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Paediatric Respiratory Reviews

C L Yang, M Chilvers, M Montgomery, S J Nolan
No abstract text is available yet for this article.
September 15, 2016: Paediatric Respiratory Reviews
John Lowe, Michael Cousins, Sarah J Kotecha, Sailesh Kotecha
Physical activity (PA) is an important mediator of health and disease. Many correlates may play an important role in explaining differences in PA between populations; however, the role of birth outcomes such as prematurity on levels of PA is relatively poorly represented in the literature. Children born preterm may be at risk for reduced levels of PA as they have increased respiratory symptoms as well as decrements in lung function and exercise capacity. Emerging evidence suggests that the effects are prevalent across the whole range of gestational age...
August 30, 2016: Paediatric Respiratory Reviews
Franca Rusconi, Maja Popovic
Obesity represents one of the major public health problems worldwide, with an increased prevalence also among women of reproductive age. Maternal pre-pregnancy overweight and obesity are important risk factors for a number of maternal and foetal/neonatal complications. The objective of this review is to provide an overview of the most recent evidence regarding the associations between pre-pregnancy overweight/obesity and wheezing and asthma in childhood. Potential mechanisms, mediators and confounding factors involved in these associations are also discussed...
August 26, 2016: Paediatric Respiratory Reviews
Erin V McGillick, Sandra Orgeig, Dino A Giussani, Janna L Morrison
Exposure to altered intrauterine conditions during pregnancy influences both fetal growth and organ development. Chronic fetal hypoxaemia is a common pregnancy complication associated with intrauterine growth restriction (IUGR) that may influence the risk of infants experiencing respiratory complications at birth. There are a variety of signalling pathways that contribute to normal fetal lung development at the molecular level. The specific molecular effects of chronic hypoxaemia associated with IUGR on lung development are likely to be dependent on the specific aetiology (maternal, placental and/or fetal factors) that can alter hormone concentrations, oxygen and nutrient transport to the fetus...
August 21, 2016: Paediatric Respiratory Reviews
M B Azad, B L Moyce, L Guillemette, C D Pascoe, B Wicklow, J M McGavock, A J Halayko, V W Dolinsky
Diabetes is an increasingly common complication of pregnancy. In parallel with this trend, a rise in chronic lung disease in children has been observed in recent decades. While several adverse health outcomes associated with exposure to diabetes in utero have been documented in epidemiological and experimental studies, few have examined the impact of diabetes in pregnancy on offspring lung health and respiratory disease. We provide a comprehensive overview of current literature on this topic, finding suggestive evidence that exposure to diabetes in utero may have adverse effects on lung development...
August 19, 2016: Paediatric Respiratory Reviews
A L Slogrove, L Frigati, D M Gray
With improved prevention of mother to child transmission of HIV, paediatric HIV disease is less common. However, the number of HIV exposed but uninfected infants is growing. Exposure to maternal HIV impacts infant respiratory health through an increase in known risk factors such as increased preterm birth and low birth weight, suboptimal breastfeeding, increased psychosocial stressors and increased exposure to infective pathogens. Exposure to the HIV virus and altered maternal immune environment result in immunologic changes in the infant that may contribute to respiratory disease risk...
August 19, 2016: Paediatric Respiratory Reviews
Insa Korten, Kathryn Ramsey, Philipp Latzin
Air pollution exposure has increased extensively in recent years and there is considerable evidence that exposure to particulate matter can lead to adverse respiratory outcomes. The health impacts of exposure to air pollution during the prenatal period is especially concerning as it can impair organogenesis and organ development, which can lead to long-term complications. Exposure to air pollution during pregnancy affects respiratory health in different ways. Lung development might be impaired by air pollution indirectly by causing lower birth weight, premature birth or disturbed development of the immune system...
August 19, 2016: Paediatric Respiratory Reviews
Cindy T McEvoy, Eliot R Spindel
Maternal smoking during pregnancy is the largest preventable cause of abnormal in-utero lung development. Despite well known risks, rates of smoking during pregnancy have only slightly decreased over the last ten years, with rates varying from 5-40% worldwide resulting in tens of millions of fetal exposures. Despite multiple approaches to smoking cessation about 50% of smokers will continue to smoke during pregnancy. Maternal genotype plays an important role in the likelihood of continued smoking during pregnancy and the degree to which maternal smoking will affect the fetus...
August 19, 2016: Paediatric Respiratory Reviews
Theresa W Gauthier, Lou Ann S Brown
Maternal alcohol use during pregnancy exposes both premature and term newborns to the toxicity of alcohol and its metabolites. Foetal alcohol exposure adversely effects the lung. In contrast to the adult "alcoholic lung" phenotype, an inability to identify the newborn exposed to alcohol in utero has limited our understanding of its effect on adverse pulmonary outcomes. This paper will review advances in biomarker development of in utero alcohol exposure. We will highlight the current understanding of in utero alcohol's toxicity to the developing lung and immune defense...
