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Author: Charles Warren Bierman
Publisher: W.B. Saunders Company
ISBN:
Category : Medical
Languages : en
Pages : 870
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Book Description
Author: Charles Warren Bierman
Publisher: W.B. Saunders Company
ISBN:
Category : Medical
Languages : en
Pages : 870
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Book Description
Author: Nils Åberg
Publisher:
ISBN: 9789179005955
Category :
Languages : en
Pages : 50
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Book Description
Author: David R. Stukus
Publisher: Springer
ISBN: 3319774859
Category : Medical
Languages : en
Pages : 253
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Book Description
This unique book is intended to assist readers in understanding various allergic diseases as they pertain to the adolescent, with a strong focus on encouraging their transition into self-management. Allergies and Adolescents thoroughly addresses both the cognitive and social development of adolescents and provides effective strategies for involving them in their own self-management. Different types of nonadherence are covered in detail, and specific conditions such as allergic rhinitis, asthma, food allergy, and eczema each have a chapter devoted to a comprehensive discussion of basic concepts surrounding diagnosis and management. These chapters are then followed by a separate chapter providing details as to how that condition can specifically impact adolescents. Chapters containing practical tips that can be immediately implemented by adolescents and their families as well as clinicians conclude the book. Written by experts in their respective fields, Allergies and Adolescents is a comprehensive resource for multiple audiences, including the allergist, pediatrician, and any other healthcare provider working with adolescents, guiding them towards self-management, and preparing them for independent living.
Author: Thomas Werfel
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805595700
Category : Medical
Languages : en
Pages : 170
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Book Description
Covering epidemiology, pathophysiology, genetics, management and treatment Atopic dermatitis is amongst the most common disorders of the skin in young people around the world. This timely book presents the newest insights and novel concepts in relation to all aspects of this skin disorder. Classification, clinical features and differential diagnosis are reviewed in the first chapter, while risk factors, susceptibility and an epidemiological overview are outlined in the next chapter, followed by a detailed discussion of the immunology of the skin and the pathophysiology of dermatitis. Further chapters present exciting new data delineating clinical aspects of current genetic findings and insights into concepts of neuroimmunology, as well as the very crucial and severe clinical aspect of itching. New data on the topic of inhalant allergy, specific immunologic treatments and the latest on food allergy are also included. A valuable reference for anyone interested in atopic dermatitis, this book is particularly useful for pediatricians and clinical practitioners seeing children and adolescents with atopic dermatitis on a daily basis.
Author: Hugo Van Bever
Publisher: World Scientific
ISBN: 9814273538
Category : Medical
Languages : en
Pages : 316
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Book Description
The purpose of this book is to share information and knowledge on allergic disorders in children with everybody, especially parents. Allergies in children are a common and growing problem. From the author's experience, many parents lack correct information on allergy. This has led to wrong approaches in dealing with the problem, with some parents experimenting with all kinds of non-scientifically proven testing and treatments. Sometimes these treatments can be harmful for the child. The book comprises twelve chapters, each covering a specific aspect of allergy in children. The first part covers general issues, such as underlying mechanisms, allergens, and epidemiology of allergic diseases. In the second part, specific allergic diseases are covered. The book ends with considerations on diagnosis and treatment, and offers suggestions for future research on allergy in children. This book will provide useful information to the public, especially parents of allergic children. Based on current scientific information, the book should help allergic children to obtain optimal diagnosis and treatment of their allergic diseases.
