Objective: To analyze the diagnosis of NT-proBNP and C-reactive protein in children with Kawasaki disease, and to study its economics and significance. Methods: Twenty patients with acute Kawasaki disease and 20 patie...Objective: To analyze the diagnosis of NT-proBNP and C-reactive protein in children with Kawasaki disease, and to study its economics and significance. Methods: Twenty patients with acute Kawasaki disease and 20 patients with Kawasaki disease recovery from June 2017 to June 2018 were enrolled in our hospital. Twenty patients with respiratory infection were included in the control group. The levels of proBNP and C-reactive protein were divided into children without Kawasaki disease and coronary artery disease group, and the levels of NT-proBNP and C-reactive protein were compared. Results: The levels of NT-proBNP and C-reactive protein in the acute phase of Kawasaki disease and the recovery group of Kawasaki disease were significantly higher than those in the control group, and the acute phase group was significantly higher than the recovery group. The difference between the groups was statistically significant. In the detection of lesions in children with acute Kawasaki disease, the levels of WBC, PLT, and CRP in children with lesions were higher than those without lesions. The difference between the detection indexes and the lesions was P<0.05, but NT There was no significant difference in the level of -proBNP. There was no significant difference in NT-proBNP levels between the non-coronary lesion group and the coronary artery disease group in the acute phase of Kawasaki disease. The level of C-reactive protein in the group was significantly higher than that in the group without coronary artery disease, and the two groups were statistically significant. Conclusion: The detection of NT-proBNP and C-reactive protein in children with Kawasaki disease can accurately determine the extent of disease, and can be used as a laboratory index and treatment guidance. The combined detection accuracy of these two is more accurate, and it has important clinical significance for the diagnosis and treatment of Kawasaki disease value.展开更多
Background Respiratory syncytial virus(RSV)is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5...Background Respiratory syncytial virus(RSV)is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years,representing a major global healthcare burden.There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life.A multidisciplinary consensus development group comprising experts in epidemiology,infectious diseases,respiratory medicine,and methodology aims to develop the current consensus to address clinical issues of RSV infections in children.Data sources The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Library,using variations in terms for"respiratory syncytial virus","RSV","lower respiratory tract infection","bronchiolitis","acute","viral pneumonia","neonatal","infant""children",and"pediatric".Results Evidence-based recommendations regarding diagnosis,treatment,and prevention were proposed with a high degree of consensus.Although supportive care remains the cornerstone for the management of RSV infections,new monoclonal antibodies,vaccines,drug therapies,and viral surveillance techniques are being rolled out.Conclusions This consensus,based on international and national scientific evidence,reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections.Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.展开更多
Background Mycoplasma pneumoniae(M.pneumoniae)is a significant contributor to community-acquired pneumonia among children.Since 1968,when a strain of M.pneumoniae resistant to macrolide antibiotics was initially repor...Background Mycoplasma pneumoniae(M.pneumoniae)is a significant contributor to community-acquired pneumonia among children.Since 1968,when a strain of M.pneumoniae resistant to macrolide antibiotics was initially reported in Japan,macrolide-resistant M.pneumoniae(MRMP)has been documented in many countries worldwide,with varying incidence rates.MRMP infections lead to a poor response to macrolide antibiotics,frequently resulting in prolonged fever,extended antibiotic treatment,increased hospitalization,intensive care unit admissions,and a significantly higher proportion of patients receiving glucocorticoids or second-line antibiotics.Since 2000,the global incidence of MRMP has gradually increased,especially in East Asia,which has posed a serious challenge to the treatment of M.pneumoniae infections in children and attracted widespread attention from pediatricians.However,there is still no global consensus on the diagnosis and treatment of MRMP in children.Methods We organized 29 Chinese experts majoring in pediatric pulmonology and epidemiology to write the world’s first consensus on the diagnosis and treatment of pediatric MRMP pneumonia,based on evidence collection.The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,CNKI,Medline,and the Cochrane Library.We used variations in terms for“macrolide-resistant”,“Mycoplasma pneumoniae”,“MP”,“M.pneumoniae”,“pneumonia”,“MRMP”,“lower respiratory tract infection”,“Mycoplasma pneumoniae infection”,“children”,and“pediatric”.Results Epidemiology,pathogenesis,clinical manifestations,early identification,laboratory examination,principles of antibiotic use,application of glucocorticoids and intravenous immunoglobulin,and precautions for bronchoscopy are highlighted.Early and rapid identification of gene mutations associated with MRMP is now available by polymerase chain reaction and fluorescent probe techniques in respiratory specimens.Although the resistance rate to macrolide remains high,it is fortunate that M.pneumoniae still maintains good in vitro sensitivity to second-line antibiotics such as tetracyclines and quinolones,making them an effective treatment option for patients with initial treatment failure caused by macrolide antibiotics.Conclusions This consensus,based on international and national scientific evidence,provides scientific guidance for the diagnosis and treatment of MRMP in children.Further studies on tetracycline and quinolone drugs in children are urgently needed to evaluate their effects on the growth and development.Additionally,developing an antibiotic rotation treatment strategy is necessary to reduce the prevalence of MRMP strains.展开更多
