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paediatric pulmonary

Daniel B Hawcutt, Ben Francis, Daniel F Carr, Andrea L Jorgensen, Peng Yin, Naomi Wallin, Natalie O'Hara, Eunice J Zhang, Katarzyna M Bloch, Amitava Ganguli, Ben Thompson, Laurence McEvoy, Matthew Peak, Andrew A Crawford, Brian R Walker, Joanne C Blair, Jonathan Couriel, Rosalind L Smyth, Munir Pirmohamed
BACKGROUND: A serious adverse effect of corticosteroid therapy is adrenal suppression. Our aim was to identify genetic variants affecting susceptibility to corticosteroid-induced adrenal suppression. METHODS: We enrolled children with asthma who used inhaled corticosteroids as part of their treatment from 25 sites across the UK (discovery cohort), as part of the Pharmacogenetics of Adrenal Suppression with Inhaled Steroids (PASS) study. We included two validation cohorts, one comprising children with asthma (PASS study) and the other consisting of adults with chronic obstructive pulmonary disorder (COPD) who were recruited from two UK centres for the Pharmacogenomics of Adrenal Suppression in COPD (PASIC) study...
March 15, 2018: Lancet Respiratory Medicine
Neeraj Raizada, Sunil D Khaparde, Soumya Swaminathan, Sanjay Sarin, Virender Singh Salhotra, Aakshi Kalra, Ashwani Khanna, K K Chopra, M Hanif, K R Umadevi, Syed Hissar, Sreenivas Achuthan Nair, C H Surya Prakash, B K Saha, Raghuram Rao, Claudia Denkinger, Catharina Boehme
BACKGROUND: Unlike in adults, diagnosis of TB can be challenging in children, as signs and symptoms of paediatric TB can be very non-specific and similar to other common childhood chest infections, which may lead to under or delayed diagnosis of TB disease. In spite of the increasing availability of rapid high-sensitivity diagnostics in public and private sectors, majority of paediatric TB cases are empirically diagnosed, without laboratory confirmation. To address these diagnostic challenges, World Health Organization (WHO) has recommended upfront Xpert MTB/RIF (Xpert) testing for the diagnosis of TB in paediatric presumptive pulmonary and extra-pulmonary TB (EPTB) cases...
2018: PloS One
Barbara Giordani, Annalisa Amato, Fabio Majo, Gianluca Ferrari, Serena Quattrucci, Laura Minicucci, Rita Padoan, Giovanna Floridia, Gianna Puppo Fornaro, Domenica Taruscio, Marco Salvatore
INTRODUCTION: The Italian Cystic Fibrosis Registry (ICFR) is based on a new agreement about the data flow towards the Registry signed on October, 4th 2016 by the Centre for Rare Diseases of the Italian National Institute of Health (NIH), the clinicians of the Italian National Referral and Support Centres for Cystic Fibrosis, the Paediatric Hospital "Bambino Gesù" (Rome), the Italian Cystic Fibrosis Society, and the Italian League for Cystic Fibrosis. OBJECTIVES: The aim of the present Report is to improve the knowledge on cystic fibrosis (CF) through the epidemiological description of Italian patients...
January 2018: Epidemiologia e Prevenzione
Lucie Cluver, Marija Pantelic, Mark Orkin, Elona Toska, Sally Medley, Lorraine Sherr
INTRODUCTION: The Sustainable Development Goals (SDGs) present a groundbreaking global development agenda to protect the most vulnerable. Adolescents living with HIV in Sub-Saharan Africa continue to experience extreme health vulnerabilities, but we know little about the impacts of SDG-aligned provisions on their health. This study tests associations of provisions aligned with five SDGs with potential mortality risks. METHODS: Clinical and interview data were gathered from N = 1060 adolescents living with HIV in rural and urban South Africa in 2014 to 2015...
February 2018: Journal of the International AIDS Society
Emanuele Pontali, Dina Visca, Rosella Centis, Lia D'Ambrosio, Antonio Spanevello, Giovanni Battista Migliori
PURPOSE OF REVIEW: Multidrug-resistant (MDR) tuberculosis (TB) and extensively drug-resistant (XDR)-TB epidemics are key obstacles towards TB control and elimination. RECENT FINDINGS: Diagnosis of MDR/XDR-TB is difficult and requires several weeks. New diagnostic tools are being tested and proposed allowing for shorter time to diagnosis and reduced delays in starting an adequate treatment regimen. MDR/XDR-TB treatment strategies are currently on an evolving stage...
February 20, 2018: Current Opinion in Pulmonary Medicine
Endale Tefera, Mohamed Leye, Patrick Garceau, Denis Bouchard, Joaquim Miró
BACKGROUND: The Inoue balloon technique is the standard technique for mitral valve balloon commissurotomy at this stage. However, the hardware for this technique is expensive and may not always be available in resource-limited settings. OBJECTIVE: This article reports our experience with percutaneous transmitral balloon commissurotomy using a single balloon (Nucleus) with arteriovenous loop stabilisation. METHOD: Eleven young patients, aged 12-26 years and weighing 23-48 kg, underwent transmitral balloon commissurotomy using the described technique at our centre from April to May 2014...
