Defining Asthma in the Preschool-Aged Child

PEDIATRICS ◽  
2002 ◽  
Vol 109 (Supplement_E1) ◽  
pp. 357-361
Author(s):  
Robert C. Strunk
Keyword(s):  
Chart Review ◽  
Skin Testing ◽  
Definitive Diagnosis ◽  
Pulmonary Medicine ◽  
Specific Test ◽  
Sweat Chloride ◽  
Preschool Aged Child ◽  
Aged Child ◽  
Allergy Skin Testing ◽  
Rule Out

A physician faces many challenges in making a definitive diagnosis of asthma in young children. Although there are clinical and historical features consistent with asthma, identical features are present in many other diseases. Furthermore, there is no specific test for asthma. Other diseases must always be ruled out before a definitive diagnosis of asthma is made. Determining whether cough or wheeze is the primary symptom is important because asthma is primarily a wheezing disease. Sweat chloride testing, chest radiography, and allergy skin testing should be performed in children with persistent wheezing to rule out other causes and help support a diagnosis of asthma. Allergy skin testing provides particularly useful information for making a diagnosis of asthma in the preschool-aged child. A chart review of patients presenting consecutively to the Division of Allergy and Pulmonary Medicine provides insight and information on an approach to make an asthma diagnosis for this population.

scholarly journals Penicillin Allergy Skin Testing as an Antibiotic Stewardship Intervention in Hematopoietic Cell Transplant Recipients

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S266-S267 ◽  
Author(s):  
Christopher Kovacs ◽  
Vasilios Athans ◽  
David Lang ◽  
Ronald Sobecks ◽  
Lisa Rybicki ◽  
...  
Keyword(s):  
Antibiotic Stewardship ◽  
Skin Testing ◽  
Hematopoietic Cell ◽  
Penicillin Allergy ◽  
Cell Transplant ◽  
Transplant Recipients ◽  
Hematopoietic Cell Transplant ◽  
Allergy Skin Testing

Controversial Techniques in Allergy

PEDIATRICS ◽  
1988 ◽  
Vol 82 (6) ◽  
pp. 935-937
Author(s):  
GAIL G. SHAPIRO ◽  
JOHN A. ANDERSON
Keyword(s):  
Respiratory Tract ◽  
Physical Examination ◽  
Skin Test ◽  
Skin Testing ◽  
Skin Tests ◽  
Sensitive Test ◽  
Financial Gain ◽  
Specific Antigens ◽  
Laboratory Procedures ◽  
Allergy Skin Testing

Ten years ago a commentary appeared in Pediatrics entitled "Allergy Skin Testing: Science or Quackery?"1 This statement was a rejoinder to a commentary in Pediatrics in 19752 that included allergy skin testing in a list of laboratory procedures that are abused for financial gain. The gist of the reply was that allergy skin tests themselves were not the problem because they were valid bioassays for IgE antibody to specific antigens. Abuse and quackery set in when numerous, indiscriminately chosen skin tests were performed instead of an appropriate history, physical examination, and carefully selected tests based on that evaluation. The allergy skin test was at that time and remains today the most sensitive test for specific allergic antibody in the skin, its presence there reflecting its presence in the blood and respiratory tract.

scholarly journals Outcomes of early repeat sweat testing in infants with cystic fibrosis transmembrane conductance regulator-related metabolic syndrome (CRMS)/CF screen-positive, inconclusive diagnosis (CFSPID)

2021 ◽  
Author(s):  
vito terlizzi ◽  
Laura Claut ◽  
Carla Colombo ◽  
Antonella Tosco ◽  
Alice Castaldo ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Definitive Diagnosis ◽  
First Year ◽  
Transmembrane Conductance Regulator ◽  
Transmembrane Conductance ◽  
Sweat Chloride ◽  
Sweat Testing ◽  
Cf Transmembrane Conductance Regulator ◽  
First Year Of Life

