1
|
Kaviany P, Shah A. Current Practices in Pediatric Asthma Care. Clin Chest Med 2024; 45:611-623. [PMID: 39069325 DOI: 10.1016/j.ccm.2024.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
This article is a comprehensive review of the latest knowledge and developments on pediatric asthma. It serves as a guide for general practitioners and subspecialists who treat asthma. The pathophysiology and critical features of asthma that should be addressed and the latest therapies available are discussed. The areas where further investigation is needed are also highlighted.
Collapse
Affiliation(s)
- Parisa Kaviany
- Division of Pulmonary & Sleep Medicine, Children's National Hospital, George Washington University School of Medicine, 111 Michigan Avenue Northwest, Washington, DC 20010, USA
| | - Avani Shah
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 155 East Superior Street, Box #48, Chicago, IL 60611, USA.
| |
Collapse
|
2
|
Gan Q, Liu Q, Wu Y, Zhu X, Wang J, Su X, Zhao D, Zhang N, Wu K. The Causal Association Between Obstructive Sleep Apnea and Child-Onset Asthma Come to Light: A Mendelian Randomization Study. Nat Sci Sleep 2024; 16:979-987. [PMID: 39050365 PMCID: PMC11268851 DOI: 10.2147/nss.s472014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
Purpose Obstructive sleep apnea (OSA) had been associated with asthma in observational studies, but the effect of OSA on the onset of asthma in childhood or adulthood remains unclear, and the causal inferences have not been confirmed. This study aims to investigate the potential causal association between OSA with asthma, including different age-of-onset subtypes, providing reliable basis for the clinical treatment of OSA and asthma. Patients and Methods Causality between OSA and asthma was assessed using a two-sample bi-directional Mendelian randomization (MR) analysis. OSA data were obtained from the FinnGen consortium R9, while asthma and its subtypes (adult-onset asthma, child-onset asthma, and moderate-to-severe asthma) were sourced from the IEU OpenGWAS project. The inverse-variance weighted (IVW) method was chosen as the primary analysis and was complemented by various sensitivity analyses. The MR-PRESSO outlier test was employed to systematically identify and remove outlier variants, mitigating heterogeneity and potential effects of horizontal pleiotropy. Results The MR analyses provided evidence of genetically predicted OSA having a promoting effect on child-onset asthma (OR,1.49; 95% CI, 1.05-2.11; P=0.025) and moderate-to-severe asthma (OR,1.03; 95% CI, 1.00-1.06; P=0.046). However, no causal association between OSA with asthma and adult-onset asthma was observed. Conclusion Our study revealed a causal association between OSA and child asthma, but not in adults. Moderate-to-severe asthma may have a potential promoting effect on OSA. These findings underscore the importance of age-specific considerations in managing asthma and suggests the need for personalized approaches in clinical practice.
Collapse
Affiliation(s)
- Qiming Gan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Quanzhen Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
- Nanshan School, Guangzhou Medical University, Guangzhou, Guangdong, 511436, People’s Republic of China
| | - Yanjuan Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Xiaofeng Zhu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
- Nanshan School, Guangzhou Medical University, Guangzhou, Guangdong, 511436, People’s Republic of China
| | - Jingcun Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Xiaofen Su
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Dongxing Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Nuofu Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Kang Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Disease, Department of Sleep Medicine Center, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| |
Collapse
|
3
|
Fields CM, Poupore NS, Barengo JH, Smaily H, Nguyen SA, Angles J, Clemmens CS, Pecha PP, Carroll WW. Does REM AHI Predict Persistent OSA After Pediatric Adenotonsillectomy? Ann Otol Rhinol Laryngol 2024; 133:431-440. [PMID: 38258762 DOI: 10.1177/00034894241227030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
OBJECTIVE The utility of REM AHI in managing pediatric obstructive sleep apnea (OSA) is not fully understood. This study aimed to evaluate the relationship of preoperative REM AHI to postoperative persistence of OSA in children who underwent adenotonsillectomy. METHODS This retrospective chart review identified children under the age of 18 years that received an adenotonsillectomy for OSA and a preoperative and postoperative polysomnogram. Children with craniofacial or neuromuscular disorders or a tracheostomy were excluded. The primary outcome was the postoperative persistence of OSA, defined as a postoperative obstructive apnea-hypopnea index (oAHI) ≥ 1.5 events/hour. REM-predominant OSA was defined as a ratio of REM/NREM AHI ≥ 2. REM AHI minus NREM AHI and REM AHI minus oAHI helped to identify patients with a larger distribution of REM AHI. RESULTS A total of 353 patients were included. Postoperative persistent OSA was seen in 232 (65.7%) children. The preoperative REM AHI, REM AHI minus NREM AHI, and REM AHI minus oAHI of children with persistent OSA did not differ significantly from children with resolution of OSA. Rates of persistence were not different between those with REM-predominant OSA and REM-independent OSA (63.8% vs 70.7%, P = .218). CONCLUSION This study suggests that preoperative REM AHI may be a poor predictor of OSA persistence after adenotonsillectomy. Further study is needed to help characterize how pre-operative REM AHI should impact clinicians' decision making, family counseling and recommendations.