Author: Pablo Bertrand
Publisher: Springer Nature
ISBN: 3030269612
Category : Medical
Languages : en
Pages : 797
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Book Description
This is a comprehensive and authoritative textbook on pediatric pulmonology. Edited by Pablo Bertrand and Ignacio Sánchez, renowned academics and pediatricians from the Pontifical Catholic University of Chile, it encompasses five sections and 74 chapters, presenting and discussing the most important topics related to pediatric respiratory diseases. Written and presented in a simple and didactic format, it intends to ease learning and settlement of doubts in pediatric respiratory diseases. The reader is naturally introduced into the physiology, diagnosis, syndromes, diseases and the treatment associated with the respiratory pathologies affecting children. The chapters include algorithms for the treatment of various syndromes and updated treatment proposals grounded in evidence-based medicine for more than 50 pulmonary diseases. Pediatric Respiratory Diseases – A Comprehensive Textbook is an essential reference for the proper clinical approach to respiratory diseases in children. It is intended for all interns, residents and fellows with interest in pediatric pulmonary medicine, as well as practicing physicians, general practitioners, pediatricians and pulmonologists who face pediatric respiratory disorders in daily clinical practice.
Author: Erick Forno
Publisher: Springer Nature
ISBN: 3030274314
Category : Medical
Languages : en
Pages : 365
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Book Description
This book provides readers with a comprehensive review of severe asthma in children and adolescents, covering epidemiology, genetics, risk factors, co-morbidities, clinical presentation, diagnosis and treatment. Written by leaders in the field, chapter discussions draw on the mechanisms driving the disease, genetics, multidisciplinary approaches, immunomodulators, and other important aspects in the management of the disease. Severe Asthma in Children and Adolescents: Mechanisms and Management is designed to be a practical guide, opening with an introduction on the epidemiology of severe childhood asthma, as well as a discussion of special considerations of the disease unique to the preschool-aged patient. The distinctions between the diagnosis and management of asthma in young children of various ages, and specific approaches for the adolescent with severe asthma, including the transition into adult care are then addressed. Finally, the book closes with a discussion on the current state and future avenues for severe asthma research. Severe Asthma in Children and Adolescents is an indispensable reference for the healthcare professional, for basic and translational researchers, as well as for students, residents and fellows.
Author: Johanna Huoman
Publisher: Linköping University Electronic Press
ISBN: 9179297870
Category : Electronic books
Languages : en
Pages : 107
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Book Description
The prevalence of allergic diseases has in the past century increased among children in affluent societies. Underlying causes are incompletely disentangled, but decreased diversity in environmental and microbial exposures could drive allergy development. Allergic individuals possess imbalanced immune responses, skewed in favour of Th2 cells along with lesser Th1 and Treg responses. As allergy development early in life increases the risk of developing further allergic manifestations later, early prevention is key. Thus, interventions in pregnancy, early life and childhood may modulate immunity towards tolerance, although underpinnings of immune maturation and modulation in allergy prevention throughout childhood are not entirely understood. In this thesis, these questions are addressed in children with a high propensity of developing allergic disease or who already have manifested allergies. Chemokines are crucial for immune cell recruitment to the allergic reaction site, and associate with allergy development in childhood. In Paper I, circulating levels of the allergy-related chemokines CCL17, CCL18, CCL22, CXCL10 and CXCL11 were studied in the natural course of allergic disease. Elevated levels of the Th2/Treg-regulated chemokine CCL18 in infancy and childhood associated with development of asthma and/or sensitisation. Moreover, this finding conferred higher odds of developing asthma and sensitisation from early school age until adolescence. Additionally, increased levels of the Th1-associated chemokines CXCL10 after birth, and decreased levels of CXCL11 at birth, preceded asthma development later in life. Hence, Paper I showed that circulating chemokine levels in different ways precede allergy development. Epigenetic modifications, such as DNA methylation, comprise a link between the genetic setup and environmental exposures, and regulate processes such as Th cell differentiation. Perinatal treatment with Lactobacillus reuteri and ?