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Pediatric Pulmonology

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https://www.readbyqxmd.com/read/27905200/induced-sputum-to-detect-lung-pathogens-in-young-children-with-cystic-fibrosis
#1
Pamela D'Sylva, Daan Caudri, Nicole Shaw, Lidija Turkovic, Tonia Douglas, Jane Bew, Anthony D Keil, Stephen Stick, André Schultz
INTRODUCTION: Induced sputum sampling holds promise as a method for obtaining samples representative of the lower airways in young children. Collection of induced sputum samples in young children differs from older children and adults' as pharyngeal suctioning is often required. Our aim was to determine the sensitivity and specificity of induced sputum with and without airway clearance techniques to detect lower airway pathogens in children less than age 7 with cystic fibrosis. METHODS: Microbiological culture results were compared between 61 paired induced sputum and bronchoalveolar lavage fluid samples from young children with cystic fibrosis...
November 30, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27893197/importance-to-question-sinonasal-symptoms-and-to-perform-rhinoscopy-and-rhinomanometry-in-cystic-fibrosis-patients
#2
J M Bock, M Schien, C Fischer, L Naehrlich, M Kaeding, O Guntinas-Lichius, A Gerber, C Arnold, J G Mainz
OBJECTIVES: Cystic fibrosis (CF) patients almost regularly reveal sinonasal pathology. The purpose of this study was to assess association between objective and subjective measurements of sinonasal involvement comparing nasal airflow obtained by active anterior rhinomanometry (AAR), nasal endoscopic findings, and symptoms assessed with the Sino-Nasal Outcome Test-20 (SNOT-20). METHODS: Nasal cavities were explored by anterior rigid rhinoscopy and findings were compared to inspiratory nasal airflow measured by AAR to quantify nasal patency and subjective health-related quality of life in sinonasal disease obtained with the SNOT-20 questionnaire...
November 28, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27880037/suppressed-erythropoietin-expression-in-a-nitrofen-induced-congenital-diaphragmatic-hernia
#3
Hajime Takayasu, Koki Hagiwara, Kouji Masumoto
BACKGROUND: Erythropoietin (EPO), an essential stimulator of erythropoiesis produced by the fetal liver, is important both in vascular remodeling and modulation of the endothelial response in the pulmonary vasculature. In addition, EPO guides alveolar development, along with retinoic acid (RA). EPO is a direct target of RA, and the retinoid pathway is altered in the nitrofen-induced congenital diaphragmatic hernia (CDH) model. In the present study, we tested the hypothesis that the synthesis of EPO is suppressed in a rat model of CDH...
November 23, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27875026/disseminated-bcg-pneumonitis-revealing-severe-combined-immunodeficiencyxs-in-charge-syndrome
#4
Hyung Young Kim, Yoo-Mi Kim, Hee Ju Park
CHARGE (coloboma, heart defect, atresia choanae, retarded growth and development, genital hypoplasia, and ear anomalies/deafness) syndrome is a rare genetic disorder caused by CHD7 mutation and is related to immunodeficiency. A 6-month-old girl with right lung agenesis, congenital heart defects, and ear anomalies developed repeated and serious respiratory infection for a short period. She was clinically diagnosed with typical CHARGE syndrome with severe combined immunodeficiency (T-, B+, NK-); however, CHD7 mutation was not detected...
November 22, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27875025/adherence-and-barriers-to-hyperinsufflation-in-children-with-congenital-muscular-dystrophy
#5
John E Pascoe, Hemant Sawnani, Oscar H Mayer, Keith McConnell, Joseph M McDonough, Cynthia White, Anne M Rutkowski, Raouf S Amin, Avani C Modi
BACKGROUND: Congenital muscular dystrophy (CMD) is a rare, inherited neuromuscular disease characterized by progressive muscle weakness, thoracic insufficiency, and ultimately respiratory failure. Adherence to respiratory therapies in children with neuromuscular disorders is unknown. This study examined the multimodal assessment of adherence and barriers to 15 min, twice daily hyperinsufflation in children with CMD. Adherence was hypothesized to be greater than 50% and discomfort, embarrassment, and difficulty finding time were hypothesized to be barriers...
November 22, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27870384/high-flow-nasal-cannula-use-outside-of-the-icu-factors-associated-with-failure
#6
Kristina A Betters, Scott E Gillespie, Judson Miller, David Kotzbauer, Kiran B Hebbar
OBJECTIVES: High flow nasal cannula (HFNC) use is increasing in pediatrics. Few studies exist examining the safety of HFNC use outside the intensive care unit (ICU). This study aimed to characterize patient qualities associated with failure of HFNC use outside the ICU. STUDY DESIGN: A retrospective chart review of patients placed on HFNC outside the ICU from September 2011 to July 2013 was completed. Failure was defined as intubation or cardiopulmonary arrest. Two-sample tests and binary logistic regression determined significant factors associated with failed HFNC administration, both unadjusted and adjusted for hospital...
