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https://www.readbyqxmd.com/read/28538237/update-on-postnatal-steroids
#1
Henry L Halliday
Antenatal steroid treatment to enhance fetal lung maturity and surfactant treatment to prevent or treat respiratory distress syndrome have been major advances in perinatal medicine in the past 40 years contributing to improved outcomes for preterm infants. Use of postnatal steroids to prevent or treat chronic lung disease in preterm infants has been less successful and associated with adverse neurodevelopmental outcomes. Although early (in the first week of life) postnatal steroid treatment facilitates earlier extubation and reduces the risk of chronic lung disease, it is associated with adverse effects, such as hyperglycemia, hypertension, gastrointestinal bleeding and perforation, hypertrophic cardiomyopathy, growth failure, and cerebral palsy, and cannot be recommended...
2017: Neonatology
https://www.readbyqxmd.com/read/28530117/combined-impact-of-smoking-and-early-life-exposures-on-adult-lung-function-trajectories
#2
James P Allinson, Rebecca Hardy, Gavin C Donaldson, Seif O Shaheen, Diana Kuh, Jadwiga A Wedzicha
BACKGROUND: Both adverse early life exposures and adult smoking can negatively influence adult lung function trajectory but few studies consider how the impact of early life exposures may be modified by subsequent smoking. METHODS: The Medical Research Council National Survey of Health and Development is a nationally representative cohort, initially of 5362 individuals, followed since enrolment at birth in March 1946. Using data collected prospectively across life and multilevel modelling we investigated how the relationships between early life exposures (infant lower respiratory infection, manual social class, home overcrowding and pollution exposure) and FEV1 and FVC trajectories between ages 43 and 60-64 were influenced by smoking behaviour...
May 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28529118/early-life-allergen-and-air-pollutant-exposures-alter-longitudinal-blood-immune-profiles-in-infant-rhesus-monkeys
#3
Candace M Crowley, Justin H Fontaine, Joan E Gerriets, Edward S Schelegle, Dallas M Hyde, Lisa A Miller
Early life is a critical period for the progressive establishment of immunity in response to environmental stimuli; the impact of airborne challenges on this process is not well defined. In a longitudinal fashion, we determined the effect of episodic house dust mite (HDM) aerosol and ozone inhalation, both separately and combined, on peripheral blood immune cell phenotypes and cytokine expression from 4 to 25weeks of age in an infant rhesus monkey model of childhood development. Immune profiles in peripheral blood were compared with lung lavage at 25weeks of age...
May 18, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28529001/a-single-intranasal-administration-of-virus-like-particle-vaccine-induces-an-efficient-protection-for-mice-against-human-respiratory-syncytial-virus
#4
Yue-Ying Jiao, Yuan-Hui Fu, Yi-Fei Yan, Ying Hua, Yao Ma, Xiu-Juan Zhang, Jing-Dong Song, Xiang-Lei Peng, Jiaqiang Huang, Tao Hong, Jin-Sheng He
Human respiratory syncytial virus (RSV) is an important pediatric pathogen causing acute viral respiratory disease in infants and young children. However, no licensed vaccines are currently available. Virus-like particles (VLPs) may bring new hope to producing RSV VLP vaccine with high immunogenicity and safety. Here, we constructed the recombinants of matrix protein (M) and fusion glycoprotein (F) of RSV, respectively into a replication-deficient first-generation adenoviral vector (FGAd), which were used to co-infect Vero cells to assemble RSV VLPs successfully...
