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Wheezy in children

Fernando Maria de Benedictis, Andrew Bush
Wheeze is a common symptom in young children and is usually associated with viral illnesses. It is a major source of morbidity and is responsible for a high consumption of healthcare and economic resources worldwide. A few children have a condition resembling classical asthma. Rarer specific conditions may have a wheezy component and should be considered in the differential diagnosis. Over the last half century, there have been many circular discussions about the best way of managing preschool wheeze. In general, intermittent wheezing should be treated with intermittent bronchodilator therapy, and a controller therapy should be prescribed for a young child with recurrent wheezing only if positively indicated, and only then if carefully monitored for efficacy...
October 4, 2016: Archives of Disease in Childhood
Grace Li, Ofran Almossawi, Hasna Dulfeker, Vicky Jones, Felicity Taylor
AIM: To compare the palatability of oral non-soluble and oral soluble prednisolone tablets in paediatric patients admitted to the general paediatric wards in an acute London Trust. METHOD: As part of ongoing quality improvement initiatives, the Paediatric and Pharmacy departments compared tolerability of soluble versus non-soluble prednisolone in a group of 27 patients. Using a modified 5 point hedonic scale with 'smiley' faces we measured palatability and tolerance (swallowed versus refusal or vomiting) over two three week periods: the first period whilst soluble prednisolone was dispensed (n=17) and the second period after the switch to non-soluble prednisolone had been made (n=10)...
September 2016: Archives of Disease in Childhood
Wenjing Gu, Yuqing Wang, Chuangli Hao, Xinxing Zhang, Yongdong Yan, Zhengrong Chen, Wujun Jiang, Xuejun Shao, Wei Ji
This study was conducted to study the epidemiology and clinical manifestations of human metapneumovirus (hMPV) infection in children in the Suzhou area, China, and to investigate the effect of thymic stromal lymphopoietin (TSLP) on wheezing in hMPV-infected children. The study comprised 13 533 children with respiratory tract infection admitted to Children's Hospital of Soochow University between January 2009 and December 2014. Clinical data was recorded. The plasma levels of TSLP, IL4, and IL2 in 35 wheezing children with single hMPV infection and 15 non-wheezy children with hMPV infection and 35 wheezing children with other viral infections were compared...
June 30, 2016: Japanese Journal of Infectious Diseases
Véronique Nève, Sébastien Hulo, Jean-Louis Edmé, Sophie Boileau, Georges Baquet, Guillaume Pouessel, Caroline Thumerelle, Antoine Deschildre, Régis Matran
Uncontrolled wheezing disorder is common in preschoolers and disease control assessment is challenging as parents frequently overestimate the extent to which their child's disease is controlled. This is the first study of forced expiratory volume in t s (FEVt)/forced vital capacity (FVC) ratio measurements (i.e. FEV1/FVC, FEV0.75/FVC and FEV0.5/FVC) in wheezy preschoolers in relation to disease control. Our objective was to evaluate whether FEVt/FVC ratios less than the lower limit of normal (LLN; z-score <-1...
August 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Selda Hançerli-Törün, Deniz Özçeker, Metin Uysalol, Zeynep Tamay, Güntülü Şık, Ayper Somer, Meral Çıplak, Agop Çıtak, Nuran Salman, Nermin Güler
The aim of study was to evaluate various risk in patients who were hospitalized with moderate to severe virus-induced wheezing. Infants hospitalized with virus-induced wheezing were enrolled in the study. Respiratory viruses were detected in nasopharyngeal swab and total IgE levels and skin prick tests were performed in all patients. The mean age of the patients was 11.2±9 months. The most common detected viral agents were Respiratory Syncytial Virus, (33.6%), Influenza virus (16.3.%). Children with positive family history of atopy had their first virus-induced wheezing at an earlier age (9...
