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Monica Alexoae

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

ATOPIA, FACTOR DE RISC IN APARITIA OTITEI SEROASE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ATOPIA, FACTOR DE RISC IN APARITIA OTITEI SEROASE LA COPIL

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ABSTRACT

Otita medie seroasă cronică, cauză majoră a hipoacuziei în perioada copilăriei, este frecvent asociată cu sensibilizarea alergică. Prevalenţa în continuă creştere a atopiei la această vârstă implică o abordare multidisciplinară a copiilor cu adenoidite, otite recurente şi disfuncţii tubare, în vederea unui management patogenic complex.
Obiectivul studiului a constat în determinarea asocierii otitelor medii cu bolile alergice, şi implicaţiile acestei asocieri în tratamentul şi evoluţia pacienţilor.
Material şi metodă. S-a realizat un studiu retrospectiv care a inclus 92 de copii, cu vârste cuprinse între 6 luni şi 6 ani internaţi în Clinica II Pediatrie, Spitalul Clinic de Copii „Sf. Maria“, Iaşi, cu diagnosticul de otită medie, pe o perioadă de 1 an (ianuarie 2015 – ianuarie 2016).
Rezultate. Majoritatea cazurilor au fost otite supurate (61 de pacienţi), 31 de cazuri au fost otite seroase, dintre care 23 au fost recurente. Asocierea cu bolile alergice a fost mai frecventă la copiii cu otită seroasă (26/31 cazuri). 4 pacienţi cu otită supurată au prezentat reacţii adverse la antibiotice, cu implicaţii majore în evoluţia cazurilor. Asocierea cu refluxul gastroesofagian a fost relativ asemănătoare între cele 2 loturi (11/61 de cazuri şi respectiv 10/31 de cazuri), la 10 pacienţi atopici, obiectivându-se alergia la proteinele laptelui de vacă.
În concluzie, copiii cu otite medii, în special cei cu otite medii seroase recurente ar trebui investigaţi pentru determinarea coexistenţei atopiei şi a refluxului gastroesofagian, eventual cu dozarea markerilor de inflamaţie alergică sau a pepsinei în exsudatul otic, în vederea unui management terapeutic ţintit.

Keywords: otită seroasă, alergie, copii

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ATOPY, RISK FACTOR FOR OTITIS MEDIA WITH EFFUSION

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

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ATOPY, RISK FACTOR FOR OTITIS MEDIA WITH EFFUSION

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ABSTRACT

Chronic otitis, one of the major causes of pediatric hypoacusia is frequent associated with some allergic diseases. The continuous rice of atopic diseases prevalence in childhood, involves a multidisciplinary approach of Eustachian tube dysfunction, adenoid inflammation or recurrent otitis, for a complex pathogenic management.
The objective of this study was to determinate the association between otitis media and the allergic diseases with the implication in the treatment and evolution of this patients.
Methods. Retrospective study on 92 children, between 6 month and 6 years, admitted in II Pediatric Clinic, Clinical Hospital of Children “Sf. Maria” Iasi with diagnosis of acute otitis media, for a period of 1 year.
Results. Majority of cases (61patients) have been suppurate otitis, 31 cases have been otitis media with effusion out of which 23 have been recurrent. Association with allergic diseases has been more frequent in children with serous otitis media (26/31 cases). 4 cases with suppurate otitis media have developed adverse reaction to antibiotics with major implication in the cases evolution. Association with gastroesophageal reflux was relatively similar between cases with serous otitis and the suppurate ones (10/31 cases and 11/61 cases). From the atopic patients with gastroesophageal reflux, 10 presented cow’s milk protein allergy.
In conclusion, the children with otitis media, especially those with recurrent none suppurate form should be investigated for atopy and, eventually, for gastroesophageal reflux, possibly with determination of the allergic markers or of pepsin in the otic exudates, in order to a targeted therapeutic management.

Keywords: otitis, effusion, allergy, children

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DIAGNOSTICUL POZITIV AL ALERGIEI ALIMENTARE MEDIATE IgE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 1, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ICMJE- Recommendations

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DIAGNOSTICUL POZITIV AL ALERGIEI ALIMENTARE MEDIATE IgE LA COPIL

and

REZUMAT

Diagnosticul alergiei alimentare este dificil în pofida progreselor recente înregistrate în descifrarea patogeniei bolii. Suspiciunea clinică necesită confirmare printr-o baterie de investigaţii (anamneză, examen fizic, jurnal alimentar, teste cutanate alergologice, determinarea IgE serice totale şi specifice, investigarea leziunii ţesutului intestinal prin biopsie şi/sau testul permeabilităţii intestinale, alte teste folosite în special în scop de cercetare: eliberarea de histamină din bazofile şi mastocitele intestinale, determinarea complexelor imune circulante, testul transformării limfoblastice, dozarea triptazei şi a proteinei cationice a eozinofilului). Proba de provocare alimentară dublu orb controlată placebo reprezintă gold standardul diagnostic în alergia alimentară la copil, dar nu se poate efectua decât în centre specializate de către personal instruit în acest sens, fiind inaccesibilă practicii curente.