May 18, 2017: Antiviral Research
https://www.readbyqxmd.com/read/28520902/early-acquisition-of-pneumocystis-jirovecii-colonization-and-potential-association-with-respiratory-distress-syndrome-in-preterm-newborn-infants
#5
Pilar Rojas, Vicente Friaza, Elisa Garcia, Carmen de la Horra, Sergio L Vargas, Enrique J Calderón, Antonio Pavón
Background: Pneumocystis pneumonia is a well-recognized lung disease of premature and malnourished babies. Even though, serologic studies have shown that children are exposed to Pneumocystis jirovecii early in life the epidemiology of human P. jirovecii infection and the host-microorganism relationship in infancy remain poorly understood. The aim of the present study was to investigate the prevalence of P. jirovecii colonization in preterm infants and its possible association with medical complications...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28520106/prophylactic-sustained-inflation-is-just-one-step-to-preventing-bronchopulmonary-dysplasia
#6
G Lista, I Bresesti
I am glad to see that the Sustained Lung Inflation (SLI) trial (1) still draws a great deal of attention and I would like to clarify some aspects of the trial, in response to the comments by Gupta and Argarwal (2) in Acta Paediatrica. A meta-analysis carried out in 2016 demonstrated that starting non-invasive respiratory support from birth could reduce the incidence of bronchopulmonary dysplasia and death. However, about 50% of very low birth weight infants who are initially on nasal continuous positive airway pressure need subsequent intubation and mechanical ventilation...
May 18, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28516132/life-threatening-hypercalcemia-during-prodrome-of-pneumocystis-jiroveci-pneumonia-in-an-immunocompetent-infant
#7
Judith Sebestyen VanSickle, Tarak Srivastava, Uri S Alon
Severe hypercalcemia in infants is usually attributed to genetic etiologies and less commonly to acquired ones. An 8-week-old girl presented with failure to thrive, mild respiratory distress, and life-threatening hypercalcemia (23.5 mg/dL). Serum 1,25(OH)2-vitamin D (1,25(OH)2-D) level was elevated and parathyroid hormone undetectable. Evaluation for genetic mutations and malignant etiologies of hypercalcemia was negative. Treatment with intravenous hydration, loop diuretic, and calcitonin failed to correct the hypercalcemia, which was subsequently controlled with bisphosphonate therapy...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28514958/neonatal-respiratory-morbidity-following-exposure-to-chorioamnionitis
#8
Amy Metcalfe, Sarka Lisonkova, Yasser Sabr, Amelie Stritzke, K S Joseph
BACKGROUND: There are conflicting results in the literature on the impact of chorioamnionitis on neonatal respiratory morbidities. However, most studies are based on small clinical samples and fail to account for the competing risk of perinatal death. This study aimed to determine whether chorioamnionitis affects the incidence of respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) after accounting for the increased risk of death. METHODS: Retrospective cohort study using linked birth and infant death registration and hospitalization records from Washington State between 2002 and 2011 (n = 763,671 singleton infants and n = 56,537 singleton preterm infants)...
May 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28513136/cold-chain-free-storable-hydrogel-for-infant-friendly-oral-delivery-of-amoxicillin-for-the-treatment-of-pneumococcal-pneumonia
#9
Keming Xu, Liang Li, Mingyue Cui, Yiyuan Han, Huseyin Enis Karahan, Vincent Tak Kwong Chow, Chenjie Xu
Pneumonia is the major cause of death in children under five, particularly in developing countries. Antibiotics such as amoxicillin greatly help in mitigating this problem. However, there is lack of an infant/toddler-friendly formulation for countries with limited clean water and electricity. Here we report the development of a shear-thinning hydrogel system for the oral delivery of amoxicillin to the infant/toddler patients, without the need of clean water and refrigeration. The hydrogel formulation consists of metolose (hydroxypropyl methylcellulose) and amoxicillin...
May 17, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28512724/congenital-pulmonary-alveolar-proteinosis-from-birth-to-ten-years-of-age
#10
Sandra Alavuk Kundović, Ljiljana Popović
Pulmonary alveolar proteinosis is a rare lung disease in which lipoproteinaceous material accumulates within the alveoli, interfering with gas exchange. The disease is classified into congenital, secondary, and acquired. The congenital form includes inborn errors of surfactant metabolism, lysinuric protein intolerance and mutations in the components of granulocyte-macrophage colony-stimulating factor receptor. The main symptoms are non-specific. The radiologic appearance of pulmonary alveolar proteinosis is bilateral, symmetric and perihilar airspace consolidation...