Background There are limited studies comparing budesonide inhalation suspension(BIS)with montelukast in real-world settings where treatment adherence and persistency may be suboptimal.This real-world study aims to inv...Background There are limited studies comparing budesonide inhalation suspension(BIS)with montelukast in real-world settings where treatment adherence and persistency may be suboptimal.This real-world study aims to investigate the control effectiveness of montelukast or BIS as a monotherapy in Chinese children with mild asthma.Methods Data were derived from a retrospective questionnaire-based analysis of 2-14-year-old children with mild persistent asthma,who received either 500 pg of BIS(n=153)or 4-5 mg of montelukast(n=240)once daily.The indicators of asthma control,the Asthma Control Test(ACT)/Childhood ACT(C-ACT)score,and the asthma-related medical costs were assessed.The differences between the two groups were compared using an unpaired-t-test(normally distributed).Mann-Whitney U test(non-normally distributed)or chi-squared test(categorical variables).Results Medication compliance in the past 3-month period was better in the montelukast group than in the BIS group(P=0.042).The montelukast group exhibited better asthma control in the past 4-week period,including lower percentages of asthmatic children with symptoms more than twice a week(P=0.021),had night waking or night coughing(P=0.022),or required reliever medication more than twice a week(P<0.001).The montelukast group had a lower percentage of children with an ACT/C-ACT score≤19(P=0.015).Caregivers reported a significantly better exercise tolerance in the children who received montelukast vs.BIS in the past 12 months(P<0.001).Significantly higher medical expenditures attributable to asthma in the past 12 months were observed in the BIS group vs.montelukast group(P<0.001).Conclusion Both treatments provided acceptable overall asthma control in children with mild persistent asthma;however,more reliever medication and more medical expenditures attributable to asthma were needed for BIS vs.montelukast in real-world settings,where factors such as compliance were also taken into account.展开更多
文摘Objective: To analyze the diagnosis of NT-proBNP and C-reactive protein in children with Kawasaki disease, and to study its economics and significance. Methods: Twenty patients with acute Kawasaki disease and 20 patients with Kawasaki disease recovery from June 2017 to June 2018 were enrolled in our hospital. Twenty patients with respiratory infection were included in the control group. The levels of proBNP and C-reactive protein were divided into children without Kawasaki disease and coronary artery disease group, and the levels of NT-proBNP and C-reactive protein were compared. Results: The levels of NT-proBNP and C-reactive protein in the acute phase of Kawasaki disease and the recovery group of Kawasaki disease were significantly higher than those in the control group, and the acute phase group was significantly higher than the recovery group. The difference between the groups was statistically significant. In the detection of lesions in children with acute Kawasaki disease, the levels of WBC, PLT, and CRP in children with lesions were higher than those without lesions. The difference between the detection indexes and the lesions was P<0.05, but NT There was no significant difference in the level of -proBNP. There was no significant difference in NT-proBNP levels between the non-coronary lesion group and the coronary artery disease group in the acute phase of Kawasaki disease. The level of C-reactive protein in the group was significantly higher than that in the group without coronary artery disease, and the two groups were statistically significant. Conclusion: The detection of NT-proBNP and C-reactive protein in children with Kawasaki disease can accurately determine the extent of disease, and can be used as a laboratory index and treatment guidance. The combined detection accuracy of these two is more accurate, and it has important clinical significance for the diagnosis and treatment of Kawasaki disease value.
文摘Background Respiratory syncytial virus(RSV)is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years,representing a major global healthcare burden.There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life.A multidisciplinary consensus development group comprising experts in epidemiology,infectious diseases,respiratory medicine,and methodology aims to develop the current consensus to address clinical issues of RSV infections in children.Data sources The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Library,using variations in terms for"respiratory syncytial virus","RSV","lower respiratory tract infection","bronchiolitis","acute","viral pneumonia","neonatal","infant""children",and"pediatric".Results Evidence-based recommendations regarding diagnosis,treatment,and prevention were proposed with a high degree of consensus.Although supportive care remains the cornerstone for the management of RSV infections,new monoclonal antibodies,vaccines,drug therapies,and viral surveillance techniques are being rolled out.Conclusions This consensus,based on international and national scientific evidence,reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections.Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.
