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Pediatric Pulmonology

Jose A Castro-Rodriguez, Carlos E Rodriguez-Martinez, Francine M Ducharme
BACKGROUND: Most international asthma guidelines recommend that children ≤5 years with asthma or recurrent wheezing be treated with daily low- moderate dose inhaled corticosteroids (ICS) as the preferred controller and leukotriene receptor antagonists (LTRA) as alternative therapy. There is no systematic review comparing the efficacy of ICS versus LTRA monotherapy in this age group. OBJECTIVE: To compare the efficacy of daily ICS versus LTRA in preschoolers with asthma or recurrent wheezing...
November 5, 2018: Pediatric Pulmonology
Scott D Grosse, Thuy Quynh N Do, Michelle Vu, Lisa B Feng, Jay G Berry, Gregory S Sawicki
OBJECTIVES: Published cost estimates for cystic fibrosis (CF) are based on older data and do not reflect increased use of specialty drugs in recent years. We assessed recent trends in healthcare expenditures for CF patients in the United States (US) with employer-sponsored health insurance. METHODS: The study is a retrospective analysis of claims data for privately insured individuals aged 0-64 years who were continuously enrolled in non-capitated plans for at least 1 calendar year during 2010-2016...
October 31, 2018: Pediatric Pulmonology
Shu-Ling Chong, Oi Fah Lai, Leodivica Castillo, Joo Guan Yeo, Nivedita Nadkarni, Oon Hoe Teoh, Jan Hau Lee
OBJECTIVE: Nasal biomarkers have potential to add objectivity to the clinical assessment of the child with bronchiolitis. We aim to study, if nasal caspase and high-mobility group box 1 protein (HMGB1) levels differ between patients who were hospitalized and those discharged from the emergency department (ED), among patients with bronchiolitis. METHODS: Using an observational cross-sectional study design, we recruited patients younger than 24 months presenting to the ED from September 1, 2015 to May 31, 2017 with a diagnosis of acute bronchiolitis...
October 26, 2018: Pediatric Pulmonology
Jessica Erkman, Allen Vaynblat, Kristen Thomas, Leopoldo N Segal, Jeremiah Levine, Libia Moy, Melanie Greifer, Robert Giusti, Rasik Shah, Mikhail Kazachkov
AIM: Children with severe uncontrolled asthma (SUA) have a high burden of symptoms and increased frequency of asthma exacerbations. Reflux esophagitis and eosinophilic esophagitis are important co-morbid factors for SUA. Both are associated with the presence of eosinophils in esophageal mucosa. We hypothesized that esophageal eosinophils are frequently present and correlate with the presence of airway eosinophils in children with SUA. METHOD: We performed a retrospective analysis of a prospective database of children who underwent "triple endoscopy" (sleep laryngoscopy, bronchoscopy with bronchoalveolar lavage [BAL] and endobronchial biopsy [EBB], and esophagogastroduodenoscopy with esophageal biopsy [EsB]) at our Aerodigestive Center for evaluation of SUA...
October 23, 2018: Pediatric Pulmonology
Matthew D McGraw, Grace H Houser, Csaba Galambos, Eric P Wartchow, Paul C Stillwell, Jason P Weinman
Marijuana use has risen dramatically over the past decade. Over this same time period, pediatric hospitals have seen an increase in presentation of adolescents with acute respiratory symptoms after recent marijuana inhalation. We report a case series of three adolescent males with significant findings of bilateral pulmonary nodules and ground glass opacities on chest imaging associated with recent marijuana inhalation. Lung biopsies in two of the three patients confirmed silica-induced pneumoconiosis. The third patient was diagnosed with acute hypersensitivity pneumonitis without lung biopsy...
October 23, 2018: Pediatric Pulmonology
Laura A Barnes, Philippe R Gaillard, Jeremiah S Menk, Andrew R Wey, Warren E Regelmann, Nadir Demirel
BACKGROUND: The impact of separating the adult from pediatric patients on Pseudomonas aeruginosa (P. aeriginosa) detection in the respiratory cultures of patients was examined at the University of Minnesota CF Center. METHODS: This study was a retrospective review using data recorded in the University of Minnesota CF Database between 1995 and 2010. Respiratory culture results obtained during routine University of Minnesota Cystic Fibrosis (CF) Center. CF clinic encounters of two cohorts of pediatric and adult CF patients (pre- and post-separation) were analyzed for presence of P...