Collapse
Affiliation(s)
- Caroline M Fields
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Nicolas S Poupore
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Jenna H Barengo
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Hussein Smaily
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Jacqueline Angles
- Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Clarice S Clemmens
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Phayvanh P Pecha
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - William W Carroll
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| |
Collapse
|
4
|
Lai WY, Wei CC, Lin CH, Hang LW, Shih YH, Huang FW, Yen HR. Integrative traditional Chinese medicine treatment for children with obstructive sleep apnea. J Tradit Complement Med 2024; 14:109-120. [PMID: 38223810 PMCID: PMC10785241 DOI: 10.1016/j.jtcme.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 01/16/2024] Open
Abstract
Purpose Obstructive sleep apnea (OSA) is a chronic disease that affects 1%-6% of children. Our study aims to explore the effectiveness and clinical characteristics of integrative Traditional Chinese Medicine (ITCM) for pediatric OSA. Materials and methods In this retrospective cohort study, we assessed differences of polysomnography (PSG) parameters and clinical characteristics between 2009 and 2020. Children <12 years old diagnosed with OSA (n = 508) were included and were categorized into ITCM cohort, western medicine (WM) cohort ,and surgery cohort. Outcomes were apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and body mass index (BMI). Results There were 56 (11%), 324 (63.8%), and 128 (25.2%) patients in the ITCM, WM, and surgery cohorts. Among 17, 26, and 33 patients in the ITCM, WM, and surgery cohorts underwent follow-up PSG studies, respectively. In the ITCM follow-up cohort, AHI were significantly reduced (9.59 to 5.71, p < 0.05). BMI significantly increased in the WM follow-up cohort (19.46 to 20.50, p < 0.05) and the surgery follow-up cohort (18.04 to 18.85, p < 0.01). Comparing ITCM to WM cohort, a significant difference was found between the changes in RDI (ITCM: -6.78, WM: 0.51, p < 0.05) after treatment. Among ITCM follow-up cohort, the most prescribed TCM formula was Forsythia and Laminaria Combination. The most prescribed TCM herb was Ephedrae Herba. Conclusions ITCM therapy can significantly reduce RDI and control BMI. We identified potential TCM treatments for pediatric OSA. Further study of the pharmacological mechanisms and clinical efficacy is warranted.
Collapse
Affiliation(s)
- Wan-Yu Lai
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chang-Ching Wei
- Department of Pediatrics, Children's Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chien-Heng Lin
- Department of Pediatrics, Children's Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Liang- Wen Hang
- Sleep Medicine Center, China Medical University Hospital, Taichung, Taiwan
| | - Ying-Hsiu Shih
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Fen-Wei Huang
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Rong Yen
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
- Research Center for Traditional Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
| |
Collapse
|
5
|
Wang Z, Wu X, Liu J, Wang Y, Zhang Y, Wu Y, Kang Y, Zhang R, Li J, Liu D. Effects of oral cysteine leukotriene receptor antagonist-montelukast on adenoid lymphoid tissue: a histopathological study under light microscope. Front Pharmacol 2023; 14:1285647. [PMID: 38026964 PMCID: PMC10651758 DOI: 10.3389/fphar.2023.1285647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Adenoidal hypertrophy (AH) is one of the most common causes of upper airway obstruction in children. Drug and surgical treatment are the typical treatment of AH. The study on the inflammatory mechanism of AH in children provides a new idea for preoperative intervention and non-surgical treatment with anti-inflammatory drugs such as montelukast sodium (a cysteine leukotriene receptor antagonist). The aim of this study is to evaluate the effect of montelukast sodium on adenoidal lymphoid tissue pathology in children with AH under light microscope. Objective: To study whether there is any change in pathology of the adenoidal lymphoid tissue under the light microscope compared with the control group in children with moderate to severe simple AH treated with montelukast sodium for 1 month before operation. Materials and methods: Twenty patients (8 males, 12 females, 3-8 years old) with moderate to severe AH who were prepared for surgical treatment were selected. All the patients were examined by Nasopharyngeal CT and hemocyte analysis before operation. 