July 2015: Turkish Journal of Pediatrics
Qing Fan, Tingting Gu, Peijie Li, Ping Yan, Dehong Chen, Bingchao Han
BACKGROUND: The study aimed to explore possible factors influencing wheezing in children with Mycoplasma pneumoniae pneumonia (MPP). METHODS: The study included 84 children with MPP, who were divided into two groups: wheezy group (n=40) and non-wheezy group (n=44), along with 30 age-matched healthy controls. T-cell immunoglobulin and mucin domain gene (Tim) 1, 3 and Toll-like receptor (TLR) 2, 4 were evaluated using RT-PCR. Serum IL-10, TNF-α, IFN-γ and IgE were assessed by enzyme-linked immunosorbent assay...
April 30, 2016: Heart, Lung & Circulation
Dorottya Czövek, Claire Shackleton, Zoltán Hantos, Kate Taylor, Anushma Kumar, Archana Chacko, Robert S Ware, Gergely Makan, Bence Radics, Zoltán Gingl, Peter D Sly
RATIONALE: Individual assessment of airway obstruction in preschool-age children requires sensitive and specific lung function methods with low demand of cooperation. Although the forced oscillation technique (FOT) is feasible in young children, conventional measurements of respiratory impedance (Zrs) have limited diagnostic power in individuals. OBJECTIVE: To find descriptors of within-breath Zrs that are sensitive indicators of airway obstruction during tidal breathing in children...
October 2016: Thorax
Victoria MacBean, Caroline J Jolley, Timothy G Sutton, Akash Deep, Anne Greenough, John Moxham, Gerrard F Rafferty
BACKGROUND: Parasternal intercostal muscle electromyography (EMGpara) represents a novel tool to assess respiratory load when volitional techniques are not possible. This study examined the application of EMGpara in healthy, wheezy, and critically ill children. METHODS: Surface EMGpara was measured during tidal breathing in 92 healthy children, 20 wheezy preschool children (with measurements repeated following bronchodilator), and 25 mechanically ventilated children during supported ventilation and on continuous positive airways pressure...
September 2016: Pediatric Research
C C Grant, J Crane, E A Mitchell, J Sinclair, A Stewart, T Milne, J Knight, C Gilchrist, C A Camargo
BACKGROUND: Vitamin D has immune-modulating effects. We determined whether vitamin D supplementation during pregnancy and infancy prevents aeroallergen sensitization and primary care respiratory illness presentations. METHODS: A randomized, double-blind, placebo-controlled parallel-group trial. We assigned pregnant women, from 27-week gestation to birth, and then their infants, from birth to 6 months, to placebo or one of two dosages of daily oral vitamin D. Woman/infant pairs were randomized to: placebo/placebo, 1000 IU/400 IU or 2000 IU/800 IU...
September 2016: Allergy
Solomon Shavit, Shlomo Cohen, Aliza Goldman, Lior Ben-Dov, Avraham Avital, Chaim Springer, Avigdor Hevroni
OBJECTIVE: Spirometry including bronchodilator responsiveness is considered routine in the workup of asthma in older children. However, in wheezy infants the existence of bronchodilator responsiveness and its prognostic significance remain unclear. METHODS: Infants (< 2 years) with chronic or recurrent wheezing or coughing were evaluated by infant pulmonary function testing (PFT). Maximal expiratory flow at the point of functional residual capacity (V̇maxFRC) was measured before and 20 minutes after salbutamol administration...
September 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Ilknur Bostanci, Serap Ozmen, Hilal Susam Sen, Emine Misirlioglu Dibek, Pelin Zorlu
BACKGROUND: It is important to determine the presence of asthma in children under the age of three with recurrent wheezing. Inflammatory markers have been investigated in the diagnosis and treatment of asthma. We aimed to investigate the relationship between recurrent wheezing with or without modified asthma predictive index (mAPI) positivity and high sensitivity-C reactive protein (hs-CRP) levels in children between aged 6 and 36 months. METHODS: Ninety-nine children with recurrent wheezing and 47 healthy children aged 6-36 months were included in our cross sectional, case-control study...
