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Why we should focus on adolescents and young adults
Clinical & Experimental Allergy ( IF 6.3 ) Pub Date : 2020-06-01 , DOI: 10.1111/cea.13666
G Roberts 1, 2, 3
Affiliation  

Adolescence and young adults are an overlooked population. They are assumed to be fit and healthy when actually there is a spike of morbidity and mortality in this age group. There are many reasons for this. Over adolescence, they have to go from being dependent children to independent, expert, adult patients. This is at the same time as they have huge biological changes in body stature and form along with huge sociological changes around interpersonal relationships. Over the last three years, I have led a European Task Force looking at how we can improve the management and outcome of this age group (Figure 1). Our recently published systematic reviews1,2 have documented the current state of the evidence. Healthcare professionals need to take into account the challenges faced by this age group around changing personal relationships, education and employment problems plus depression and anxiety.1,3,4 More positively, there are some data on interventions for this age group2 albeit much of the evidence is provisional. Perhaps the most important advance in our understanding of this age group is the realization that the major changes seen in the adolescent brain continue to around 25 years of age. With different parts of the brain developing at different speeds, there is an imbalance in systems responsible for reactivity and regulation. This explains much of the characteristic behavioural traits seen in this age group, so the task force chose to focus on an 11to 25-year age range. A guideline to support the transition of adolescents and young adults will be published later in 2020. It is hoped that this will support paediatricians and adult physicians in managing this vulnerable age group and improve their health outcomes. Jendoubi et al have undertaken a systematic review to assess the efficacy and safety of omalizumab for mastocytosis.5 They were only able to include a total of 69 participants in their review, from observational studies. Encouragingly though, omalizumab was associated with the tolerance of venom immunotherapy, complete resolution of idiopathic anaphylaxis episodes and other symptoms in many participants (Figure 2). The authors suggest that we need a randomized controlled trial to assess the efficacy of omalizumab in mastocytosis. F I G U R E 1 Adolescent and young adult task force

中文翻译:

为什么我们应该关注青少年和年轻人

青少年和年轻人是一个被忽视的人群。当实际上这个年龄组的发病率和死亡率激增时,他们被认为是健康的。这件事情是由很多原因导致的。在青春期,他们必须从依赖孩子变成独立的、专业的、成年患者。与此同时,他们的身材和形态发生了巨大的生物学变化,以及围绕人际关系的巨大社会学变化。在过去的三年里,我领导了一个欧洲工作组,研究我们如何改善这个年龄组的管理和结果(图 1)。我们最近发表的系统评价 1,2 记录了证据的当前状态。医疗保健专业人员需要考虑到这个年龄组在改变个人关系方面面临的挑战,教育和就业问题加上抑郁和焦虑。1,3,4 更积极的是,有一些关于这个年龄组 2 的干预措施的数据,尽管大部分证据是临时的。也许我们对这个年龄组的理解最重要的进步是认识到青少年大脑的主要变化会持续到 25 岁左右。由于大脑的不同部分以不同的速度发育,负责反应和调节的系统存在不平衡。这解释了这个年龄组的许多典型行为特征,因此工作组选择关注 11 至 25 岁的年龄范围。支持青少年和年轻人过渡的指南将于 2020 年晚些时候发布。希望这将支持儿科医生和成年医生管理这个弱势年龄组并改善他们的健康状况。Jendoubi 等人进行了一项系统评价,以评估奥马珠单抗治疗肥大细胞增多症的有效性和安全性。5 他们的评价仅纳入了来自观察性研究的 69 名参与者。令人鼓舞的是,奥马珠单抗与毒液免疫疗法的耐受性、特发性过敏反应发作和许多参与者的其他症状的完全解决有关(图 2)。作者建议我们需要一项随机对照试验来评估奥马珠单抗在肥大细胞增多症中的疗效。图 1 青少年和青年工作组 Jendoubi 等人进行了一项系统评价,以评估奥马珠单抗治疗肥大细胞增多症的有效性和安全性。5 他们的评价仅纳入了来自观察性研究的 69 名参与者。令人鼓舞的是,奥马珠单抗与毒液免疫疗法的耐受性、特发性过敏反应发作和许多参与者的其他症状的完全解决有关(图 2)。作者建议我们需要一项随机对照试验来评估奥马珠单抗在肥大细胞增多症中的疗效。图 1 青少年和青年工作组 Jendoubi 等人进行了一项系统评价,以评估奥马珠单抗治疗肥大细胞增多症的有效性和安全性。5 他们的评价仅纳入了来自观察性研究的 69 名参与者。令人鼓舞的是,奥马珠单抗与毒液免疫疗法的耐受性、特发性过敏反应发作和许多参与者的其他症状的完全解决有关(图 2)。作者建议我们需要一项随机对照试验来评估奥马珠单抗在肥大细胞增多症中的疗效。图 1 青少年和青年工作组 许多参与者的特发性过敏反应发作和其他症状完全解决(图 2)。作者建议我们需要一项随机对照试验来评估奥马珠单抗在肥大细胞增多症中的疗效。图 1 青少年和青年工作组 许多参与者的特发性过敏反应发作和其他症状完全解决(图 2)。作者建议我们需要一项随机对照试验来评估奥马珠单抗在肥大细胞增多症中的疗效。图 1 青少年和青年工作组
更新日期:2020-06-01
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