Tag: Primary

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[Specific antibody deficiency: Primary immunodeficiency associated to respiratory allergy].

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[Specific antibody deficiency: Primary immunodeficiency associated to respiratory allergy].

Rev Chil Pediatr. 2016 Sep 7;

Authors: Fernández F, Campillay R, Palma V, Norambuena X, Quezada A

Abstract
INTRODUCTION: Specific antibody deficiency (SAD) with normal immunoglobulin and normal B cells is a primary immunodeficiency characterized by reduced ability to produce antibodies to specific antigens especially polysaccharides.
OBJECTIVE: To describe the characteristics of patients diagnosed with SAD emphasizing the association between primary immunodeficiency and allergic diseases.
PATIENTS AND METHOD: Descriptive study showing patients with SAD treated at a public hospital between August 2007 and July 2015. Other secondary or primary immunodeficiency was discarded. The diagnosis of SAD was based on recurrent infections and abnormal response to pneumococcal polysaccharide vaccine assessed by specific IgG to 10 pneumococcal serotypes.
RESULTS: Twelve patients were included, 4 males, mean age 6 years, recurrent pneumonia predominated (91.7%) as well as other respiratory and invasive infections. All patients with SAD had associated asthma, 11 had allergic rhinitis, and other allergies. Three patients did not respond to any of the 10 serotypes contained in pneumococcal polysaccharide vaccine, and those who responded were with low titers. Treatment with conjugate pneumococcal vaccine was favorable in 11/12 patients.
CONCLUSION: In children older than 2 years with recurrent respiratory infections or invasive S. pneumoniae infections with normal immunoglobulin we recommend to investigate SAD, especially if they have a concurrent allergic disease.

PMID: 27614984 [PubMed – as supplied by publisher]

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Management and referral of patients with severe and poorly controlled asthma in primary care.

Management and referral of patients with severe and poorly controlled asthma in primary care.

Fam Pract. 2016 Aug 20;

Authors: Orozco-Beltrán D, Carratalá-Munuera C, Arriero JM, Campo P, Martínez-Moragón E, Molina J, Quintano-Jiménez JA, Gil-Guillén VF, Working Group for the Consensus Document on the Management of Severe Asthma in Adults in Primary Health Care

Abstract
BACKGROUND: Over 50% of treated patients with asthma in Europe are not well controlled. Their management in primary health care (PHC) differs from that in specialized care, and there is no real coordination between the two.
OBJECTIVES: To identify barriers and solutions to improving the management of patients with severe and poorly controlled asthma and the communication between specialists and PHC, and to reach a consensus on the criteria for referral patients.
METHODS: An observational study using a modified Delphi technique. About 79 physicians from PHC, pneumology and allergy fields from different Spanish regions were invited to participate via an online questionnaire. Consensus was reached on an item when more than two-thirds of the panel members scored within the 3-point category (1-3 or 7-9) containing the median and the interquartile range of answers had to be ?4 points.
RESULTS: Response rate: 52%. After the second round, consensus items were 40 (62.5%): of which 37 in agreement and 3 in disagreement. Around 92.68% of respondents agreed that it would be useful to incorporate questionnaires for asthma control into PHC computer-based searches. About 100% of participants agreed that clear consensus criteria between PHC and specialists must be determined to decide when a patient with asthma is referred from PHC to specialist or vice versa. Ten of the proposed criteria reached consensus agreement.
CONCLUSION: The failure to use guidelines and specific questionnaires for asthma control in PHC is one reason why there is underdiagnosis and poor control of asthma. Some strategies to improve the asthma care management emerged from the survey results.

PMID: 27543792 [PubMed – as supplied by publisher]

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New Primary Care-Based Program Improves Pediatric Asthma Assessment and Treatment – MD Magazine


MD Magazine

New Primary Care-Based Program Improves Pediatric Asthma Assessment and Treatment
MD Magazine
The research team used the Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma, and requested that clinicians ask patients five standardized questions regarding their asthma symptoms and use of rescue medication.

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Primary care-based program can help improve assessment and treatment of asthma in children – News-Medical.net

Primary care-based program can help improve assessment and treatment of asthma in children
News-Medical.net
An innovative primary care-based asthma program improves identification of poorly controlled asthma among children and enhances treatment plans, compared to care provided during routine office visits, according to research published in the current …

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Integrated Primary Care for Chronic Lung Disease: PACK Brazil

Conditions:   Asthma;   Chronic Obstructive Pulmonary Disease
Interventions:   Behavioral: Outreach education training;   Behavioral: No outreach education training
Sponsors:   University of Sao Paulo General Hospital;   University of Sao Paulo;   Santa Catarina Federal University;   University of Cape Town;   Federal University of Bahia;   Medical Research Council, South Africa;   University of East Anglia
Not yet recruiting – verified May 2016

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The dangers of widespread nitric oxide screening for primary ciliary dyskinesia.

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The dangers of widespread nitric oxide screening for primary ciliary dyskinesia.

Thorax. 2016 Feb 19;

Authors: Collins SA, Behan L, Harris A, Gove K, Lucas JS

Abstract
Primary ciliary dyskinesia (PCD) is underdiagnosed and requires complex testing at specialist diagnostic centres. Measurement of nasal nitric oxide (nNO) has good sensitivity and specificity screening for PCD, but is currently usually measured at PCD centres rather than prior to referral. Proposals to include NO testing for asthma diagnoses could widen access to PCD screening if nasal mode analysers are available. Data from 282 consecutive referrals to our PCD diagnostic centre (31 PCD positive) were used to model predictive values for nNO testing with varying pretest probability and showed that predictive values were good in the referral population, but extending screening to more general populations would result in excessive false positives that may overwhelm diagnostic services. Although nNO remains a useful test, a ‘normal’ result with classical clinical history should still be considered for further testing.

PMID: 26896442 [PubMed – as supplied by publisher]

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Common colds at school a primary driver of asthma hospitalisations for children – HealthCanal.com (press release) (blog)

Common colds at school a primary driver of asthma hospitalisations for children
HealthCanal.com (press release) (blog)
The most dangerous times of year for children with asthma are soon after their schools reopen after a break, and cold viruses are largely to blame, according to a new study published in the journal Proceedings of the National Academy of Sciences.

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