November 21, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27870227/aspergillosis-and-the-role-of-mucins-in-cystic-fibrosis
#7
REVIEW
Abigail C Cowley, David J Thornton, David W Denning, Alexander Horsley
The prevalence of aspergillosis in CF patients has until recently been underestimated, but increasing evidence suggests that it may play an important role in the progression of CF lung disease. In healthy airways, Aspergillus fumigatus can be efficiently removed from the lung by mechanisms such as mucociliary clearance and cough. However, these mechanisms are defective in CF, allowing pathogens such as A. fumigatus to germinate and establish chronic infections within the airways. The precise means by which A...
November 21, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27865065/how-do-we-recognize-the-child-with-osas
#8
Koen F Joosten, Helena Larramona, Silvia Miano, Dick Van Waardenburg, Athanasios G Kaditis, Nele Vandenbussche, Refika Ersu
Obstructive sleep-disordered breathing includes a spectrum of clinical entities with variable severity ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). The clinical suspicion for OSAS is most often raised by parental report of specific symptoms and/or abnormalities identified by the physical examination which predispose to upper airway obstruction (e.g., adenotonsillar hypertrophy, obesity, craniofacial abnormalities, neuromuscular disorders). Symptoms and signs of OSAS are classified into those directly related to the intermittent pharyngeal airway obstruction (e...
November 16, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27801982/risk-factors-for-pulmonary-arterial-hypertension-in-children-and-young-adults
#9
Estelle Naumburg, Lars Söderström, Daniel Huber, Inge Axelsson
OBJECTIVES: Pulmonary hypertension (PH) has been linked to preterm birth explained by congenital heart defects and pulmonary diseases. WORKING HYPOTHESIS: Other factors may influence the risk of PH among adolescences and children born premature. STUDY DESIGN: This national registry-based study assess risk of PH following premature birth adjusted for known risk factors. PATIENT-SUBJECT SELECTION AND METHODOLOGY: All cases born 1993-2010, identified by diagnostic codes applicable to PH and retrieved from the Swedish Registry of Congenital Heart Disease (N = 67)...
November 1, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27797458/therapeutic-laryngoscopy-during-exercise-a-novel-non-surgical-therapy-for-refractory-eilo
#10
J Tod Olin, Emily H Deardorff, Elizabeth M Fan, Kristina L Johnston, Valerie L Keever, Camille M Moore, Bruce G Bender
BACKGROUND: Exercise-induced laryngeal obstruction (EILO) may affect as many as 6% of the adolescent population, with some patients experiencing symptoms refractory to conservative interventions. OBJECTIVES: This report describes therapeutic laryngoscopy during exercise, a novel, non-surgical intervention that harnesses real-time laryngoscopy video as biofeedback to control laryngeal aperture during high-intensity exercise. Additionally, we quantitate patient-reported perceptions of procedure safety, tolerability, learning value, and effectiveness...
October 31, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27797455/implementation-of-cystic-fibrosis-clinical-pathways-improved-physician-adherence-to-care-guidelines
#11
Sachinkumar B Singh, Annie U Shelton, Barbara Greenberg, Timothy D Starner
INTRODUCTION: There is significant variability in clinical outcomes, including growth and lung function, between the various cystic fibrosis (CF) centers. No specific or unique therapeutic practices have been identified to account for these differences. However, more uniform care within centers was associated with better outcomes. The objective of this study was to implement clinical pathways for diagnosis and treatment of nutritional failure and lung inflammation in order to achieve better health care provider adherence to center-specific, agreed-on practices...
October 31, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27797454/thoracic-mri-evaluation-of-sarcoidosis-in-children
#12
Sureyya Burcu Gorkem, Seçil Köse, Edward Y Lee, Selim Doğanay, Ayse Seda Coskun, Mehmet Köse
BACKGROUND: Childhood sarcoidosis is a very rare granulomatous disorder with an unknown etiology. Stage 1 disease is the most common whereas stages 2, 3, and 0 are rare in children. OBJECTIVE: To evaluate thoracic findings of pediatric pulmonary sarcoidosis on MRI and to compare them with CT findings. METHODS: Between August 2010 and May 2015, seven consecutive pediatric patients (four male, three female; age range: 8-18 years, mean age: 13...
October 31, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27787952/outcomes-of-mechanical-support-in-a-pediatric-lung-transplant-center
#13
Demet Toprak, Levent Midyat, Dawn Freiberger, Debra Boyer, Francis Fynn-Thompson, Gary Visner
Pediatric lung transplantation is a lifesaving option for patients with end stage lung disease, although the scarcity of suitable donor organs results in long wait times and increased waitlist mortality. Many pediatric centers consider mechanical ventilatory support, such as long-term invasive ventilation and ECMO, a contraindication to lung transplantation. We hypothesized that current survival rates and outcomes for patients on mechanical ventilatory support in the pre-transplant period were not remarkably different...
