Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
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Pediatr Allergy Immunol · Sep 2016
Review Meta AnalysisMaternal vitamin D status and childhood asthma, wheeze, and eczema: A systematic review and meta-analysis.
Maternal vitamin D status has been reported to be associated with childhood allergic diseases. However, this association remains to be fully elucidated. ⋯ Our meta-analysis found that lower maternal vitamin D during pregnancy was associated with an increased risk of childhood eczema but was not associated with childhood asthma or wheeze. The role of maternal vitamin D as an important protective factor for the development of childhood eczema remains to be elucidated.
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Pediatr Allergy Immunol · Sep 2015
Review Meta AnalysisSystematic review on the use of omalizumab for the treatment of asthmatic children and adolescents.
There are less data on omalizumab treatment in pediatric asthma than in adult population. Thus, to establish the efficacy and safety of subcutaneous omalizumab as an add-on therapy, a systematic review of placebo-controlled studies was performed. ⋯ Data indicate that the efficacy of an add-on omalizumab in patients with moderate-to-severe allergic asthma uncontrolled with recommended inhaled steroid treatment is accompanied by an acceptable safety profile.
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Pediatr Allergy Immunol · Mar 2014
Review Meta AnalysisSystematic review of montelukast's efficacy for preventing post-bronchiolitis wheezing.
Infants often develop reactive airway diseases subsequent to respiratory syncytial virus (RSV) bronchiolitis. Cysteinyl leukotrienes (cysLTs), a class of lipid mediators that have been implicated in the pathogenesis of allergic rhinitis and asthma, are released during RSV infection, thereby contributing to the pathogenic changes in airway inflammation. Many pediatric patients, especially those of very young age, continue to have recurrent episodes of lower airway obstruction after bronchiolitis treatment. ⋯ In general, the side effects of rash, vomiting, and insomnia caused by montelukast occurred in 1.5% of patients analyzed. The recent evidences indicate that montelukast may reduce the frequency of post-bronchiolitic wheezing without causing significant side effects but that it has no effects on decreasing incidences of recurrent wheezing, symptom-free days, or the associated usage of corticosteroid in post-bronchiolitis patients. The small number of enrolled participants and the inability to pool all clinical outcomes precludes us from making solid recommendations.
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Pediatr Allergy Immunol · Sep 2012
Review Meta AnalysisExposure to farming environments in childhood and asthma and wheeze in rural populations: a systematic review with meta-analysis.
Asthma is a chronic respiratory disorder that has become substantially more common over the past decades. One environmental factor for which particularly strong associations with asthma and allergic diseases have been described is exposure to farming environments in childhood. The aim of this systematic review was to update and extend existing narrative reviews, test for heterogeneity of effect across studies, and conduct a meta-analysis to report a summary effect measure. ⋯ The protective 'farm-effect' on asthma was reported in numerous studies. Its underlying factors ought to be studied, and promising efforts have been already made. However, the heterogeneity of the effect across studies should also be investigated because whatever causes it is a potential threat to valid synthesis of evidence and to the detection of specific protective factors.
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Pediatr Allergy Immunol · Jun 2004
Review Meta AnalysisPrevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention.
The development and phenotypic expression of atopic diseases depends on a complex interaction between genetic factors, environmental exposure to allergens,and non-specific adjuvant factors, such as tobacco smoke, air pollution and infections. Preventive measures may include both exposure to allergens and adjuvant risk/protective factors and pharmacological treatment. These measures may address the general population, children at risk for development of atopic disease (high-risk infants), children with early symptoms of allergic disease or children with chronic disease. ⋯ HDM and pets. In symptomatic children allergen-specific treatment may influence both the symptoms and the prognosis. Allergen avoidance can reduce the need for pharmacological treatment, SIT may have the potential for preventing the development of asthma in children with allergic rhinoconjunctivitis. and it may be possible to interfere with the natural course of allergic diseases.