20 subjects were randomly divided into two groups: One group was given montelukast chewable tablets 5 mg/d, qn, for 4 weeks; The control group was given placebo 5 mg/d, qn, for 4 weeks. After 4 weeks, the adenoids were removed and examined histopathology. Results: Compared with the control group, the number of lymphocytes in the blood cell analysis of the study group was significantly reduced, with a statistically significant difference (p < 0.05). And the number of germinal centers in adenoid tissue of the study group was relatively reduced, no small cyst was found in the epithelium, and the degree of inflammatory cell infiltration was reduced, with a statistically significant difference (p < 0.05). Conclusion: Montelukast can reduce the number of reactive cells, the number of lymphocytes in blood cells and blood vessels in adenoid lymphoid tissue, which can provide a new idea for preoperative intervention and non-surgical treatment of adenoid hypertrophy in children. However, this is only a pilot study and a longer treatment period is needed to assess the long-term effects of montelukast sodium on adenoid lymphoid tissue. Clinical Trial Registration: www.Chictr.org.cn, identifier ChiCTR2300075040.
Collapse
Affiliation(s)
- Zhengying Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
- China Medical University, Shenyang, Liaoning, China
| | - Xiuling Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Jinghong Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
- Department of Otorhinolaryngology, Panjin Municipal Central Hospital, Panjin, Liaoning, China
| | - Yu Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Yue Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
| | - Yan Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
| | - Yingxue Kang
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Ronghai Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Jin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Delong Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Dalian municipal Central Hospital, Dalian, Liaoning, China
| |
Collapse
|
6
|
Johnson ZJ, Lestrud SO, Hauck A. Current understanding of the role of sleep-disordered breathing in pediatric pulmonary hypertension. PROGRESS IN PEDIATRIC CARDIOLOGY 2022. [DOI: 10.1016/j.ppedcard.2022.101609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
7
|
Skoner DP, Golant AK, Norton AE, Stukus DR. Is This Medication Safe for My Child? How to Discuss Safety of Commonly Used Medications With Parents. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:3064-3072. [PMID: 35963511 DOI: 10.1016/j.jaip.2022.07.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 12/14/2022]
Abstract
All drugs have potential side effects, but thoughtful use can maximize benefits while minimizing risks. Children should not be considered just small adults regarding drug safety because their growth and development are discordant with their ability to sense and self-report drug side effects. Detecting side effects requires vigilance and education from prescribers to parents, who are tasked with monitoring their child over time. A drug's safety profile is published in the package label after pivotal trials are conducted in relatively small and sometimes narrow segments of the population during the U.S. Food and Drug Administration approval process. Drug safety profiles can change as data from postmarketing reports and long-term monitoring during phase IV trials emerge. As such, prescribers are obligated to maintain current understanding of any changes to drug labels. Discussing potential side effects, monitoring, and when to report concerns can be a time-consuming process during patient encounters. This review offers current information regarding potential side effects of some of the most commonly used medications for allergic conditions, asthma, and atopic dermatitis. This information and discussion will hopefully assist clinicians in their conversations with parents, including advice surrounding prescribing medication to minimize adverse effects, parental monitoring, and documentation.
Collapse
Affiliation(s)
- David P Skoner
- Section of Allergy and Immunology, West Virginia University Children's Hospital, Morgantown, WVa
| | - Alexandra K Golant
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Allison E Norton
- Division of Allergy, Immunology and Pulmonology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tenn
| | - David R Stukus
- Division of Allergy and Immunology, Nationwide Children's Hospital, Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio.