October 23, 2018: Pediatric Pulmonology
Enrico Lombardi, Valentina Fainardi, Claudia Calogero, Monia Puglia, Fabio Voller, Marina Cuttini, Franca Rusconi
OBJECTIVE: We assessed lung function and respiratory health in an area-based prospective cohort of preschool children born very preterm. DESIGN: Lung function was measured by interrupter respiratory resistance (Rint) and forced oscillation technique (FOT) (respiratory resistance (Rrs8), reactance (Xrs8), and area under the reactance curve (AX)) at a median age of 5.2 years in a cohort of 194 children born at 22-31 weeks of gestational age (GA) in Tuscany, Italy...
October 21, 2018: Pediatric Pulmonology
BreAnna Kinghorn, Rosalyn Singleton, Gabrielle B McCallum, Lisa Bulkow, Keith Grimwood, Leslie Hermann, Anne B Chang, Gregory Redding
INTRODUCTION: Alaska Native (AN) children from the Yukon Kuskokwim (YK) Delta region have high rates of chronic suppurative lung disease (CSLD), including bronchiectasis. We characterized the clinical progress of an AN adolescent cohort with CSLD/bronchiectasis, and estimated bronchiectasis prevalence trends in this region. METHODS: The original cohort comprised 41 AN children (originally aged 0.5-8 years) with CSLD/bronchiectasis, recruited between 2005 and 2008, with follow-up in 2015-2016...
October 16, 2018: Pediatric Pulmonology
Lael M Yonker, T Bernard Kinane
"Pulmonary Interstitial Glycogenosis: Diagnostic Evaluation and Clinical Course," written by Liptzin et al is a timely and insightful phenotypic summary of a rare pediatric interstitial lung disease. Twenty-four infants with biopsy-proven pulmonary interstitial glycogenosis (PIG) were reviewed at their center. Genetic analysis, bronchoscopy results, imaging, biopsy, and cardiology findings were described, and treatment decision and clinical outcomes were discussed.
September 26, 2018: Pediatric Pulmonology
Lei Wu, Qiaoru Hou, Yingying Lu, Jie Bai, Liping Sun, Yue Huang, Mazhong Zhang, Jijian Zheng
BACKGROUND: Pulmonary overflow (PO) is one of the most common complications in congenital heart disease (CHD) children with an incidence of 48-60% approximately. This study explored the feasibility of using lung ultrasound (LUS) to assess pulmonary overcirculation in CHD children and compare the diagnostic performance of LUS and chest radiography (CXR) for the detection of pulmonary overcirculation. METHOD: The upper anterior area, lower anterior area, upper lateral area, and lower posterior area, in each hemithorax were scanned in 59 children in the supine position...
September 24, 2018: Pediatric Pulmonology
Adaeze C Ayuk, Jordache Ramjith, Heather J Zar
Background Asthma prevalence in African children is high. Factors driving the prevalence or disease severity are poorly understood. This study aims to investigate environmental factors associated with asthma and severity in African children. Methods Population based cross-sectional study of children aged 13-14 years from 10 African centers who participated in ISAAC III. Self-reported environmental exposures included engaging in physical exercise, television watching, various biomass and ETS exposure, consumption of paracetamol, large family sizes and having pets in the home...
September 20, 2018: 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
Ahsan Bashir, Jennifer K Henningfeld, Nathan E Thompson, Lynn A D'Andrea
Background The prevalence of respiratory-technology dependent children is increasing although for most children the goal is liberation from technology. Liberation from home mechanical ventilation (HMV) and decannulation strategies vary due to the lack of clinical practice standards. The primary objective of this study was to describe our practice utilizing a polysomnography (PSG) in the liberation from respiratory-technology process. Methods Retrospective study of tracheostomized children with and without HMV who underwent an evaluation for decannulation between January 2006 and June 2016...
November 2018: Pediatric Pulmonology
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November 2018: Pediatric Pulmonology
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