May 17, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28510235/surfactants-in-acute-respiratory-distress-syndrome-in-infants-and-children-past-present-and-future
#11
REVIEW
Angela Amigoni, Andrea Pettenazzo, Valentina Stritoni, Maria Circelli
There is a lack of definitive data on the effective management of acute respiratory distress syndrome (ARDS) in infants and children. The development and validation of the Berlin definition (BD) for ARDS and the Pediatric Acute Lung Injury Consensus Conference (PALICC) recommendations in children represented a major advance in optimizing research and treatment, mainly due to the introduction of a severe ARDS category. Proposed reasons for the lack of consistent results with surfactants in children and infants compared with neonates include different causes, type of lung damage (direct or indirect), timing and mode of administration as well as the type of surfactant used...
May 16, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28508992/palivizumab-prophylaxis-in-infants-with-cystic-fibrosis-does-not-delay-first-isolation-of-pseudomonas-aeruginosa-or-staphylococcus-aureus
#12
Clélia Buchs, Marie-Laure Dalphin, Stéphane Sanchez, Marie Perceval, Laurianne Coutier, Catherine Mainguy, Behrouz Kassaï-Koupaï, Philippe Reix
Respiratory syncytial virus (RSV) infections may worsen cystic fibrosis (CF) lung disease and favor Pseudomonas aeruginosa (Pa) or Staphylococcus aureus (Sa) acquisition, which is of particular importance in the youngest patients. We aimed to determine the effectiveness of PVZ on microbiological outcomes in young children with CF. We conducted a retrospective case-control study to compare these outcomes in children who systematically received PVZ (PVZ+; n = 40) or not (PVZ-; n = 140). One case was matched with at least three same-gender controls born the same year and month...
May 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28504997/lung-rest-during-extracorporeal-membrane-oxygenation-for-neonatal-respiratory-failure-practice-variations-and-outcomes
#13
Deepthi Alapati, Zubair H Aghai, Md Jobayer Hossain, Daniel R Dirnberger, Mark T Ogino, Thomas H Shaffer
OBJECTIVE: Describe practice variations in ventilator strategies used for lung rest during extracorporeal membrane oxygenation for respiratory failure in neonates, and assess the potential impact of various lung rest strategies on the duration of extracorporeal membrane oxygenation and the duration of mechanical ventilation after decannulation. DATA SOURCES: Retrospective cohort analysis from the Extracorporeal Life Support Organization registry database during the years 2008-2013...
May 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28504341/breathing-circuit-compliance-and-accuracy-of-displayed-tidal-volume-during-pressure-controlled-ventilation-of-infants-a-quality-improvement-project
#14
Todd A Glenski, Carrie Diehl, Rachel G Clopton, Robert H Friesen
INTRODUCTION: Anesthesia machines have evolved to deliver desired tidal volumes more accurately by measuring breathing circuit compliance during a preuse self-test and then incorporating the compliance value when calculating expired tidal volume. The initial compliance value is utilized in tidal volume calculation regardless of whether the actual compliance of the breathing circuit changes during a case, as happens when corrugated circuit tubing is manually expanded after the preuse self-test but before patient use...
May 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28503300/how-to-decrease-bronchopulmonary-dysplasia-in-your-neonatal-intensive-care-unit-today-and-tomorrow
#15
REVIEW
Leif D Nelin, Vineet Bhandari
Bronchopulmonary dysplasia, or BPD, is the most common chronic lung disease in infants. Genetic predisposition and developmental vulnerability secondary to antenatal and postnatal infections, compounded with exposure to hyperoxia and invasive mechanical ventilation to an immature lung, result in persistent inflammation, culminating in the characteristic pulmonary phenotype of BPD of impaired alveolarization and dysregulated vascularization. In this article, we highlight specific areas in current management, and speculate on therapeutic strategies that are on the horizon, that we believe will make an impact in decreasing the incidence of BPD in your neonatal intensive care units...
2017: F1000Research
https://www.readbyqxmd.com/read/28500974/ongoing-developments-in-rsv-prophylaxis-a-clinician-s-analysis
#16
REVIEW
Fariba Rezaee, Debra T Linfield, Terri J Harford, Giovanni Piedimonte
Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children worldwide. Lower respiratory tract infection due to RSV is one of the most common causes of hospitalization for infants, especially those born premature or with chronic lung or heart disease. Furthermore, RSV infection is an important cause of morbidity in adults, particularly in the elderly and immunocompromised individuals. The acute phase of this infection is often followed by episodes of wheezing that recur for months or years and usually lead to a physician diagnosis of asthma...