| |
Collapse
|
8
|
Dawson D, Patterson M, Patel A, Vickery C. Where does Allergy Management Fit in Obstructive Sleep Apnea? CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00405-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
9
|
Paljarvi T, Forton J, Luciano S, Herttua K, Fazel S. Analysis of Neuropsychiatric Diagnoses After Montelukast Initiation. JAMA Netw Open 2022; 5:e2213643. [PMID: 35608857 PMCID: PMC9131741 DOI: 10.1001/jamanetworkopen.2022.13643] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE The evidence base for the association between montelukast and adverse neuropsychiatric outcomes is mixed and inconclusive. Several methodological limitations have been identified in the evidence base on the safety of montelukast in observational studies. OBJECTIVE To investigate the association between new montelukast exposure and 1-year incident neuropsychiatric diagnoses with improved precision and control for baseline confounders. DESIGN, SETTING, AND PARTICIPANTS This propensity score-matched cohort study was conducted using electronic health records from 2015 to 2019 in the TriNetX Analytics Network patient repository of more than 51 million patients from 56 health care organizations, mainly in the US. Included patients were those aged 15 to 64 years at index prescription for montelukast or for control prescription who had a history of asthma or allergic rhinitis. After propensity score matching for various baseline confounders, including comorbidities and dispensed prescription medicines, we included 154 946 patients, of whom 77 473 individuals were exposed to montelukast. Patients were followed up for 12 months. Data were analyzed from June through November 2021. EXPOSURES New dispensed prescription for leukotriene receptor antagonist montelukast or control medication. MAIN OUTCOMES AND MEASURES Incident neuropsychiatric diagnoses at 12 months identified using International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. RESULTS There were 72 490 patients with asthma (44 726 [61.7%] women; mean [SD] age at index prescription, 35 [15] years) and 82 456 patients with allergic rhinitis (54 172 [65.7%] women; mean [SD] age at index prescription, 40 [14] years). In patients exposed to montelukast, the odds ratio [OR] for any incident neuropsychiatric outcome was 1.11 (95% CI, 1.04-1.19) in patients with asthma and 1.07 (95% CI, 1.01-1.14) in patients with allergic rhinitis compared with patients who were unexposed. The highest OR was for anxiety disorders (OR, 1.21; 95% CI, 1.05-1.20) among patients with asthma exposed to montelukast and insomnia (OR, 1.15; 95% CI, 1.05-1.27) among patients with allergic rhinitis exposed to montelukast. CONCLUSIONS AND RELEVANCE This study found that patients with asthma or allergic rhinitis had increased odds of adverse neuropsychiatric outcomes after montelukast initiation. These findings suggest that clinicians should consider monitoring potential adverse mental health symptoms during montelukast treatment, particularly in individuals with a history of mental health or sleep problems.
Collapse
Affiliation(s)
- Tapio Paljarvi
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, England, United Kingdom
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
| | - Julian Forton
- Children’s Hospital for Wales, Heath Park, Cardiff, Wales, United Kingdom
| | | | - Kimmo Herttua
- Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, England, United Kingdom
- Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, England, United Kingdom
| |
Collapse
|
10
|
Damian A, Gozal D. Innovations in the Treatment of Pediatric Obstructive Sleep Apnea. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1384:339-350. [PMID: 36217094 DOI: 10.1007/978-3-031-06413-5_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Obstructive sleep apnea affects a large proportion of otherwise healthy children in the context of interactions between craniofacial elements, adenotonsillar hypertrophy and other anatomical factors, and neuromuscular reflexes of the upper airway. In light of the adverse consequences of sleep apnea, it is important not only to proceed with early diagnosis but also to implement adequate treatment that is guided by the pathophysiological determinants of the disease in each child. Here, we will describe the current standard of care approaches to the treatment of pediatric obstructive sleep apnea, and will also explore novel management strategies that should enable more personalized therapy in the near future.
Collapse
Affiliation(s)
- Allan Damian
- Department of Neurology, University of Missouri School of Medicine, Columbia, MO, USA
- Comprehensive Sleep Medicine Program, University of Missouri School of Medicine, Columbia, MO, USA
| | - David Gozal
- Comprehensive Sleep Medicine Program, University of Missouri School of Medicine, Columbia, MO, USA.
- Department of Child Health and the Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA.
| |
Collapse
|
11
|
Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020). Pediatr Investig 2021; 5:167-187. [PMID: 34589673 PMCID: PMC8458722 DOI: 10.1002/ped4.12284] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/10/2021] [Indexed: 11/09/2022] Open
|
12
|
Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020). World J Otorhinolaryngol Head Neck Surg 2021; 7:201-220. [PMID: 34430828 PMCID: PMC8356108 DOI: 10.1016/j.wjorl.2021.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/06/2021] [Indexed: 11/30/2022] Open
|