Source Type: research
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