August 19, 2016: Paediatric Respiratory Reviews
Ana Carla Carvalho Coelho, Carolina de Souza-Machado, Adelmir Souza-Machado
Asthma is a public health problem that is responsible for significant symptomatology and in extreme cases, premature deaths among adolescents. Lack of knowledge of the disease contributes to both its morbidity and mortality. In this manuscript, we discuss school interventions in asthma, in particular their impacts on improving knowledge of the disease and their ability to both make the school environment safer and reduce morbidity indicators. These interventions have been successful when implemented in higher income countries...
August 6, 2016: Paediatric Respiratory Reviews
Iolo Doull
Studies published in the last year have expanded our knowledge of potential disease modifying agents in the treatment of class II, III and IV CFTR mutations, and included the first report of an efficacious gene therapy for CF. There is also an important message on increasing use of conventional chronic therapies even in milder disease, and the pernicious effect of chronic infection on pulmonary function.
August 2016: Paediatric Respiratory Reviews
Malcolm Marquette, Charles S Haworth
Low bone mineral density is common in children and adults with CF. It has a multifactorial aetiology that includes direct effects of CFTR dysfunction on bone cell activity, as well as the secondary effects of CFTR dysfunction including pancreatic insufficiency (leading to malnutrition/malabsorption of fat soluble vitamins) and pulmonary infection (leading to systemic inflammation and increased bone resorption). Strategies to improve bone health in CF include optimising general CF nutritional and pulmonary care and the judicious use of bisphosphonates in selected patients...
August 2016: Paediatric Respiratory Reviews
Rania Abusamra, Donna McShane
Aminoglycosides are widely used in cystic fibrosis management. The m.1555A>G mutation predisposes to aminoglycoside ototoxicity. It may cause later onset hearing loss in the absence of aminoglycosides use and gradual hearing loss may be an inevitable consequence of the mutation. Given that aminoglycoside therapy forms the backbone of IV protocols in CF, this article recommends screening for this mutation to allow informed decision-making prior to aminoglycoside administration, to avoid preventable deafness...
August 2016: Paediatric Respiratory Reviews
T J David
No abstract text is available yet for this article.
August 2016: Paediatric Respiratory Reviews
Daniel Peckham
The health informatics revolution was spear-headed in the 1980s by pioneers in primary care who worked in an opportune environment and were able to successfully implement electronic patient records (EPR) as far back as the 1990s. Although the ambitious and costly National Programme for IT failed to deliver an integrated EPR, the project achieved the creation of the Spine, the N3 Network, choose and book, picture archiving, communication systems and standards which have allowed integration. Real change is taking place within the NHS with the launch of exciting new projects focusing on true integration and secure data flows across primary, community and secondary care...
August 2016: Paediatric Respiratory Reviews
Nick P Talbot, William G Flight
Achromobacter spp. are emerging pathogens in the lungs of patients with cystic fibrosis. We report the case of an adult patient with cystic fibrosis and chronic A. xylosoxidans infection who experienced rapid, progressive clinical deterioration. Metagenomic analysis of the sputum revealed that the airway microbiota was almost entirely dominated by A. xylosoxidans. We review the impact of this organism on lung function and the airway microbiome in cystic fibrosis, and discuss the potential for cross-infection between patients...
August 2016: Paediatric Respiratory Reviews
Robert W Lord, Andrew M Jones, A Kevin Webb, Peter J Barry
Pneumothorax is a serious but common complication in patients with cystic fibrosis (CF). It has adverse prognostic implications as well as associations with subsequent reduction in lung function and significant risk of recurrence. Management dilemmas frequently occur that are beyond current guidelines. We review the evidence and highlight management difficulties in pneumothoraces in CF.
August 2016: Paediatric Respiratory Reviews
Robert Ian Ketchell
With the NHS under increasing financial pressure and healthcare costs soaring year on year, it is perhaps not surprising that assessment agencies focus on cost-effectiveness analysis when assessing new therapies. Such an approach does not however, always take sufficient account of treatment burden, lifestyle and patient choice and therefore new equally effective but perhaps "easier to take" formulations and faster delivery systems for current therapies do not always take precedence in current treatment guidelines...
August 2016: Paediatric Respiratory Reviews
Michael D Waller, Nicholas J Simmonds
Whilst cystic fibrosis is a monogenic condition, variation in phenotype exists for the same CFTR genotype, which is influenced by multiple genetic and non-genetic (environmental) factors. The R117H-CFTR mutation has variability directly relating to in cis poly-thymidine alleles, producing a differing spectrum of disease. This paper provides evidence of extreme phenotype variability - including fertility status - in the context of male monogenetic twins, discussing mechanisms and highlighting the diagnostic and treatment challenges...
August 2016: Paediatric Respiratory Reviews
Alan Smyth
This article describes the nature and significance of pulmonary exacerbations in cystic fibrosis (CF). The effectiveness and safety of current exacerbation treatment are explored. The article concludes with a summary of clinical trials (completed and ongoing) which aim to improve the efficacy and safety of exacerbation treatment.
August 2016: Paediatric Respiratory Reviews
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