May 10, 2017: Current Opinion in Virology
https://www.readbyqxmd.com/read/28498973/chordoma-occurs-in-young-children-with-tuberous-sclerosis
#17
Nathan A Dahl, Timothy Luebbert, Michele Loi, Ilana Neuberger, Michael H Handler, Bette Kay Kleinschmidt-DeMasters, Jean M Mulcahy Levy
Chordomas are rare bony neoplasms usually unassociated with a familial tumor predisposition syndrome. The peak incidence of this midline axial skeletal tumor is in adulthood but when very young children are affected, consideration should be given to occurrence within the tuberous sclerosis (TS) complex, especially when presenting in neonates <3 months of age. To call attention to this association, we present a brachyury-immunopositive chordoma occurring in the skull base of a 2-month-old male infant who was later realized to have metastases to the subcutaneous tissues and lungs, as well as rhabdomyoma of the heart and renal cysts/angiomyolipomas, that is, characteristic features of the TS complex...
June 1, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28497033/intrapulmonary-percussive-ventilation-as-an-airway-clearance-technique-during-venoarterial-extracorporeal-life-support-in-an-infant-with-pertussis
#18
Conrad Krawiec, Ken Ballinger, E Scott Halstead
Initiation of extracorporeal life support (ECLS) is often followed by complete opacification of pulmonary parenchyma and volume loss. The optimal mechanical ventilator management and lung recruitment strategy of a pediatric patient requiring extracorporeal membrane oxygenation is not known. We present a case of a 4-week old infant who developed a severe pertussis infection requiring ECLS. The severity of his illness and pertussis infection-associated intraluminal bronchiole obstruction made medical management challenging...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28495620/vitamin-c-to-decrease-the-effects-of-smoking-in-pregnancy-on-infant-lung-function-vcsip-rationale-design-and-methods-of-a-randomized-controlled-trial-of-vitamin-c-supplementation-in-pregnancy-for-the-primary-prevention-of-effects-of-in-utero-tobacco-smoke-exposure
#19
Cindy T McEvoy, Kristin F Milner, Ashley J Scherman, Diane G Schilling, Christina J Tiller, Brittany Vuylsteke, Lyndsey E Shorey-Kendrick, Eliot R Spindel, Robert Schuff, Julie Mitchell, Dawn Peters, Jill Metz, David Haas, Keith Jackson, Robert S Tepper, Cynthia D Morris
Despite strong anti-smoking efforts, at least 12% of American women cannot quit smoking when pregnant resulting in >450,000 smoke-exposed infants born yearly. Smoking during pregnancy is the largest preventable cause of childhood respiratory illness including wheezing and asthma. Recent studies have shown a protective effect of vitamin C supplementation on the lung function of offspring exposed to in utero smoke in a non-human primate model and an initial human trial. Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP) is a randomized, double-blind, placebo-controlled trial to evaluate pulmonary function at 3months of age in infants delivered to pregnant smokers randomized to 500mg/day of vitamin C versus placebo during pregnancy...
May 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28485984/vascular-endothelial-mitochondrial-function-predicts-death-or-pulmonary-outcomes-in-preterm-infants
#20
Jegen Kandasamy, Nelida Olave, Scott W Ballinger, Namasivayam Ambalavanan
RATIONALE: Vascular endothelial mitochondrial dysfunction contributes to the pathogenesis of several oxidant stress associated disorders. Oxidant stress is a major contributor to the pathogenesis of bronchopulmonary dysplasia (BPD), a chronic lung disease of prematurity that often leads to sequelae in adult survivors. OBJECTIVES: This study was conducted to identify whether differences in mitochondrial bioenergetic function and oxidant generation in HUVEC (human umbilical venous endothelial cells) obtained from extremely preterm infants were associated with risk for BPD or death before 36 weeks post-menstrual age...
May 9, 2017: American Journal of Respiratory and Critical Care Medicine
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