-3 fatty acids prevent development of some IgE-mediated manifestations. However, the drivers of the immunostimulating and pro-resolving effects of these treatments are sparsely examined. In Papers II and III, epigenome-wide DNA methylation patterns in CD4+ cells upon pre-and postnatal L. reuteri supplementation alone or in combination with ?-3 fatty acids were studied. In Paper II, the greatest epigenome wide differential methylation was evident at birth, mainly directed towards hypomethylation, indicating transcriptional availability of affected genes. Network analyses revealed several immune related pathways, and a relationship of differentially methylated genes to allergy development. Thus, prenatal L. reuteri treatment seemingly poises Th cells towards immune activation at birth, possibly influencing immune maturation as well as allergy development in the child. In Paper III, epigenome-wide DNA methylation patterns were surveyed at birth. In this on-going trial, mothers are treated during the latter half of pregnancy with a combination of L. reuteri and ?-3 fatty acids. Four different treatment groups were studied, and the largest differential methylation was seen in the double active treatment group. In contrast to Paper II, most CpGs and genes were hypermethylated, indicating repressed gene transcription. In line with Paper II, network analyses showed that T cell and immune mediated pathways were affected by treatment, and synergistic effects of the double treatment were indicated. Taken together, prenatal treatment with L. reuteri and/or ?-3 fatty acids altered the epigenome to different extents at birth, mainly towards hypermethylation, and often affected immune related pathways. Immunomodulatory effects of sublingual immunotherapy in children and adolescents are scarcely investigated. In Paper IV, circulating and salivary immune mediators were investigated in timothy grass-pollen allergic children treated with sublingual immunotherapy. Actively treated children had elevated levels of timothy grass pollen-specific IgA antibodies in saliva, along with increased circulating levels of the Th1-associated chemokines CXCL10 and CXCL11, both after treatment ending and two years later. Taken together, sublingual immunotherapy modulates local and peripheral immune responses in children with timothy grass pollen-induced allergy, by augmenting Th1-responses, lessening Th2-responses and inducing immunomodulatory responses, suggesting induction of tolerance, also partly in the long-term. Altogether, the studies in this thesis have shown altered immune regulation in children developing allergies. Moreover, immunomodulatory effects of prenatal treatment with probiotics and ?-3 fatty acids, and sublingual immunotherapy in children with grass pollen-induced allergic disease, were revealed. DNA methylation patterns and immunologic mediators in blood and saliva could potentially serve as appropriate biomarkers for allergic disease. Long term health benefits can be reached by intervening early in life, and further knowledge about the mechanisms behind this could promote the prevention of allergic diseases and hence improve the quality of life for children and adolescents. Förekomsten av allergiska sjukdomar, som böjveckseksem, hösnuva och astma, har under det senaste århundradet ökat markant bland barn i industrialiserade samhällen. De bakomliggande orsakerna är inte helt klarlagda, men samhälleliga förändringar har minskat vår mångfaldiga exponering för bakterier, virus och parasiter. Detta skulle kunna ligga till grund för immunförsvarets felaktiga reaktion mot egentligen ofarliga ämnen som ses vid allergier. Hos allergiska individer är immunförsvaret obalanserat, med en relativ övervikt av det så kallade Thjälpar- 2 (Th2)-svaret gentemot Th1- och det regulatoriska T-cells (Treg)-svaret. Allergiska sjukdomar utvecklas ofta tidigt i livet, vilket ökar risken för att utveckla vidare allergier senare i livet. Därför är det viktigt att motverka den allergiska marschens framfart tidigt genom förebyggande behandlingar. Ett tillvägagångsätt är att påbörja behandling under graviditeten och tidiga barndomen hos barn med hög risk för att bli allergiska, då grunden för immunsystemet läggs redan under fosterlivet. För redan utvecklade allergier är det tänkbart att omforma dessa immunsvar med immunterapi, som kan minska symptom av befintliga allergier samtidigt som det är möjligt att motverka utvecklingen av senare allergier. Det är dock inte helt klarlagt hur immunutmognaden under barndomen är reglerad, eller hur dessa typer av behandlingar skulle kunna påverka allergiutveckling under den perioden. I denna avhandling undersöks immunutmognad vid allergiutveckling hos barn, och möjliga immunmodulerande förebyggande behandlingar hos barn med genetisk benägenhet att bli allergiska eller som redan utvecklat allergisk sjukdom. För att celler ska rekryteras till platsen för en allergisk reaktion krävs bland annat s.k. kemokiner. I det första arbetet undersöktes dessa lockelseämnen, då våra tidigare studier visat att nivåerna av vissa kemokiner vid födseln förutspår utvecklingen av allergi hos barn. De allergirelaterade kemokinerna CCL17, CCL18, CCL22, CXCL10 och CXCL11 analyserades i blodprover vid födseln, 1 och 8 års ålder hos barn från en populationsbaserad observationsstudie. Förhöjda nivåer av CCL18, ett kemokin under reglering av både Th2- och Treg-svar, uppmättes vid 1 och/eller 8 års ålder hos barn som hade astma (särskilt svår astma) och/eller var sensibiliserade. De ökade nivåerna associerade också till högre odds för utveckling av astma från tidig skolålder upp till övre tonåren, med liknande resultat för sensibilisering. Även ökade nivåer av de Th1-associerade kemokinerna CXCL10 efter födseln och minskade nivåer av CXCL11 vid födseln föregick utvecklingen av astma senare i livet. Det första arbetet visade alltså på att cirkulerande kemokiner på olika vis föregår utvecklingen av allergier hos barn och ungdomar. Som länk mellan arv och miljö står s.k. epigenetiska modifieringar, vilka reglerar genaktiviteten utan att förändra den genetiska koden i arvsmassan. Till dessa modifieringar räknas DNAmetylering, en process som bl.a. styr utmognad av de allergirelaterade T-hjälparcellerna. Vi har i tidigare separata studier med den probiotiska stammen Lactobacillus reuteri och omega-3- behandling visat förebyggande av vissa IgE-medierade allergier. Vad som föranleder de immunstimulerande och immunmodulerande effekterna av behandlingarna är dock otillräckligt undersökt. I det andra och tredje arbetet undersöktes hur L. reuteri separat eller i kombination med omega-3-fettsyror påverkar DNA-metyleringsmönster i CD4+ Th-celler hos barn som behandlats före och efter födseln. I det andra arbetet undersöktes DNA-metyleringsmönster både lokalt och i hela genomet vid födseln, ett och två års ålder. Behandling med L. reuteri förändrade DNA-metyleringsmönster i allergirelaterade T-hjälparceller mest vid födseln mot s.k. hypometylering, vilket pekar på ökad tillgänglighet av generna för proteinuttryck. Vidare nätverksanalyser visade att flera immunrelaterade processer påverkades av behandlingen. Därtill var generna från nätverket till stor del associerade med allergiutveckling. Maternell behandling med L. reuteri under den sista graviditetsmånaden tycks alltså förändra DNA-metyleringsmönster i T-hjälparceller hos fostret mot ökad immunaktivering vid födseln, vilket i sin tur skulle kunna påverka både immunutmognad och allergiutveckling hos barnet. I likhet med det andra arbetet undersöktes i det tredje arbetet DNA-metyleringsmönster i hela epigenomet, fast endast vid födseln. I denna pågående studie behandlas mödrarna under den andra halvan av graviditeten med en kombination av L. reuteri och omega-3-fettsyror. Fyra olika behandlingsgrupper undersöktes och den största förändringen i DNA-metylering återfanns i den kombinerade aktiva behandlingsgruppen. I motsats till det andra arbetet var dock de flesta CpG positionerna och generna hypermetylerade, vilket tyder på att genernas tillgänglighet för proteinuttryck hämmas. I linje med det andra arbetet framkom T-cells- och immunrelaterade signalvägar i nätverksanalyser på dessa gener, och det fanns indikationer