Environmental exposure to Staphylococcus aureus and SEB are associated with asthma symptoms and worse lung function among low-income, urban children with asthma

Background: Ciclesonide (CIC) is an inhaled corticosteroid (ICS) approved for the maintenance treatment of asthma in patients ages ≥ 12 years. The prodrug aspect of CIC is associated with a safety profile that may make it ideal for children. Objective: The objective was to summarize efficacy results from the eight phase III, randomized, double-blind, controlled trials in children with asthma conducted during CIC clinical development. Methods: Four trials compared CIC 40, 80, or 160 µg/day with placebo. Two trials compared CIC 160 µg/day with fluticasone propionate 200 µg/day, one trial compared CIC 80 or 160 µg/day with fluticasone 200 µg/day, and one trial compared CIC 160 µg/day with budesonide 400 µg/day. Results: The primary end point was met by at least two CIC doses versus placebo in the trials in which the primary end point was the change from baseline in lung function outcome (forced expiratory volume in 1 second [FEV1] % predicted or morning peak expiratory flow [PEF]). A trial that compared CIC with placebo did not meet the primary end point of superiority in time-to-first severe wheeze exacerbation or lack of improvement. The primary end point of noninferiority to the active control (fluticasone or budesonide) in the change from baseline in a lung function outcome (FEV1, morning PEF, evening PEF) was met with the CIC 160-µg dose in all active control trials. CIC generally demonstrated statistically significant improvements in forced expiratory flow at 25%‐75% of forced vital capacity, asthma symptoms, rescue medication use, and asthma control when compared with placebo and noninferiority for these outcomes compared with fluticasone or budesonide. Conclusion: In children with asthma, once-daily CIC significantly improved large and small airway function, asthma symptoms, and asthma control, and reduced rescue medication use compared with placebo. CIC was comparable with other ICS used to treat asthma in children, which demonstrated its worth for the pediatric population.

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Relationship of Scabies With Pioderma: As a Risk Factor

SRIWIJAYA JOURNAL OF MEDICINE ◽

10.32539/sjm.v1i1.6 ◽

2018 ◽

Vol 1 (1) ◽

pp. 33-42

Author(s):

Yulia Farida Yahya ◽

Fifa Argentina ◽

Rusmawardiana Rusmawardiana

Keyword(s):

Staphylococcus Aureus ◽

Elementary School ◽

Risk Factor ◽

Low Income ◽

Primary Schools ◽

Pediatric Patients ◽

Group A Streptococcus ◽

Cross Sectional ◽

The Government ◽

Scabies Infestation

Scabies is a parasitic infestation of the skin, that is affecting on the low income and crowded community in many tropical countries, especially developing countries such as Indonesia. Scabies infestation increases the incidence of secondary pyoderma include impetigo, folliculitis, cellulitis, ecthyma, abscess. Secondary pyoderma is a skin infection disease mainly caused by group A Streptococcus (GAS) and Staphylococcus aureus (SA). Pyoderma is a risk factor for the glomerulonephritis infection, rheumatic diseases, which significantly increases morbidity and mortality, causing the government burden. The aim of this study is determining the etiology and correlation of pyoderma infection in scabies patient. To determine sosio-demographic included sex, age in pediatric patients in primary schools (SD) in the district of Kertapati Palembang. The study design was cross sectional, and study samples were new scabies patients in the elementary school (age 6-14-year-old) with or without pyoderma. Clinical findings included history, physical examination and diagnostic procedure, which was investigation of skin scraping specimen material (SSB = skin surface biopsy) in confirmation with dermoscopic polar examination (DS) to show Sarcoptes scabiei mites. Microbiological examination with Gram stain identified the etiology of pyoderma. Results of this study shows that there was a significance relationship between scabies infestation and pyoderma in children in elementary school. Staphylococcus aureus dan GAS are the most common caused of pyoderma in pediatric patients with scabies. Conclusion is there is a significant correlation between scabies and pyoderma. There is a need to provide scabies and pyoderma medication at primary care health center as well as counseling for prevention in Palembang area with crowded population periodically.

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Fungal sensitization and positive fungal culture from sputum in children with asthma are associated with reduced lung function and acute asthma attacks respectively

Clinical & Experimental Allergy ◽

10.1111/cea.13799 ◽

2020 ◽

Author(s):

Kathryn G. Welsh ◽

Karl A. Holden ◽

Andrew J. Wardlaw ◽

Jack Satchwell ◽

William Monteiro ◽

...

Keyword(s):

Lung Function ◽

Acute Asthma ◽

Fungal Culture ◽

Children With Asthma ◽

Fungal Sensitization

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Effects of Dingchuan Decoction on Lung Function and Clinical Effectiveness Rate in Children with Asthma: A Systematic Review and Meta-Analysis

Complementary Medicine Research ◽

10.1159/000512669 ◽

2021 ◽

pp. 1-12

Author(s):

Sheng-Nan Wang ◽

Jia-Li Yan ◽

Shao-Xing Wu ◽

Lei Wu ◽

Yan-Chan Zheng ◽

...

Keyword(s):

Lung Function ◽

Randomized Controlled Trials ◽

Large Scale ◽

Clinical Effectiveness ◽

Controlled Trials ◽

Improvement Rate ◽

Randomized Controlled ◽

Conventional Medication ◽

Effectiveness Rate ◽

Children With Asthma

Dingchuan decoction (DCD) is a traditional Chinese prescription for asthma that remains popular today. To systematically evaluate the effect of DCD on lung function, clinical effectiveness rate, and safety in children with asthma, significant databases were searched for randomized controlled trials from their inception to September 9, 2019. Randomized controlled trials assessing the effect of DCD on lung function and clinical effectiveness rate in children with asthma were included in this meta-analysis. The methodological quality of the included trials was assessed using the Cochrane risk of bias tool. RevMan 5.3 was used for data analysis. Fourteen studies with 1,384 children were reviewed. FEV<sub>1</sub> improvement rate (mean difference [MD] 12.50, 95% confidence interval [CI] 8.72–16.29), PEF improvement rate (MD 14.28, 95% CI 11.08–17.49), and clinical effectiveness rate (relative risk 1.19, 95% CI 1.14–1.25) significantly increased in the DCD group when compared to simple conventional medication. Four trials suggest that DCD is safe for children. In conclusion, the use of DCD combined with conventional medication improves lung function and clinical effectiveness rate better than simple conventional medication. However, the selected trials lack blinding and large-scale studies. Therefore, to better manage DCD in clinical practice, more randomized controlled trials and large-scale studies are required for further evaluation.

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