February 19, 2018: Cardiovascular Journal of Africa
P Frykholm, E Schindler, R Sümpelmann, R Walker, M Weiss
The current guidelines for preoperative fasting recommend intervals of 6, 4, and 2 h (6-4-2) of fasting for solids, breast milk, and clear fluids, respectively. The objective is to minimize the risk of pulmonary aspiration of gastric contents, but also to prevent unnecessarily long fasting intervals. Pulmonary aspiration is rare and associated with nearly no mortality in paediatric anaesthesia. The incidence may have decreased during the last decades, judging from several audits published recently. However, several reports of very long fasting intervals have also been published, in spite of the implementation of the 6-4-2 fasting regimens...
March 2018: British Journal of Anaesthesia
Nataliya R Nichay, Irina Y Zhuravleva, Yuriy Y Kulyabin, Tatyana P Timchenko, Alexey V Voitov, Elena V Kuznetsova, Ilia A Soynov, Alexey V Zubritskiy, Alexander V Bogachev-Prokophiev, Alexander M Karaskov
OBJECTIVES: In this study, we aimed to determine the incidence of reintervention and calcification of xenografts in paediatric patients who underwent placement of the right ventricle-to-pulmonary artery valved conduits. METHODS: We retrospectively analysed clinical data of paediatric patients (1 day-18 years) who underwent right ventricular outflow tract reconstruction using xenograft from 2000 to 2016 at a single centre. RESULTS: A total of 301 patients underwent the placement of 337 xenografts, including glutaraldehyde-treated bovine jugular vein (n = 171, 50...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Vandana Jain, Santosh Kumar, Naval K Vikram, Mani Kalaivani, Surya Prakash Bhatt, Rajni Sharma, Kumar Kabra Sushil
Background & objectives: Cystic fibrosis (CF) is a life-limiting genetic condition resulting in chronic respiratory infections, pancreatic enzyme insufficiency and associated complications. This pilot study was undertaken to assess the glucose tolerance and insulin secretion and sensitivity among Indian children with CF. Methods: Children with CF under regular follow up at the Paediatric Pulmonology Clinic of a tertiary care hospital in New Delhi, India, were enrolled...
October 2017: Indian Journal of Medical Research
Priya N Bhat, John M Costello, Ranjit Aiyagari, Paul J Sharek, Claudia A Algaze, Mjaye L Mazwi, Stephen J Roth, Andrew Y Shin
Introduction Diagnostic errors cause significant patient harm and increase costs. Data characterising such errors in the paediatric cardiac intensive care population are limited. We sought to understand the perceived frequency and types of diagnostic errors in the paediatric cardiac ICU. METHODS: Paediatric cardiac ICU practitioners including attending and trainee physicians, nurse practitioners, physician assistants, and registered nurses at three North American tertiary cardiac centres were surveyed between October 2014 and January 2015...
February 7, 2018: Cardiology in the Young
Jonathan I Silverberg, Lauren Kwa, Michael C Kwa, Anne E Laumann, Kaveh Ardalan
Objective: JDM is associated with multiple potential risk factors for cardiovascular disease, including reduced heart rate variability, systolic/diastolic cardiac dysfunction, abnormal brachial artery reactivity and metabolic syndrome. However, little is known about cardiovascular risk in JDM. We sought to examine the association between JDM and cardiovascular risk factors and disease in US children. Methods: Data from the 2002-12 National Inpatient Sample was analysed, including ∼20% of all US hospitalizations (n = 14 535 620 paediatric hospitalizations)...
January 24, 2018: Rheumatology
Kiyotaka Fukamachi, Jamshid H Karimov, David J Horvath, Gengo Sunagawa, Nicole A Byram, Barry D Kuban, Nader Moazami
OBJECTIVES: Mechanical circulatory support has become standard therapy for adult patients with end-stage heart failure; however, in paediatric patients with congenital heart disease, the options for chronic mechanical circulatory support are limited to paracorporeal devices or off-label use of devices intended for implantation in adults. Congenital heart disease and cardiomyopathy often involve both the left and right ventricles; in such cases, heart transplantation, a biventricular assist device or a total artificial heart is needed to adequately sustain both pulmonary and systemic circulations...
January 19, 2018: Interactive Cardiovascular and Thoracic Surgery
A Beningfield, A Jones
BACKGROUND: Chest physiotherapy (CPT) is implemented before and after congenital heart disease (CHD) surgery in paediatrics to prevent and treat postoperative pulmonary complications (PPC). Currently, there are no systematic reviews or meta-analyses on the efficacy of CPT in this population. OBJECTIVE: To conduct a systematic review and meta-analysis to determine whether peri-operative CPT is safe and effective for paediatric patients with CHD. DATA SOURCES: A literature search was conducted on PEDro, MEDLINE, CINAHL, Informit, The Cochrane Library and Scopus in March and April 2016...