Cuvinte cheie: alergie alimentară, diagnostic, copil

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Scleroderma in young children

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

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Promoting Global Health

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Scleroderma in young children

, , , , and

ABSTRACT

Chronic disease of unknown etiology, scleroderma represents a disease that occurs rarely in young children, with an estimated frequency of less than 1% up to age 5. Evolution of scleroderma is variable, unpredictable and the delineation of clinical forms in children is difficult. Some patients may experience periods of calm for many years, others have a progressive worsening, without remission and death. Our case is characterized by the onset at a young age, bringing together major and minor criteria for systemic scleroderma.

Key words: systemic scleroderma, young children

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SCLERODERMIA LA COPILUL MIC

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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SCLERODERMIA LA COPILUL MIC

, , , , and

REZUMAT

Boală cronică de etiologie necunoscută, sclerodermia este o boală care apare rar la copilul mic, estimându-se o frecvenţă de sub 1% până la vârsta de 5 ani. Evoluţia cazurilor de sclerodermie este variabilă, imprevizibilă, delimitarea formelor clinice fiind dificilă la copil. Unii bolnavi pot prezenta perioade de acalmie mai mulţi ani, alţii au o evoluţie progresivă spre agravare (fără remisiuni) şi deces. Cazul prezentat se particularizează prin debutul sclerodermiei la vârstă mică, bolnavul întrunind, la 1 an si 3 luni, criterii majore şi minore de sclerodermie sistemică.

Cuvinte cheie: sclerodermie sistemică, copil mic

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Quality of life assessment – an important part of the food allergy management in children

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 3, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

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ICMJE- Recommendations

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Promoting Global Health

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Quality of life assessment – an important part of the food allergy management in children

and

ABSTRACT

The prevalence of food allergy is increased during the last decades (25-30%); it is involved in skin and respiratory allergic diseases. Elimination diet of the food identified through history and specific tests represents the only benefic therapeutic measure. The quality of life’s impact of food allergy is influenced by the necessity of a continuous vigilance for careful reading of the labels of the commercial foods, recognition of the less known terms, correction of the nutritional deficiencies due to the absence of an essential food, increased price of the hypoallergenic formula, other allergic comorbidities and parents’ concerns of fatal allergic reaction.

Key words: food allergy, diet, quality of life

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EVALUAREA CALITATII VIETII – COMPONENTA IMPORTANTA A MANAGEMENTULUI ALERGIEI ALIMENTARE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 3, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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EVALUAREA CALITATII VIETII – COMPONENTA IMPORTANTA A MANAGEMENTULUI ALERGIEI ALIMENTARE LA COPIL

and

REZUMAT

Alergia alimentară se înscrie pe panta ascendentă a prevalenţei alergiilor (25-30%), fiind implicată etiopatogenetic în boli cutanate şi/sau respiratorii. Dieta de eliminare a alimentului identificat prin anamneză şi investigaţii specifice ca fiind responsabil pentru simptomatologie reprezintă singura măsură terapeutică cu rezultate benefice. Calitatea vieţii copiilor şi familiei este afectată de necesitatea unei vigilenţe crescute pentru citirea atentă a etichetelor produselor comerciale şi recunoaşterea termenilor mai puţin cunoscuţi, corectarea deficienţelor nutriţionale datorate absenţei alimentelor esenţiale din dietă, costul ridicat al formulelor hipoalergenice, existenţa altor comorbidităţi alergice, îngrijorarea unei posibile reacţii alergice fatale.

Cuvinte cheie: Boala Addison, copil

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Risk factors for asthma in children (6-18 years)

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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Risk factors for asthma in children (6-18 years)

, , , , and

ABSTRACT

Asthma is one of the most common diseases in children and an important cause of morbidity and mortality, with recent increased prevalence. Asthma diagnosis in children is often underestimated in early childhood. The aim of present study is to anamnestically assess using clinical and specific paraclinic exploration the incidence of the risk factors highly suggestive of asthma in children (6-18 years) and the correlation with disease severity. The questionnaires used in this study included relevant information to known risk factors for asthma during pre and postnatal period, preadolescence and adolescence stage. The principal risk factors for asthma identified in descending order of frequency were: personal atopy, recurrent wheezing, male gender, urban environment, indoor air allergens exposure (house dust, domestic animals, house mold) allergic sensitization to indoor allergens (house-dust mites), infant artificial feeding, family atopy, exposure to second hand tobacco smoke. Allergic polisensitization and tobacco smoke exposure are associated with severe asthma. The majority of cases were affected by asthma-related comorbid conditions and allergic rhinitis was the most frequent comorbidity.

