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Pediatric Pulmonology

Parniya Arooj, Robert Plant, Kishore Doddakula, Barry J Plant
A 40-year-old male with Cystic Fibrosis developed a sudden onset choking, cough, dyspnea and hemoptysis after using his inhaler. He presented to A&E. CT scan located a foreign body in his right bronchus intermedius (RBI). Rigid bronchoscopy was performed and removed a plastic rawl plug with screw from his RBI. He made a rapid recovery. On questioning he mentioned he had stored his inhaler uncapped in the same pocket he had this screw which he found at work. Small objects can lodge in inhalers due to their design/mouthpiece uncapping...
September 18, 2018: Pediatric Pulmonology
S Javed Zaidi, Lorene Schweig, Dhaval Patel, Alexander Javois, Javeed Akhter
INTRODUCTION: Hemoptysis in children is an uncommon presenting symptom but can be life-threatening if massive. Cardiac catheterization and coil embolization of aorto-pulmonary collateral vessels (APCs) is uncommon in pediatric hemoptysis patients without congenital heart disease. METHODS: We present a series of seven infants (≤12 months of age) with hemoptysis, all of whom underwent cardiac catheterization to look for and intervene upon APCs, if found. Only those patients who underwent both bronchoscopy as well as cardiac catheterization from January 1995 to January 2015 were included in this retrospective review...
September 18, 2018: Pediatric Pulmonology
Alexandra T Geanacopoulos, Jill J Savla, Jennifer Pogoriler, Joseph Piccione, Pelton Phinizy, Aaron G DeWitt, Joshua J Blinder, Erin Pinto, Maxim Itkin, Yoav Dori, Samuel B Goldfarb
BACKGROUND: Percutaneous lymphatic intervention (PCL) is a promising new therapy for plastic bronchitis (PB). We characterized bronchoalveolar lavage (BAL) and cast morphology in surgically repaired congenital heart disease (CHD) patients with PB during PCL. We quantified respiratory and bronchoscopic characteristics and correlated them with post-intervention respiratory outcomes. METHODS: We retrospectively reviewed patients with PB and surgically repaired CHD undergoing PCL and bronchoscopy at our institution...
September 12, 2018: Pediatric Pulmonology
Hiroo Wada, Manami Kimura, Tomokazu Tajima, Ryutaro Shirahama, Yohei Suzuki, Yuka Suzuki, Toshinari Hayashi, Koutatsu Maruyama, Motoki Endo, Naoko Sakamoto, Ai Ikeda, David Gozal, Takeshi Tanigawa
INTRODUCTION: The association between nocturnal enuresis (NE) and sleep disordered breathing (SDB) has been repeatedly reported, but has primarily been focused on clinical cohorts. The purpose of this study, was to assess whether SDB-related symptoms such as snoring and unrefreshing sleep in the morning are associated with NE in a large-scale community school-based survey. METHODS: A cross-sectional assessment using a standard questionnaire was conducted on nearly 20 000 primary school children (5-12 years old) in Matsuyama, Japan...
September 11, 2018: Pediatric Pulmonology
Sylvia Nyilas, Anja Bigler, Sophie Yammine, Elisabeth Kieninger, Isabelle Rochat, Kathryn Ramsey, Carmen Casaulta, Alexander Moeller, Philipp Latzin, Florian Singer
INTRODUCTION: Normalized phase III slope (SnIII ) indices from multiple breath washout (MBW) estimate ventilation inhomogeneity. Alternate (*) protocols for SnIII indices exist, however the utility of these outcomes in children with mild-to-moderate cystic fibrosis (CF) is unknown. METHODS: We measured nitrogen MBW and spirometry in 135 children (43 controls) aged 4-18 years. We assessed validity, practicability, and reliability of SnIII protocols. Outcomes included the ability to detect abnormal lung function, test agreement, measurement duration, intra-test repeatability, and quality...
August 30, 2018: Pediatric Pulmonology
Wesley M Jackson, Thomas Michael O'Shea, Elizabeth N Allred, Matthew M Laughon, William Adam Gower, Alan Leviton
OBJECTIVES: To evaluate the hypothesis that chronic lung disease of prematurity (CLD) is a risk factor for asthma in children born extremely preterm, and the hypothesis that the risk factors for CLD are similar to those for asthma. METHODS: A retrospective analysis was performed using data collected prospectively from 882 children born before the 28th week of gestation between 2002 and 2004 who returned for follow-up at ages 12 and 24 months and 10 years. We created time-oriented logistic regression models to compare risk factors for CLD, defined as need for supplemental oxygen at 36 weeks postmenstrual age, and parent-reported asthma at 10 years of age...