December 5, 2017: Physiotherapy
Daniel L Varela, Mohamed Teleb, Wael El-Mallah
Pulmonary arterial hypertension (PAH) secondary to congenital heart disease (CHD) is the third most common cause of PAH, and it is becoming increasingly common as improvements in the management of CHD have led to increased life expectancy for these patients. The medical management of PAH due to CHD (PAH-CHD) is largely the same as what has been used for the treatment of idiopathic PAH, though the body of literature supporting this management decision is very small. There are currently few studies available which specifically focus on the treatment of PAH-CHD...
2018: Open Heart
Abdelhakim Elyajouri, Rachid Abilkacem, Aomar Agadr
This report aims to describe the epidemiologic findings of the workload associated with paediatric consultation of the Moroccan Military field hospital in the Gaza Strip. The patient Administration System and Biostatistics Activity database was reviewed and queried for all patients < 15 years of age who were consulted in the Moroccan Army hospital in the Gaza Strip between November 2012 to February 2013. Paediatric consultations during the study period were 7420 (19.9%) out of 37 227 consultations. The largest proportion of children were from 2 to 13 years old (3066 of 7420 children; 41...
January 2, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
Anna-May Long, Kathryn J Bunch, Marian Knight, Jennifer J Kurinczuk, Paul D Losty
PURPOSE: This study aims to describe short-term outcomes of live-born infants with congenital diaphragmatic hernia (CDH) and to identify prognostic factors associated with early mortality. DESIGN: A prospective population cohort study was undertaken between April 2009 and September 2010, collecting data on live-born infants with CDH from all 28 paediatric surgical centres in the UK and Ireland using an established surgical surveillance system. Management and outcomes are described...
January 4, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Marcin Szczechowicz, Sabreen Mkalaluh, Mina Farag, Ahmed Mashhour, Tsvetomir Loukanov, Jacek Kolcz, Matthias Karck, Alexander Weymann
BACKGROUND: Surgery of the pulmonary valve, right ventricular outflow tract, and pulmonary artery falls under the domain of paediatric cardiac surgery. However, 97 adult patients underwent such operations in our establishment from 1993 to 2016. AIM: This study aims to analyse preoperative risk factors, intraoperative data, postoperative outcomes, and long-term survival to identify the potential predictors of mortality and high-risk patients.
 METHODS: We divided our patient cohort into three groups in accordance with surgical indications: 17 patients with pulmonary valve endocarditis (group A), 70 patients with congenital defects involving the pulmonary valve (group B), and 10 patients who underwent pulmonary valve surgery for other indications, like tumor or other acquired valvular disease (group C)...
January 3, 2018: Kardiologia Polska
Murat Ozer, Betul Buyuktiryaki, Umit Murat Sahiner, Ozlem Teksam, Betul Karaatmaca, Ozge Soyer, Bulent Enis Sekerel
AIM: We aimed to identify the frequency, magnitude and risk factors of salbutamol-induced hypoxia in children with acute asthma. METHODS: This study was conducted at Hacettepe University on children who presented to the paediatric allergy clinic or the paediatric emergency room with acute asthma between July 2014 and June 2015. Vital signs, pulse oximeter defined oxygen saturation and modified pulmonary index scores were evaluated before and after the first, second and third doses of nebulised salbutamol and repeated one and 10 days later...
December 28, 2017: Acta Paediatrica
Leonardo Martinez, Ye Shen, Andreas Handel, Srijita Chakraburty, Catherine M Stein, LaShaunda L Malone, W Henry Boom, Frederick D Quinn, Moses L Joloba, Christopher C Whalen, Sarah Zalwango
BACKGROUND: Tuberculosis is a leading cause of global childhood mortality; however, interventions to detect undiagnosed tuberculosis in children are underused. Child contact tracing has been widely recommended but poorly implemented in resource-constrained settings. WHO has proposed a pragmatic screening approach for managing child contacts. We assessed the effectiveness of this screening approach and alternative symptom-based algorithms in identifying secondary tuberculosis in a prospectively followed cohort of Ugandan child contacts...
December 19, 2017: Lancet Respiratory Medicine
Villa Watch, Jimmy Aipit, Tina Kote-Yarong, Allanie Rero, John W Bolnga, Elvin Lufele, Moses Laman
Background: In Papua New Guinea, TB is considered to be a major public health problem, but little is known about the prevalence and prognosis of presumed TB in children. Methods: As part of a prospective hospital-based surveillance on the northern coast of mainland Papua New Guinea, the authors investigated the admission prevalence and case fatality rate associated with presumed TB over a 6-year period (2011-2016). All children admitted who were diagnosed with TB were followed-up until discharge or death...
November 1, 2017: International Health
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