基金supported by the grants from Key R&D Projects of Zhejiang Province(2023C03009 and 2024C03177).
文摘Background Mycoplasma pneumoniae(M.pneumoniae)is a significant contributor to community-acquired pneumonia among children.Since 1968,when a strain of M.pneumoniae resistant to macrolide antibiotics was initially reported in Japan,macrolide-resistant M.pneumoniae(MRMP)has been documented in many countries worldwide,with varying incidence rates.MRMP infections lead to a poor response to macrolide antibiotics,frequently resulting in prolonged fever,extended antibiotic treatment,increased hospitalization,intensive care unit admissions,and a significantly higher proportion of patients receiving glucocorticoids or second-line antibiotics.Since 2000,the global incidence of MRMP has gradually increased,especially in East Asia,which has posed a serious challenge to the treatment of M.pneumoniae infections in children and attracted widespread attention from pediatricians.However,there is still no global consensus on the diagnosis and treatment of MRMP in children.Methods We organized 29 Chinese experts majoring in pediatric pulmonology and epidemiology to write the world’s first consensus on the diagnosis and treatment of pediatric MRMP pneumonia,based on evidence collection.The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,CNKI,Medline,and the Cochrane Library.We used variations in terms for“macrolide-resistant”,“Mycoplasma pneumoniae”,“MP”,“M.pneumoniae”,“pneumonia”,“MRMP”,“lower respiratory tract infection”,“Mycoplasma pneumoniae infection”,“children”,and“pediatric”.Results Epidemiology,pathogenesis,clinical manifestations,early identification,laboratory examination,principles of antibiotic use,application of glucocorticoids and intravenous immunoglobulin,and precautions for bronchoscopy are highlighted.Early and rapid identification of gene mutations associated with MRMP is now available by polymerase chain reaction and fluorescent probe techniques in respiratory specimens.Although the resistance rate to macrolide remains high,it is fortunate that M.pneumoniae still maintains good in vitro sensitivity to second-line antibiotics such as tetracyclines and quinolones,making them an effective treatment option for patients with initial treatment failure caused by macrolide antibiotics.Conclusions This consensus,based on international and national scientific evidence,provides scientific guidance for the diagnosis and treatment of MRMP in children.Further studies on tetracycline and quinolone drugs in children are urgently needed to evaluate their effects on the growth and development.Additionally,developing an antibiotic rotation treatment strategy is necessary to reduce the prevalence of MRMP strains.
基金supported by MSD China,Shanghai,China(grant number:50146).
文摘Background There are limited studies comparing budesonide inhalation suspension(BIS)with montelukast in real-world settings where treatment adherence and persistency may be suboptimal.This real-world study aims to investigate the control effectiveness of montelukast or BIS as a monotherapy in Chinese children with mild asthma.Methods Data were derived from a retrospective questionnaire-based analysis of 2-14-year-old children with mild persistent asthma,who received either 500 pg of BIS(n=153)or 4-5 mg of montelukast(n=240)once daily.The indicators of asthma control,the Asthma Control Test(ACT)/Childhood ACT(C-ACT)score,and the asthma-related medical costs were assessed.The differences between the two groups were compared using an unpaired-t-test(normally distributed).Mann-Whitney U test(non-normally distributed)or chi-squared test(categorical variables).Results Medication compliance in the past 3-month period was better in the montelukast group than in the BIS group(P=0.042).The montelukast group exhibited better asthma control in the past 4-week period,including lower percentages of asthmatic children with symptoms more than twice a week(P=0.021),had night waking or night coughing(P=0.022),or required reliever medication more than twice a week(P<0.001).The montelukast group had a lower percentage of children with an ACT/C-ACT score≤19(P=0.015).Caregivers reported a significantly better exercise tolerance in the children who received montelukast vs.BIS in the past 12 months(P<0.001).Significantly higher medical expenditures attributable to asthma in the past 12 months were observed in the BIS group vs.montelukast group(P<0.001).Conclusion Both treatments provided acceptable overall asthma control in children with mild persistent asthma;however,more reliever medication and more medical expenditures attributable to asthma were needed for BIS vs.montelukast in real-world settings,where factors such as compliance were also taken into account.