August 29, 2018: Pediatric Pulmonology
Sebastian K Welsh, Alicia M Casey, Martha P Fishman
AIM: Pulmonary hemorrhage in infancy is rare, with challenges in determining its incidence, causes, and outcomes across diverse groups. Our aim was to better understand the incidence and identified causes. We further analyzed the subgroup of patients meeting criteria for acute idiopathic pulmonary hemorrhage of infancy (AIPHI) to determine recurrence, mortality, and treatment. METHODS: We performed a 10-year retrospective cohort study of infants with pulmonary hemorrhage in a large tertiary care center...
August 20, 2018: Pediatric Pulmonology
Nour Akil, Marianne S Muhlebach
Staphylococcus aureus is one of the earliest bacteria isolated from the respiratory tract in people with cystic fibrosis (CF). Its methicillin resistant form, MRSA, has gained attention due to the rapid increase in the last decades and worse outcomes with chronic infection. In the United States, prevalence of MRSA in CF is around 27%, but is much lower (3-18%) in most other countries. Methicillin is typically genetically encoded by the mecA gene, which encodes for an alternative penicillin binding protein (PRBa)...
August 2, 2018: Pediatric Pulmonology
Huayan Zhang, Kevin Dysart, Douglas E Kendrick, Lei Li, Abhik Das, Susan R Hintz, Betty R Vohr, Barbara J Stoll, Rosemary D Higgins, Leif Nelin, David P Carlton, Michele C Walsh, Haresh Kirpalani
OBJECTIVES: This study tested the hypothesis that longer duration of any type of respiratory support is associated with an increased rate of death or neurodevelopmental impairment (NDI) at 18-22 months. METHODS: Retrospective cohort study using the Generic Database of NICHD Neonatal Research Network from 2006 to 2010. Infants were born at <27 weeks gestational age with birth weights of 401-1000 g. Respiratory support received during initial hospitalization from birth was characterized as follows: no support, only invasive support, only non-invasive support or mixed invasive, and non-invasive support...
July 30, 2018: Pediatric Pulmonology
Bette S Pollard, Harvey B Pollard
Induced pluripotent stem cells (iPSCs) are a recently developed technology in which fully differentiated cells such as fibroblasts from individual CF patients can be repaired with [wildtype] CFTR, and reprogrammed to differentiate into fully differentiated cells characteristic of the proximal and distal airways. Here, we review properties of different epithelial cells in the airway, and the in vitro genetic roadmap which iPSCs follow as they are step-wise differentiated into either basal stem cells, for the proximal airway, or into Type II Alveolar cells for the distal airways...
July 30, 2018: Pediatric Pulmonology
Deborah R Liptzin, Christopher D Baker, Jeffrey R Darst, Jason P Weinman, Megan K Dishop, Csaba Galambos, John T Brinton, Robin R Deterding
OBJECTIVES: We sought to describe the phenotype for patients with P.I.G. including presentation, evaluation, cardiac co-morbidities, high resolution computed tomography findings, and outcomes. METHODS: With institutional review board approval, we performed a retrospective review of patients with biopsy-proven P.I.G. Biopsies, high resolution chest computed tomography, and cardiac evaluations were reviewed and characterized by experts in each field. RESULTS: Sixty-two percent of the patients were male...
July 18, 2018: Pediatric Pulmonology
Eline Lauwers, Kris Ides, Kim Van Hoorenbeeck, Stijn Verhulst
BACKGROUND: Intrapulmonary percussive ventilation (IPV) is frequently used in clinical practice to enhance sputum evacuation and lung recruitment. However, the evidence in different respiratory pathologies, especially in children, is still lacking. This systematic review aims to enlist the effectiveness of IPV as an airway clearance technique in pediatric patients. DATA SOURCES: A systematic literature search was performed in PubMed, Web of Science, and the Cochrane Library databases...
July 18, 2018: Pediatric Pulmonology
Andrea J Thompson, Emma L Sidebotham, Philip A J Chetcuti, David C G Crabbe
AIM: To report the natural history of a cohort of children with prenatally diagnosed congenital lung malformations (CLM) which we set out to manage expectantly. METHODS: Retrospective review of children born between 1995 and 2013 with a CLM identified on prenatal ultrasound. Prenatal ultrasound data were analyzed along with patient medical records, radiology, and pathology. RESULTS: One hundred fifty-nine newborns with a fetal lung lesion were identified during the study period...