Background: Reaching early and definitive diagnosis in infants with cystic fibrosis (CF) transmembrane conductance regulator-related metabolic syndrome (CRMS)/CF screen-positive, inconclusive diagnosis (CFSPID) is a priority of all CF newborn screening programs. Currently, sweat testing is the gold standard for CF diagnosis or exclusion. We assessed outcomes in a cohort of Italian CRMS/CFSPID infants who underwent repeat sweat testing in the first year of life. Methods: This multicentre, prospective study analysed clinical data and outcomes in CRMS/CFSPID infants born between September 1, 2018 and December 31, 2019, and followed until June 30, 2020. All subjects underwent CF transmembrane conductance regulator (CFTR) gene sequencing and the search for CFTR macrodeletions/macroduplications, and repeat sweat testing in the first year of life. Results: Fifty subjects (median age at end of follow-up, 16 months [range, 7–21 months]) were enrolled. Forty-one (82%) had the first sweat chloride in the intermediate range. During follow up, 150 sweat tests were performed (range, 1–7/infant). After a median follow-up of 8.5 months (range 1–16.2 months), 11 (22%) subjects were definitively diagnosed as follows: CF (n=2 [4%]) at 2 and 5 months, respectively; healthy carrier (n=8 [16%]), at a median age of 4 months (range 2–8 months); and healthy (n=1 [2%]) at 2 months of age. Inconclusive diagnosis remained in 39 (78%) infants. Conclusions: Early repeat sweat testing in the first year of life can shorten the time to definitive diagnosis in screening positive subjects with initial sweat chloride levels in the intermediate range.

Penicillin Allergy Skin Testing: What Do We Do Now?

2007 ◽  
Vol 27 (4) ◽  
pp. 542-545 ◽  
Author(s):  
Jeremy A Schafer ◽  
Noe Mateo ◽  
Garry L Parlier ◽  
John C Rotschafer
Keyword(s):  
Skin Testing ◽  
Penicillin Allergy ◽  
Allergy Skin Testing

Allergy skin testing: Science or quackery?

PEDIATRICS ◽  
1977 ◽  
Vol 59 (4) ◽  
pp. 495-498
Author(s):  
Gail G. Shapiro ◽  
C. Warren Bierman ◽  
Clifton T. Furukawa ◽  
William E. Pierson
Keyword(s):  
Physical Examination ◽  
American Academy ◽  
Surgical Procedures ◽  
Skin Testing ◽  
Skin Tests ◽  
Elective Surgical Procedures ◽  
American Academy Of Pediatrics ◽  
Telephone Calls ◽  
Allergy Skin Testing

A commentary in Pediatrics in September 19751 condemned procedure-oriented fee schedules because they encouraged and rewarded the abuse of laboratory and elective surgical procedures. Allergy skin testing was included in this list. Letters to the American Academy of Pediatrics and telephone calls to the Chairman of the Section on Allergy of the Academy took issue with this inclusion. The commentary, however, was directed toward physicians and allergy laboratories who abuse skin testing rather than toward the procedure itself. It was directed to those who perform innumerable and casually selected skin tests as a substitute for an appropriate history, physical examination, and carefully selected tests based on that evaluation.

Allergy Skin Testing

2021 ◽  
pp. 32-42
Author(s):  
Pudupakkam K Vedanthan ◽  
Harold Nelson
Keyword(s):  
Skin Testing ◽  
Allergy Skin Testing

Short‐wave infrared camera as a novel solution to allergy skin testing

Allergy ◽  
2019 ◽  
Vol 75 (4) ◽  
pp. 965-968 ◽  
Author(s):  
Jody Tversky ◽  
Donald MacGlashan
Keyword(s):  
Skin Testing ◽  
Infrared Camera ◽  
Short Wave ◽  
Short Wave Infrared ◽  
Allergy Skin Testing

Pilot Study: Outcomes of the Full Abdominopelvic Ultrasound Protocol for Diagnosis of Acute Appendicitis in Children: A Retrospective Chart Review

2020 ◽  
Vol 36 (6) ◽  
pp. 530-534
Author(s):  
Robert Dima ◽  
Yongdong Wang ◽  
Sarah Zuccolo ◽  
Michelle Palmer ◽  
Kerry Cheong
Keyword(s):  
Pilot Study ◽  
Acute Appendicitis ◽  
Emergency Room ◽  
Teaching Hospital ◽  
Patient Management ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Sonographic Evaluation ◽  
Suspected Acute Appendicitis ◽  
Rule Out

Objective: Sonographic evaluation for acute appendicitis in children often involves an exhaustive protocol, for which the therapeutic yield has not been formally evaluated. The purpose of the study was to pilot a retrospective chart review of children receiving an abdominopelvic sonogram upon presenting with suspected acute appendicitis. Methods: An annual retrospective chart review was designed to review abdominopelvic sonograms to rule out appendicitis and specifically performed at a Canadian children’s teaching hospital. Studies were excluded if the requisition stated multiple clinical concerns or if the patient was >18 years at the time of the sonogram. Results: Based on 230 patient cases reviewed, alternative diagnostic sonographic findings were found in 141 (61%) charts. Only 18 patient cases (8%) demonstrated both alternative sonographic findings as well as a change in management by the emergency room physician. Conclusion: Alternative diagnostic findings, based on a complete abdominopelvic sonogram, were common (61%) in this chart review but rarely changed patient management.

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