på synergistiska effekter mellan behandlingarna. Det tredje arbetet visade att behandling med L. reuteri och/eller omega- 3-fettsyror under senare delen av graviditeten förändrar T-hjälparcellernas epigenom i olika grad främst mot hypermetylering, och ofta påverkar immunrelaterade signalvägar. Relevansen av dessa fynd kommer i framtida studier att undersökas på proteinnivå och i relation till allergiutveckling. Med allergenspecifik immunterapi är det möjligt att modulera immunsvaret hos allergiska individer mot ett tolerant immunsvar, men effekter av sublingual immunterapi på immunförsvaret hos barn och ungdomar är knapphändigt undersökta. I det fjärde arbetet undersöktes olika immunologiska mediatorer i blod och saliv hos barn med gräspollenallergi, som deltagit i en studie med sublingual immunterapi. Nivåerna av allergirelaterade cytokiner och kemokiner undersöktes i blodprover från inklusionstillfället, efter tre år med behandling samt två år efter avslutad behandling i plasmaprov och allergenstimulerade blodceller. Dessutom mättes total-IgA, sekretoriskt IgA och gräspollenspecifikt IgA i saliv vid samma tillfällen. Barn som fått aktiv behandling hade högre nivåer av gräspollenspecifika IgA-antikroppar i saliv både när behandlingen avslutades och två år efter. Därtill ökade nivåerna av de Th1-associerade kemokinerna CXCL10 och CXCL11 i blodet vid samma tidpunkter. Sammantaget visade resultaten från det fjärde arbetet att behandlingen med sublingual immunterapi hos barn med gräspollenallergi modulerar immunsvaret både lokalt och i cirkulationen genom att öka Th1- svar, minska Th2-svar och inducera immunreglerande svar, vilket indikerar att tolerans har utvecklats hos dessa barn, delvis även på lång sikt. Sammanfattningsvis har studierna i denna avhandling visat på förändrad immunreglering hos barn som utvecklar allergi. Dessutom påvisades immunmodulerande effekter av prenatal behandling med probiotika och omega-3-fettsyror samt av sublingual immunterapi hos barn med gräspollenallergi. DNA-metyleringsmönster och immunologiska mediatorer i blod och saliv skulle kunna fungera som lämpliga biomarkörer för allergisk sjukdom, vilket är ett viktig led i att kunna förutsäga allergiutveckling och förbättra den kliniska behandlingen av allergier bland barn och ungdomar. Långsiktiga hälsofördelar kan uppnås genom att ingripa tidigt i livet, och vidare kunskap om mekanismerna bakom detta skulle kunna främja förebyggandet av allergiska sjukdomar och således kunna förbättra livskvaliteten för barn och ungdomar.
Author:
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805576498
Category : Medical
Languages : en
Pages : 331
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Book Description
During the last two decades the increase in allergic diseases in children, such as atopic dermatitis and asthma, has been drastic. However, this is not true for the entire world: the incidence of allergies in children has risen only in developed countries. The observation of this socio-geographic discrepancy has led to careful study of the environmental differences that exist between the diverse settings in which children are born and has resulted in the so-called 'hygiene hypothesis': the 'sterility' of modern hospitals and birth places in the developed world might lead to a lack of microbial stimulation required for the development of a balanced mucosal immune response, including expansion of T-helper (Th) cell subsets that can mediate immune responses. Therefore, this workshop was held to consider in depth the environmental factors that influence the changing pattern of worldwide childhood allergy. This publication is a valuable source of knowledge and update for nutritionists, pediatricians, immunologists, microbiologists, as well as professionals concerned with preventive medicine.
Author: Raoul L. Wolf
Publisher: McGraw Hill Professional
ISBN: 9780071416689
Category : Allergy
Languages : en
Pages : 232
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Book Description
A practical and concise guide to the assessment of allergic disorders, congenital immunodeficiency, and asthma in the child and adolescent. Focuses on the approach to diagnosis and treatment of childhood asthma, which is an increasing problem in general pediatrics. Featuring tables, bulleted lists, and a drug formulary, this book provides a quick but substantial reference to practitioners and residents.
