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Paediatric Respiratory Reviews

Rebecca Normansell, Rachel Knightly, Stephen J Milan, Jennifer A Knopp-Sihota, Brian H Rowe, Colin Powell
No abstract text is available yet for this article.
February 15, 2018: Paediatric Respiratory Reviews
Gilberto Bueno Fischer, Helena Teresinha Mocelin, Cistiano Feijó Andrade, Edgar E Sarria
Pneumonia is an important health problem in children, and parapneumonic pleural effusion (PPE) is a frequent complication. There is no standard strategy for treating PPE, reflected in the few international guidelines that have been published on the issue. Compared to adults, there is no consensus on the utility of pleural fluid analysis in paediatric PPE. This is because of the lack of good evidence either in favour or against it and the risks of procedural sedation for acquiring pleural fluid for analysis to guide management...
March 2018: Paediatric Respiratory Reviews
Iolo Doull
This is arguably the most exciting era in the treatment of Cystic Fibrosis (CF) with the emergence of potentially disease modifying therapies. The last year has seen fewer landmark papers, with the consolidation of existing knowledge and advances in the understanding of the patho-physiology and management of CF.
March 2018: Paediatric Respiratory Reviews
Suresh Kotagal
The comprehensive management of chronic disorders such as hypersomnias of childhood requires combining life-style changes with rational pharmacotherapy that is based on treating the symptoms that are most bothersome, the age, comorbidities, and metabolic and endocrine status of the patient. The excessive sleepiness of narcolepsy and idiopathic hypersomnia is best treated with dextroamphetamine or methylphenidate preparations or modafinil/armodafinil. Cataplexy treatment requires sodium oxybate, tricyclic agents, selective norepinephrine reuptake inhibitors or selective serotonin reuptake inhibitors...
January 2018: Paediatric Respiratory Reviews
Mon Ohn, Dominic A Fitzgerald
No abstract text is available yet for this article.
January 2018: Paediatric Respiratory Reviews
Fabíola Villac Adde, Sílvia Vidal Campos, Ricardo Henrique de Oliveira Braga Teixeira, Joaquim Carlos Rodrigues
The current available literature evaluating lung resection surgery and lung transplantation in children with cystic fibrosis (CF) was reviewed through a PubMed search and references from selected studies were additionally included. Pulmonary resections, i.e. lobectomy, segmentectomy, and pneumonectomy, are seldom performed in CF. The main indications, in patients with a forced expiratory volume in 1second (FEV1 ) that is greater than 30% predicted, are localized bronchiectasis/atelectasis, severe hemoptysis, and bronchopleural fistula refractory to medical management...
January 2018: Paediatric Respiratory Reviews
Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño, Gustavo Nino
OBJECTIVE: No recent studies have performed a systematic review of all available instruments aimed at evaluating the severity of bronchiolitis. The objective of the present study was to perform a systematic review of instruments aimed at evaluating the severity of bronchiolitis and to evaluate their measurement properties. METHODS: A systematic search of the literature was performed in order to identify studies in which an instrument for evaluating the severity of bronchiolitis was described...
January 2018: Paediatric Respiratory Reviews
Sarah J Kotecha, John Lowe, Sailesh Kotecha
Body composition and growth outcomes of preterm-born subjects have been studied by many researchers. In general, preterm-born children have lower height and weight especially in infancy. Despite showing potential for catch-up growth, they continue to lag behind their term counterparts in adolescence and adulthood. The various methods of studying body composition and the differing gestations and ages at which it is assessed may go some way to explaining the inconsistent results observed in different studies...
December 20, 2017: Paediatric Respiratory Reviews
Chinedu Nwokoro, Jonathan Grigg
Preschool wheeze is a common but poorly understood cause of respiratory morbidity that is both distinct from and overlaps with infantile bronchiolitis and school age asthma. Attempts at classification by epidemiology, pathophysiology, therapeutic response and clinical phenotype are imperfect and yet fundamental to both treatment choice and research design. The four main therapeutic classes for preschool wheeze, namely beta2 agonists, anticholinergics, corticosteroids and leukotriene modifiers are employed with variable and often scanty evidence base, with evidence for a genetic influence on response variations...
December 5, 2017: Paediatric Respiratory Reviews
Bruce K Rubin, Wei Zhao, Tonya A Winders
One of the most important causes of asthma morbidity, hospital admissions, and death is non-adherence to prescribed therapy. It is generally assumed that adherence rates can be increased with asthma education, although well conducted studies have not always supported this assumption. Education can be achieved, or can fail, in many ways and no two patients have the same needs or perceived needs. In order to better understand what children with asthma and their parents or caregivers would desire as support from their physician providers, we conducted a survey of nearly 1000 parents of asthmatic children affiliated with the Asthma and Allergy Network...