Key words: asthma, child, risk factors, atopy

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FACTORI DE RISC PENTRU ASTMUL BRONSIC LA COPIL (6-18 ANI)

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

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Promoting Global Health

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FACTORI DE RISC PENTRU ASTMUL BRONSIC LA COPIL (6-18 ANI)

, , , , and

REZUMAT

Astmul bronşic este considerat una dintre din cele mai comune boli cronice ale copilului şi reprezintă o cauză importantă de morbiditate şi mortalitate, cu prevalenţă în creştere, conform estimărilor recente. La acest aspect contribuie subevaluarea diagnosticului la vârstă mică. Studiul îşi propune evaluarea anamnestică şi prin explorări clinico-paraclinice a incidenţei factorilor de risc sugestivi pentru suspiciunea de diagnostic de astm bronşic la copil, la vârsta de 6-18 ani, precum şi corelaţiile acestora cu gradul de severitate a bolii. Studiul a utililizat chestionare ce au inclus informaţii relevante pentru factorii de risc cunoscuţi ante şi postnatal precum şi cei asociaţi etapelor de viaţă preadolescent şi adolescent. Principalii factori de risc pentru astmul bronşic identificaţi în studiu (în ordinea frecvenţei) au fost: prezenţa atopiei personale, istoric de wheezing recurent, sexul masculin, mediul urban, expunerea la aeroalergeni de interior (praf, păr de animale, mucegai), sensibilizarea alergică la aeroalergeni (în special la acarieni), alimentaţia artificială, prezenţa atopiei familiale, fumatul pasiv. Polisensibilizarea alergică şi expunerea la fumul de ţigară se asociază cu forme mai severe de astm. Comorbidităţi alergice au fost prezente în majoritatea cazurilor, cea mai frecventă fiind rinita alergică (78%).

Cuvinte cheie: astm bronşic, copil, factori de risc, atopie

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Chronic rhinosinusitis as a risk factor of difficult to control asthma. Therapeutical considerations

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

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Chronic rhinosinusitis as a risk factor of difficult to control asthma. Therapeutical considerations

, , , , and

ABSTRACT

Children with difficult to control asthma are a heterogeneous group. These cases need a review of diagnosis and evaluation of the different risk factors for loose control. There are known that nasal sinus disease may contribute to less control of asthma. The prevalence of chronic rhinosinusitis in the pediatric population is inversely related to the age of the patient. Many features of CRS are similar with those of viral upper respiratory tract infections or allergic rhinitis. That is why the diagnosis of CRS in this group can be more difficult to make. The effect on quality of life for chronic rhinosinusitis (CRS) in the pediatric population is also significant. Our study wants to prove that antibiotic treatment with antihistamines associated to combine asthma therapy in asthmatic children with chronic sinus disease may improve quality of life and lung function.

Methods: 31 children (ages between 8-18), with mild to severe persistent asthma and chronic rhinosinusitis were tested using tests of quality of life (Juniper 2001), ENT exam, sinus X-ray, eosinophyls and microbiological examination in sputum and nasal secretions, spirometry (Pony FX) before and after 3 month of combined anti-inflammatory and long acting beta agonist (GINA 2006) therapy, associated with a broad-spectrum antibiotic, nasal steroid and an oral antihistamine.

Results: after 3 month of combined therapy, quality testing of life was significantly improved, from symptomatic (p=0,024), activity (p=0,003) and emotional (p<0,001) point of view, as well as FEV1 (p<0,001), but has not MEF50 (p=0,105, p>0,05).The positive evolution was found in 28/31 cases. The pattern of inflammation in the airways was eosinophilic (3/21 cases tested), neutrophilic (13/21 cases tested), mixed (3/21 cases tested) and non-inflammatory (2/21 cases tested). The most common microbian agents found in sputum culture was Haemophylus influentzae (6/22 cases tested), Streptococcus pneumoniae (4/22 cases tested), Branhamella catharalis (7/22 cases tested).

Conclusions: the treatment of chronic rhinosinusitis (specific antibiotherapy, antihistamines) associated with aggressive treatment against eosinophylic inflammation of airways improve the quality of life and lung function of those children with difficult to control asthma.

Key words: chronic rhinosinusities, asthma, complex treatment, quality of life tests, pulmonary function

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