RESUMEN
Children aged 11 to <24 months received 2 intranasal doses of live attenuated influenza vaccine (LAIV) or placebo, 35+/-7 days apart. Dose 1 was administered concomitantly with a combined measles, mumps, and rubella vaccine (Priorix). Seroresponses to measles and mumps were similar between groups. Compared with placebo, response rates to rubella in LAIV+Priorix recipients were statistically lower at a 15 IU/mL threshold (83.9% vs 78.0%) and the prespecified noninferiority criteria were not met. In a post hoc analysis using an alternate widely accepted threshold of 10 IU/mL, the noninferiority criteria were met (93.4% vs 89.8%). Concomitant administration with Priorix did not affect the overall influenza protection rate of LAIV (78.4% and 63.8% against antigenically similar influenza strains and any strain, respectively).
Asunto(s)
Vacunas contra la Influenza/inmunología , Vacuna contra el Sarampión-Parotiditis-Rubéola/inmunología , Vacunación/métodos , Administración Intranasal , Anticuerpos Antivirales/sangre , Incompatibilidad de Medicamentos , Femenino , Humanos , Lactante , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Masculino , Sarampión/prevención & control , Vacuna contra el Sarampión-Parotiditis-Rubéola/administración & dosificación , Paperas/prevención & control , Placebos/administración & dosificación , Rubéola (Sarampión Alemán)/prevención & control , Vacunas Atenuadas/administración & dosificación , Vacunas Atenuadas/inmunología , Vacunas Combinadas/administración & dosificación , Vacunas Combinadas/inmunologíaRESUMEN
OBJECTIVE: To assess the changes in the prevalence of asthma and allergy in 6-7-year-old schoolchildren in Kaunas, Lithuania, using the International Study of Asthma and Allergy in Childhood (ISAAC) core questionnaire. MATERIAL AND METHODS: Two cross-sectional surveys (1994/1995-2001/2002) according to the ISAAC protocol were carried out. Lithuanian version of the ISAAC core questionnaire was completed by parents randomly selected from Kaunas primary schools. A school-based sample of 1879 participants in the 1994/1995 survey and 2772 participants in the 2001/2002 survey was study population. RESULTS: The response rates in 1994 and 2002 were 93.95% and 92.4%, respectively. There is a tendency towards an increase in the prevalence of current symptoms and diagnoses for all three conditions, but it was more pronounced in boys. Significant increases in the prevalence of asthma (0.9% vs 2.6%), allergic rhinitis (1.4% vs 2.4%), and atopic dermatitis (1.4% vs 3.5%) were observed comparing two surveys. Still a lot of allergic diseases remain undiagnosed. CONCLUSIONS: Our study shows that the prevalence of symptoms of asthma, allergic rhinitis, and atopic dermatitis is increasing, reflecting the changes in morbidity from these conditions in our country.
Asunto(s)
Asma/epidemiología , Hipersensibilidad/epidemiología , Actividades Cotidianas , Distribución de Chi-Cuadrado , Niño , Estudios Transversales , Interpretación Estadística de Datos , Dermatitis Atópica/epidemiología , Dermatitis por Contacto/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Lituania/epidemiología , Masculino , Padres , Prevalencia , Rinitis Alérgica Perenne/epidemiología , Rinitis Alérgica Estacional/epidemiología , Factores Sexuales , Encuestas y CuestionariosRESUMEN
Asthma is a chronic airway disease that is a growing problem of public health. The current consensus is based on the Global Initiative for Asthma (GINA) and other guidelines for asthma, and adapted for Lithuania. This Consensus provides physicians with recommendations for asthma management in children and adults.