November 16, 2017: Paediatric Respiratory Reviews
Merete Salveson Engeseth, Nina Rydland Olsen, Silje Maeland, Thomas Halvorsen, Adam Goode, Ola Drange Røksund
CONTEXT: Extremely premature (EP) infants are at increased risk of left vocal cord paralysis (LVCP) following surgery for patent ductus arteriosus (PDA). OBJECTIVE: A Systematical Review was conducted to investigate the incidence and outcomes of LVCP after PDA ligation in EP born infants. DATA SOURCES: Searches were performed in Cochrane, Medline, Embase, Cinahl and PsycInfo. STUDY SELECTION: Studies describing EP infants undergoing PDA surgery and reporting incidence of LVCP were included...
November 15, 2017: Paediatric Respiratory Reviews
Brit Hov, Tiina Andersen, Vegard Hovland, Michel Toussaint
Mechanical insufflation-exsufflation (MI-E) is a strategy to treat pulmonary exacerbations in neuromuscular disorders (NMDs). Pediatric guidelines for optimal setting titration of MI-E are lacking and the settings used in studies vary. Our objective was to assess the actual MI-E settings being used in current clinical treatment of children with NMDs and a survey was sent in July 2016 to European expertise centers. Ten centers from seven countries gave information on MI-E settings for 240 children aged 4 months to 17...
November 3, 2017: Paediatric Respiratory Reviews
Hui Wu, Chunwei Zhang, Yongqing Wang, Yanlin Li
Asthma is a heterogeneous disease with multiple phenotypes. Epidemiologic studies suggest a close relationship between vitamin E and the occurrence of asthma, wheezing and atopic conditions during childhood. Previous results on its effects have been conflicting. The aim of this meta-analysis was to critically examine the current evidence on the association of vitamin E with childhood asthma and wheezing. We searched electronic databases for observational studies in English-language journals published from 2000 to 2016...
October 16, 2017: Paediatric Respiratory Reviews
Colin Wallis, Clare A McLaren
Tracheobronchomalacia is a rare but clinically troublesome condition in paediatrics. The softening of the major airways - which can include some or all of the tracheobronchial tree can lead to symptoms ranging from the minor (harsh barking cough, recurrent chest infections) to severe respiratory difficulties including prolonged ventilator support and 'near death attacks'. The causes are broadly divided into intrinsic softening of the airway wall which is considered a primary defect (e.g. syndromes; post tracheo-oesophageal fistula repair; extreme prematurity) or secondary malacia due to external compression from vascular structures or cardiac components...
October 13, 2017: Paediatric Respiratory Reviews
Ian M Balfour-Lynn
The legal profession depends on expert witnesses, and indeed the first time an English Court relied on an expert medical witness was in the 14th century. Asking a specialist to comment on the standard of professional practice expected in their own specialty was first introduced in a 1767 case [1]. This article draws on 20 years of experience in medicolegal work relating to paediatric respiratory medicine. It highlights some of the legal principles that lie behind an expert opinion and what constitutes clinical negligence...
October 12, 2017: Paediatric Respiratory Reviews
Sandy Z P Lim, Dominic A Fitzgerald
Pseudomonas aeruginosa is a common bacterial pathogen in the evolution of bronchiectasis in cystic fibrosis. The appearance of resistant strains of pseudomonas is increasing with the earlier and more liberal use of a range of anti-pseudomonal antibiotics for the treatment of bacterial chest infections. The rationale for treatment and potential benefits of aggressive treatment of resistant strains of Pseudomonas aeruginosa from early in life are discussed.
September 1, 2017: Paediatric Respiratory Reviews
Dominic A Fitzgerald
Some have observed that developed world is fat and getting fatter. This is even extending into the developing world, and it is important to appreciate that the consequences of childhood obesity last into adulthood and are associated with premature death. From the paediatric respiratory perspective, the deposition of excess adipose tissue in the thoraco-abdominal region begins early in life and is believed to alter diaphragm mobility and chest wall expansion, reduce lung compliance, and result in a rapid shallow breathing pattern with an increased work of breathing and reduction in maximum ventilatory capacity...
September 2017: Paediatric Respiratory Reviews
Henry J Rozycki
No abstract text is available yet for this article.
September 2017: Paediatric Respiratory Reviews
Michael S Schechter
As technology yields new treatments, pediatric pulmonologists need determine how best to use them and how to decide which ones are best for any specific group or individual patient. Physicians have always customized therapies based upon patient response, but the new concept of "Personalized (or precision) medicine" focuses attention to a greater degree on the individual needs of patients based on their genetic, biomarker, phenotypic, or psychosocial characteristics. The newly developed biologics for treatment of asthma and CFTR modulators for treatment of cystic fibrosis (CF) highlight this newer approach...
September 2017: Paediatric Respiratory Reviews
Eitan Kerem
Significant improvement in the survival of patients with CF has been achieved in the last decades. The improved clinical status of the patients is mainly the result of a better understanding of the natural course of infection and inflammation in CF that has led to the implementation of strategies that increase the life expectancy and quality of life of the patients. These strategies include prompt diagnosis, timely and aggressive nutritional support, augmentation of MCC and improved mucous drainage, initiation of antimicrobial and anti-inflammatory therapy as soon as possible, early treatment of acute exacerbations, implementation of effective hygienic measures in and outside CF centers and prompt identification and treatment of CF-related complications...
September 2017: Paediatric Respiratory Reviews
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