July 15, 2018: Pediatric Pulmonology
Mehmet Buyuktiryaki, Hayriye G Kanmaz, Nilufer Okur, Handan Bezirganoglu, Buse Ozer Bekmez, Gulsum Kadioglu Simsek, Fuat E Canpolat, Suna S Oguz, Cuneyt Tayman
BACKGROUND AND OBJECTIVES: It is believed, that sustained lung inflation (SLI) at birth in preterm infants reduces the need for mechanical ventilation (MV) and improves respiratory outcomes. The aim of this study was to compare need for MV in preterm infants at high risk for respiratory distress syndrome (RDS) after prophylactic SLI via short binasal prongs at birth combined with early nasal continuous positive airway pressure (nCPAP) versus nCPAP alone. METHODS: Medical records of infants born at 260/7 to 296/7 weeks gestation through 2015 and 2017 were retrospectively assessed...
July 12, 2018: Pediatric Pulmonology
Ahsan Bashir, Augusto A Litonjua
No abstract text is available yet for this article.
July 12, 2018: Pediatric Pulmonology
Erica A Roesch, David P Nichols, James F Chmiel
Inflammation plays a critical role in cystic fibrosis (CF) lung pathology and disease progression making it an active area of research and important therapeutic target. In this review, we explore the most recent research on the major contributors to the exuberant inflammatory response seen in CF as well as potential therapeutics to combat this response. Absence of functional cystic fibrosis transmembrane conductance regulator (CFTR) alters anion transport across CF airway epithelial cells and ultimately results in dehydration of the airway surface liquid...
July 12, 2018: Pediatric Pulmonology
Tuğba Şişmanlar Eyüboğlu, Ayşe Tana Aslan, Alper Ceylan, Azime Şebnem Soysal, Işıl İrem Budakoğlu, Tansu Ulukavak Çiftçi, Oğuz Köktürk
BACKGROUND: Primary ciliary dyskinesia (PCD) patients have higher incidence of sleep disordered breathing which lead neurocognitive impairments such as attention-deficit/hyperactivity disorder (ADHD). It may effect academic performance of children and may cause impairment in emotional relationships. This study aim to evaluate hyperactivity and attention deficiency in PCD patients and investigate the relationship between sleep and hyperactivity and attention deficiency in PCD patients...
July 10, 2018: Pediatric Pulmonology
Michael C Tracy, Richard B Moss
Fungal infection in cystic fibrosis (CF) is a recognized challenge, with many areas requiring further investigation. Consensus definitions exist for allergic bronchopulmonary aspergillus in CF, but the full scope of clinically relevant non-allergic fungal disease in CF-asymptomatic colonization, transient or chronic infection localized to endobronchial mucus plugs or airway tissue, and invasive disease-is yet to be clearly defined. Recent advances in mycological culture and non-culture identification have expanded the list of both potential pathogens and community commensals in the lower respiratory tract...
July 10, 2018: Pediatric Pulmonology
Cecilia Hagman, Lars J Björklund, Gunnel Hellgren, Ellen Tufvesson, Ingrid Hansen-Pupp
BACKGROUND: Club cell secretory protein (CC16) probably has a role in protecting the lung from inflammation. AIM: To evaluate if low levels of CC16 in gastric fluid at birth, reflecting low levels of CC16 in the lung, would be associated with lung inflammation and respiratory morbidity. METHODS: A study of 64 infants with mean gestational age 26.1 weeks. CC16 was analyzed in gastric fluid at birth. CC16, pro-inflammatory cytokines, and MMP-9 were analyzed in tracheal aspirate within 24 h from birth...
July 10, 2018: Pediatric Pulmonology
Federica Trucco, Michelle Chatwin, Thomas Semple, Mark Rosenthal, Andrew Bush, Hui-Leng Tan
STUDY OBJECTIVES: Obstructive sleep apnoea (OSAS) in children with Down syndrome (DS) is now well recognized, but other forms of sleep disordered breathing (SDB) in this population are less well described. Anecdotally, respiratory support for SDB treatment in this population is not easily tolerated. We aimed to characterize the types of SDB in children with DS referred to a tertiary respiratory center and to assess the effectiveness and adherence to respiratory support. METHODS: Retrospective study of DS patients <18 years old under follow-up at a tertiary respiratory center...
July 10, 2018: Pediatric Pulmonology
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