October 27, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27787950/validation-of-the-pediatric-sleep-questionnaire-in-children-with-asthma
#14
Zarmina Ehsan, Carolyn M Kercsmar, Jennifer Collins, Narong Simakajornboon
OBJECTIVE: The prevalence of obstructive sleep apnea (OSA) is higher in children with poorly controlled asthma. We aimed to determine the validity of the Pediatric Sleep Questionnaire (PSQ) to screen for OSA in children with asthma. METHODS: This retrospective review encompassed sleep studies and medical records of asthmatic children evaluated in the sleep center at CCHMC over 13 years. Measures of validity were calculated using various cut-off values for obstructive apnea-hypopnea index (OI; >1, >2, >5) and PSQ scores (>0...
October 27, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27774750/pulmonary-hypertension-in-childhood-interstitial-lung-disease-a-systematic-review-of-the-literature
#15
Susan Bromley, David Vizcaya
Childhood interstitial lung disease (chILD) comprises a wide heterogeneous group of rare parenchymal lung disorders associated with substantial morbidity and mortality. Pulmonary hypertension is a common comorbidity in adults with interstitial lung disease (ILD) and associated with poor survival. We aimed to systematically review the literature regarding the occurrence of pulmonary hypertension (PH) in chILD, its effect on prognosis and healthcare use, and its treatment in clinical practice. Searches of PubMed and EMBASE databases (up to February 2016), and American Thoracic Society conference abstracts (2009-2015) were conducted using relevant keywords...
October 23, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27749021/is-impaired-glucose-metabolism-the-missing-piece-in-the-obesity-asthma-puzzle
#16
Tarig Ali-Dinar, Jason E Lang
Obesity is a major risk factor for several conditions including atherosclerotic disease, metabolic syndrome, and upper airway dysfunction. However, the purported link between obesity and asthma has remained more difficult to define, in part due to limitations in past epidemiologic studies and the inherent challenge in accurately defining asthma in children. It is possible that obesity leads to asthma only in the presence of a mediating variable such as an obesity-related conditions such as esophageal reflux or insulin resistance...
October 17, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27740725/assessment-of-extravascular-lung-water-by-ultrasound-after-congenital-cardiac-surgery
#17
Anu K Kaskinen, Laura Martelius, Turkka Kirjavainen, Paula Rautiainen, Sture Andersson, Olli M Pitkänen
BACKGROUND: Lung ultrasounds show vertical artifacts known as B-lines in the presence of increased extravascular lung water (EVLW). We aimed to investigate whether lung ultrasound could estimate EVLW after congenital cardiac surgery. METHODS: This prospective observational study comprised 61 children (age range 3 days to 7.4 years) undergoing congenital cardiac surgery. We compared postoperative B-line scores from lung ultrasounds, early postoperative ultrasound as our primary interest, with corresponding postoperative chest radiography (CXR) lung edema scores, with static lung compliance, and with short-term clinical outcome interpreted as time on mechanical ventilation and length of pediatric intensive care unit (PICU) stay...
October 14, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27740723/respiratory-syncytial-virus-hospitalization-and-mortality-systematic-review-and-meta-analysis
#18
Renato T Stein, Louis J Bont, Heather Zar, Fernando P Polack, Caroline Park, Ami Claxton, Gerald Borok, Yekaterina Butylkova, Colleen Wegzyn
BACKGROUND: Respiratory syncytial virus (RSV) is a major public health burden worldwide. We aimed to review the current literature on the incidence and mortality of severe RSV in children globally. METHODS: Systematic literature review and meta-analysis of published data from 2000 onwards, reporting on burden of acute respiratory infection (ARI) due to RSV in children. Main outcomes were hospitalization for severe RSV-ARI and death. RESULTS: Five thousand two hundred and seventy-four references were identified...
October 14, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27740722/detection-of-airborne-respiratory-syncytial-virus-in-a-pediatric-acute-care-clinic
#19
Stephanie A Grayson, Pamela S Griffiths, Miriam K Perez, Giovanni Piedimonte
OBJECTIVE: Respiratory syncytial virus (RSV) is the most common cause of respiratory illness in infants and young children, but this virus is also capable of re-infecting adults throughout life. Universal precautions to prevent its transmission consist of gown and glove use, but masks and goggles are not routinely required because it is believed that RSV is unlikely to be transmitted by the airborne route. Our hypothesis was that RSV is present in respirable-size particles aerosolized by patients seen in a pediatric acute care setting...
October 14, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27740721/mometasone-furoate-mf-improves-lung-function-in-pediatric-asthma-a-double-blind-randomized-controlled-dose-ranging-trial-of-mf-metered-dose-inhaler
#20
Niran J Amar, Tulin Shekar, Tracey A Varnell, Anish Mehta, George Philip
OBJECTIVES: Mometasone furoate (MF), delivered via dry-powder inhaler (DPI) QD in the evening (PM), is a treatment option for pediatric patients with asthma. We evaluated MF delivered via a metered-dose inhaler (MDI), in children ages 5-11 years with persistent asthma. METHODS: This was a 12-week double-blind, double-dummy, placebo-controlled trial. Pateints were randomized to the following treatments: MF-MDI 50 mcg BID, MF-MDI 100 mcg BID, MF-MDI 200 mcg BID, MF-DPI 100 mcg QD PM, and placebo...
October 14, 2016: Pediatric Pulmonology
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