Asunto(s)
Asma , Adolescente , Agonistas Adrenérgicos beta/administración & dosificación , Agonistas Adrenérgicos beta/uso terapéutico , Adulto , Factores de Edad , Antiasmáticos/administración & dosificación , Antiasmáticos/uso terapéutico , Asma/diagnóstico , Asma/tratamiento farmacológico , Asma/etiología , Asma/prevención & control , Asma/terapia , Niño , Preescolar , Diagnóstico Diferencial , Familia , Femenino , Glucocorticoides/administración & dosificación , Glucocorticoides/uso terapéutico , Hospitalización , Humanos , Inmunoterapia , Lactante , Masculino , Educación del Paciente como Asunto , Guías de Práctica Clínica como Asunto , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/terapia , Pruebas de Función Respiratoria , Terapia Respiratoria , Factores de Tiempo , Contaminación por Humo de Tabaco/efectos adversosAsunto(s)
Infección Hospitalaria/diagnóstico , Neumonía/diagnóstico , Neumonía/terapia , Adulto , Factores de Edad , Anciano , Atención Ambulatoria , Antibacterianos/uso terapéutico , Broncoscopía , Niño , Preescolar , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/etiología , Infecciones Comunitarias Adquiridas/terapia , Infección Hospitalaria/etiología , Infección Hospitalaria/prevención & control , Infección Hospitalaria/terapia , Diagnóstico Diferencial , Hospitalización , Humanos , Lactante , Vacunas Neumococicas/administración & dosificación , Neumonía/etiología , Neumonía/prevención & control , Neumonía Bacteriana/diagnóstico , Neumonía Bacteriana/etiología , Neumonía Bacteriana/terapia , Pronóstico , Factores de Riesgo , Factores de TiempoRESUMEN
Bronchiolitis is the most common lower respiratory tract infection in infants and is responsible for the majority of pediatric hospital admissions in winter. Respiratory syncytial virus has been identified as the main causative agent, causing 50-90% of the cases of bronchiolitis. Despite significant advances in pharmacotherapy, the management of infants with bronchiolitis has changed little over the years from supplemental oxygen and good fluid management. Approaches to therapy vary widely all over the world and are controversial. This paper reviews current treatment options for bronchiolitis, including the use of bronchodilators, epinephrine, steroids and ribavirin. Most recent advances, including immunotherapy and intensive care, are discussed.
Asunto(s)
Bronquiolitis Viral/terapia , Infecciones por Virus Sincitial Respiratorio/terapia , Enfermedad Aguda , Corticoesteroides/uso terapéutico , Antivirales/uso terapéutico , Bronquiolitis Viral/diagnóstico , Bronquiolitis Viral/tratamiento farmacológico , Broncodilatadores/uso terapéutico , Preescolar , Ensayos Clínicos como Asunto , Epinefrina/uso terapéutico , Femenino , Humanos , Lactante , Masculino , Terapia por Inhalación de Oxígeno , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Infecciones por Virus Sincitial Respiratorio/tratamiento farmacológico , Ribavirina/uso terapéutico , Factores de RiesgoRESUMEN
OBJECTIVE: To evaluate the effectiveness of prevention measures against dust mite sensitization. DESIGN: European (England, Germany, Greece, Lithuania) multicenter prospective single-blind randomized control trial with a follow-up of 12 months. PARTICIPANTS: Toddlers and preschoolers, with at least 1 parent with atopic symptoms and sensitization, who initially were not sensitized to mite allergens. INTERVENTIONS: A combination of education and a simple preventive measure (mattress encasement) to reduce mite allergen exposure. SETTING: Community-based study. MAIN OUTCOME MEASURES: Sensitization to mite allergens (skin-prick test or specific immunoglobulin E). RESULTS: Of 636 children (mean age, 3.1 years) included in the study, 566 (89%) participated in the first-year follow-up. The incidence of sensitization to mite allergens was 10 (3%) of 330 in the intervention vs 20 (6.5%) of 306 in the control arm, including loss of follow-up (intention-to-treat principle). Allergic symptoms were more common in sensitized than in nonsensitized children and so was the prevalence of physician-diagnosed asthma, eczema, and food allergy. CONCLUSIONS: This simple, harmless, and inexpensive measure can be used in toddlers and preschoolers of parents with atopic disorders to reduce sensitization to mite allergens. With regard to clinical manifestations of atopy, follow-up studies are needed to determine the effectiveness of the intervention.