Yiqin Chen

International consensus on (ICON) pediatric asthma

Asthma is the most common chronic lower respiratory disease in childhood throughout the world. Several guidelines and/or consensus documents are available to support medical decisions on pediatric asthma. Although there is no doubt that the use of common systematic approaches for management can considerably improve outcomes, dissemination and implementation of these are still major challenges. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), recently formed by the EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus on (ICON) Pediatric Asthma. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences, thus providing a concise reference. The principles of pediatric asthma management are generally accepted. Overall, the treatment goal is disease control. To achieve this, patients and their parents should be educated to optimally manage the disease, in collaboration with healthcare professionals. Identification and avoidance of triggers is also of significant importance. Assessment and monitoring should be performed regularly to re‐evaluate and fine‐tune treatment. Pharmacotherapy is the cornerstone of treatment. The optimal use of medication can, in most cases, help patients control symptoms and reduce the risk for future morbidity. The management of exacerbations is a major consideration, independent of chronic treatment. There is a trend toward considering phenotype‐specific treatment choices; however, this goal has not yet been achieved.

Polybrominated diphenyl ether flame retardant concentrations in faeces from young children in Queensland, Australia and associations with environmental and behavioural factors

Abstract The aim of our study was to investigate childrens exposure to the flame retardants polybrominated diphenyl ethers (PBDEs) by analysing faecal content, a non‐invasive matrix, as well as responses to an exposure‐assessment questionnaire. A convenience sample of 61 parents with children (aged >3 months to <2 years) completed an online pre‐tested questionnaire and provided faecal samples for analysis by high resolution gas chromatography/mass spectrometry. BDE‐209 was the dominant congener in faecal samples adjusted to 8.3 ng/g dry weight (dw), with >80% samples above the limit of detection (LOD). BDE‐47 (0.23 ng/g dw) and BDE‐153 (0.03 ng/g dw) were each detected above the LOD in approximately 60% of samples. Age was associated with BDE‐47 (−7%/month) and BDE‐153 (−12%/month) concentrations in faeces, but not BDE‐209. Other variables associated with PBDE concentrations included features of the home (carpet, pets) and behaviour (hand‐to‐mouth, removing shoes, using a car sunshade, frequency of walks outdoors). However, given the small sample size of this study additional research is required to confirm these findings. In this study we demonstrated that faeces may be a viable alternative to monitor human exposure to PBDEs, but further validation studies are required. HighlightsThis study provides the first report of BDE‐209 biomonitoring in Australian children.Faeces, a non‐invasive matrix, were used to assess PBDE exposure in young children (<2 years) exposure.BDE‐47 and BDE‐153 but not BDE‐209 concentrations were significantly negatively associated with childs age age.Faeces may be a viable alternative to serum for biomonitoring, but more validation studies are required.