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Author Brand, P.L.P.; Baraldi, E.; Bisgaard, H.; Boner, A.L.; Castro-Rodriguez, J.A.; Custovic, A.; de Blic, J.; de Jongste, J.C.; Eber, E.; Everard, M.L.; Frey, U.; Gappa, M.; Garcia-Marcos, L.; Grigg, J.; Lenney, W.; Le Souef, P.; McKenzie, S.; Merkus, P.J.F.M.; Midulla, F.; Paton, J.Y.; Piacentini, G.; Pohunek, P.; Rossi, G.A.; Seddon, P.; Silverman, M.; Sly, P.D.; Stick, S.; Valiulis, A.; van Aalderen, W.M.C.; Wildhaber, J.H.; Wennergren, G.; Wilson, N.; Zivkovic, Z.; Bush, A. url  doi
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  Title Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach Type Journal Article
  Year (down) 2008 Publication The European Respiratory Journal Abbreviated Journal Eur Respir J  
  Volume 32 Issue 4 Pages 1096-1110  
  Keywords Adrenal Cortex Hormones/metabolism; Allergens/metabolism; Child; Child, Preschool; Cohort Studies; Evidence-Based Medicine; Glucocorticoids/metabolism; Humans; Multicenter Studies as Topic; Patient Education as Topic; Phenotype; Randomized Controlled Trials as Topic; Respiratory Sounds/*diagnosis; Time Factors; Treatment Outcome  
  Abstract There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze both during and outside discrete episodes. Investigations are only needed when in doubt about the diagnosis. Based on the limited evidence available, inhaled short-acting beta(2)-agonists by metered-dose inhaler/spacer combination are recommended for symptomatic relief. Educating parents regarding causative factors and treatment is useful. Exposure to tobacco smoke should be avoided; allergen avoidance may be considered when sensitisation has been established. Maintenance treatment with inhaled corticosteroids is recommended for multiple-trigger wheeze; benefits are often small. Montelukast is recommended for the treatment of episodic (viral) wheeze and can be started when symptoms of a viral cold develop. Given the large overlap in phenotypes, and the fact that patients can move from one phenotype to another, inhaled corticosteroids and montelukast may be considered on a trial basis in almost any preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit. Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes.  
  Address Princess Amalia Children's Clinic, Isala klinieken, Zwolle, The Netherlands. p.l.p.brand@isala.nl  
  Corporate Author Thesis  
  Impact Factor 07,636 First Author Brand, P.L.P. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Bush, A.  
  ISSN 0903-1936 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:18827155 Approved no  
  Call Number Serial 126  
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