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Advances in the pathogenesis and personalised treatment of paediatric asthma
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  • Published on: 22 September 2023
    Addressing gaps in paediatric asthma care
    • Elizabeth S Scotney, Paediatric Respiratory Doctor NHLI, Imperial College London, Royal Brompton Hospital
    • Other Contributors:
      • Andrew Bush, Professor of Paediatrics and Paediatric Respirology

    Many thanks to Adriana de la Caridad Albert Montero and colleagues for their response to our review article and highlighting these important points.

    The prevalence of asthma in preschool age children is indeed difficult to determine due to widespread differences in definition, diagnostic criteria, and diagnostic labels given to preschool aged children with wheeze. However, population based cohort epidemiological studies, despite their limitations are an important approach for estimating the prevalence of wheeze in preschool age children, and improving understanding of factors associated with persistence of symptoms and progression to school age asthma (1).

    Educating children and their carers on the underlying airway pathogenesis is essential for helping them to better understand the mechanism of action of asthma medications, encourage adherence to treatment, elimination of asthma triggers, and improve overall asthma management. International asthma management guidelines recommend an asthma action plan review at each clinical consultation, which includes discussing asthma triggers as well as rationale for prescribed asthma management (2, 3) .

    The increase in prevalence of asthma can be attributed to many different factors, including indoor pollution and aeroallergen sensitisation (4). Other possible factors associated with the global increase in asthma prevalence include urbanisation, airway microbial dysbiosis, pollution and obesity. Allergen avo...

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    Conflict of Interest:
    None declared.
  • Published on: 7 August 2023
    Closing gaps in asthma care.
    • Adriana de la Caridad Albert Montero, Doctora Salud Trinidad
    • Other Contributors:
      • Sorahy Z Santander García, Doctora
      • Ihosvany Castellanos Santos, Máster
      • Anya González Medinilla, Doctora
      • Amalia Fernández Enriquez, Doctora
      • Liset Navarro Brito, Licenciada
      • Doralkis Mursuli Gómez, Licenciada
      • Kernel Orsini Valdivia, Licenciado
      • Marleny Moreno Pérez, Licenciada
      • Gamar Toyo Girao, Licenciado
      • Tania Martinez Medina, Licenciada

    Asthma is one of the most prevalent chronic diseases in childhood. In the first three years of life, the definition, diagnostic criteria, and even classification of asthma are complicated and subject to controversy, making it difficult to know its prevalence at these ages.
    In Cuba, one of the pillars that we take into account for the management of the asthmatic patient in the pediatric age is the education of the patient and his family, which constitutes an important element, increases their quality of life, reduces the risks of exacerbation and health costs. The patient is provided with knowledge and skills, improves their self-care and therapeutic compliance, providing greater adherence to treatment, optimal control of their disease and greater autonomy for the patient.
    It is necessary for the patient to know that asthma is a chronic disease and needs continuous treatment, even if they do not have discomfort, the differences that exist between bronchoconstriction and inflammation and between drugs that reliever the obstruction of the controllers of inflammation. In addition, patients must recognize the symptoms of the disease and identify and avoid the triggers of the disease as much as possible.
    Among the causes probably related to the growth in the prevalence of asthma, is the increase in exposure to indoor allergens, associated with the progression of sensitization to aeroallergens. Cohort studies have shown that between 40 and 80% of children with a...

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    Conflict of Interest:
    None declared.
  • Published on: 30 July 2023
    correction in the sources and selection criteria

    1. In the sources and selection criteria "We reviewed articles on paediatric asthma published from 1 January 1992 to 31 February 2023" ; it has to be changed to 28 February 2023 from 31 February 2023.
    2. In the sources and selection criteria "We used specific search terms (Asthma OR wheez* AND Child OR infant AND management OR treatment OR biologic)" ; It has to be Asthma OR wheeze

    Conflict of Interest:
    None declared.