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Article ; Online: Use of nitrous oxide in children with special health care needs

Ritwik, Priyanshi / Gupta, Kunal

Clin Dent Rev

Abstract: ... treatment for children with special health care needs. ... Providing optimal oral health care for children and individuals with special health care needs ... health care needs may have behavioral factors, medical complexities, and/or intellectual disabilities ...

Abstract	Providing optimal oral health care for children and individuals with special health care needs (SHCN) is an integral professional and ethical responsibility of dentists. Children with special health care needs may have behavioral factors, medical complexities, and/or intellectual disabilities which influence their ability to cooperate for dental treatment. They may have elevated dental fear and anxiety which may not be alleviated with basic behavior guidance strategies alone. The option to offer inhalational nitrous oxide provides an adjunctive method to help reduce a child's pain and anxiety during dental treatment. Inhalational nitrous oxide can be simply administered via a well-fitting nasal hood. Based on the underlying medical condition of the child, it may be necessary to monitor oxygen saturation with pulse oximetry. Administration of 100% oxygen preoperatively and upon completion of treatment is an essential step applicable to all the patients. Children recover quickly from the effects of nitrous oxide after post-treatment oxygenation and can be discharged to the parent without any residual effects. With appropriate case selection and administration technique, inhalational nitrous oxide is a safe and effective technique to provide dental treatment for children with special health care needs.
Keywords	covid19
Publisher	PMC
Document type	Article ; Online
DOI	10.1007/s41894-020-00085-9
Database	COVID19

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Article: A Pragmatic Primary Practice Approach to Using Specific IgE in Allergy Testing in Asthma Diagnosis, Management, and Referral.

Demoly, Pascal / Liu, Andrew H / Rodriguez Del Rio, Pablo / Pedersen, Soren / Casale, Thomas B / Price, David

Journal of asthma and allergy

2022 Volume 15, Page(s) 1069–1080

Abstract: ... recommendations apply to preschool children, school-age children, patients with persistent or difficult-to-control ... allergen immunotherapy). Allergen skin testing is common in specialized settings but less available in primary care ... eosinophil-derived neurotoxin), which can be measured in plasma or serum samples, and (ii) fractional exhaled nitric oxide (FeNO ...

Abstract	Asthma afflicts an estimated 339 million people globally and is associated with ill health, disability, and early death. Strong risk factors for developing asthma are genetic predisposition and environmental exposure to inhaled substances that may provoke allergic reactions. Asthma guidelines recommend identifying causal or trigger allergens with specific IgE (sIgE) testing after a diagnosis of asthma has been made. Allergy testing with sIgE targets subpopulations of patients considered at high risk, such as those with frequent exacerbations, emergency visits or hospitalizations, or uncontrolled symptoms. Specific recommendations apply to preschool children, school-age children, patients with persistent or difficult-to-control asthma, patients needing oral corticosteroids or high-dose inhaled steroids, patients seeking understanding and guidance about their disease, and candidates for advanced therapies (biologics, allergen immunotherapy). Allergen skin testing is common in specialized settings but less available in primary care. Blood tests for total and sIgE are accessible and yield quantifiable results for tested allergens, useful for detecting sensitization. Results are interpreted in the context of the patient's clinical presentation, age, and relevant allergen exposures. Incorporating sIgE testing into asthma management adds objective information to identify specific allergies and can guide personalized treatment plans, which reinforce patient-doctor communication. Test results can also be used to predict exacerbations and response to therapies. Additional diagnostic information can be gleaned from (i) eosinophil count ≥300 μL, which significantly increases the odds of having exacerbations, and emerging eosinophil biomarkers (eg, eosinophil-derived neurotoxin), which can be measured in plasma or serum samples, and (ii) fractional exhaled nitric oxide (FeNO), with values ≥25 ppb regarded as the cutoff for diagnosis, evaluating inhaled corticosteroid response, and of probable response to anti-IgE, anti-IL4 and anti-IL5 receptor biologics. Referral to asthma/allergy specialists is warranted when the initial diagnosis is uncertain, and when asthma symptoms, impairment, or exacerbations are repeated or severe.
Language	English
Publishing date	2022-08-16
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2494877-9
ISSN	1178-6965
ISSN	1178-6965
DOI	10.2147/JAA.S362588
Database	MEDical Literature Analysis and Retrieval System OnLINE

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