March 6, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Michael Seear, Shally Awasthi, Vishwanath Gowraiah, Rashmi Kapoor, Aradhana Awasthi, Anilkumar Verma, Saud Al-Shabibi, Claire Gowdy
OBJECTIVE: To test the predictive accuracy and reporting reproducibility of digital chest radiographs under low-resource conditions. METHODS: One hundred thirty four tachypneic children who presented to two Indian hospitals were enrolled. Based on review of 16 variables recorded in the Emergency Room (ER) by a senior pediatrician, children were given one of the four clinical diagnoses: pneumonia, wheezy disease, mixed and non-respiratory. Every child also had a digital CXR...
September 2016: Indian Journal of Pediatrics
Fernando Maria de Benedictis, Marina Attanasi
Several topics on childhood asthma were addressed in the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress. With regard to the relationship between lower respiratory tract infections and asthma, it emerges that is the number of respiratory episodes in the first years of life, but not the particular viral trigger, to be associated with later asthma development. Understanding which characteristics of individual patients are associated with an increased risk for asthma exacerbation is a critical step to implement strategies preventing these seasonal events...
March 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
Nara Tagiyeva, Graham Devereux, Shona Fielding, Stephen Turner, Graham Douglas
RATIONALE: Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD. OBJECTIVES: To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade...
January 1, 2016: American Journal of Respiratory and Critical Care Medicine
Christian J Carlsson, Nadja H Vissing, Astrid Sevelsted, Sebastian L Johnston, Klaus Bønnelykke, Hans Bisgaard
BACKGROUND: Wheezy episodes in young children are often triggered by viral and bacterial respiratory tract infections, but there is little evidence supporting the hypothesis that symptom duration depends on the specific microbial trigger. OBJECTIVE: We sought to investigate whether the duration of wheezy episodes in young children depends on the microbial trigger. METHODS: Two hundred eighty-three children from the Copenhagen Prospective Study on Asthma in Childhood2000 at-risk birth cohort were prospectively examined for common airway pathogenic bacteria and viruses during acute wheezy episodes in the first 3 years of life...
November 2015: Journal of Allergy and Clinical Immunology
Maria Luz García-Garcia, Ersilia González-Carrasco, Sergio Quevedo, Cristina Muñoz, Veronica Sánchez-Escudero, Francisco Pozo, Inmaculada Casas, Cristina Calvo
BACKGROUND: Rehospitalization of children born prematurely (referred to as preterm children) caused by severe respiratory infections is common. Most studies have focused on respiratory syncytial virus infection. We designed a study to determine the virological and clinical characteristics of severe respiratory infections of children born early (<32 weeks) and moderate preterm (32 to 36 weeks), and compared them with full term (FT; ≥37 weeks) children who were subsequently admitted with respiratory illness...
July 2015: Pediatric Infectious Disease Journal
Giulia Cangiano, Elena Proietti, Marie Noelle Kronig, Elisabeth Kieninger, Christine D Sadeghi, Meri Gorgievski, Maria Teresa Barbani, Fabio Midulla, Caroline Tapparel, Laurent Kaiser, Marco P Alves, Nicolas Regamey
The clinical course of rhinovirus (RV)-associated wheezing illnesses is difficult to predict. We measured lactate dehydrogenase concentrations, RV load, antiviral and proinflammatory cytokines in nasal washes obtained from 126 preschool children with RV wheezy bronchitis. lactate dehydrogenase values were inversely associated with subsequent need for oxygen therapy. lactate dehydrogenase may be a useful biomarker predicting disease severity in RV wheezy bronchitis.
December 2014: Pediatric Infectious Disease Journal
Metin Uysalol, Ezgi Pasli Uysalol, Yasin Yilmaz, Gunes Parlakgul, Tulin Ayse Ozden, Hayriye Vehid Ertem, Beyhan Omer, Nedret Uzel
BACKGROUND: We aimed to show the relationship between recurrence of wheezing and serum levels of vitamin D, zinc, and copper in wheezy children compared with a healthy group. METHODS: In this cross sectional study, seventy-three children with wheezing and seventy-five controls were included without a follow-up period. The clinical characteristics of the children were assessed, the asthma predictive index and temporal pattern of wheeze were determined. The serum levels of vitamin D, zinc, and copper were measured...
2014: BMC Pediatrics
Michael L Walker, Kathryn E Holt, Gary P Anderson, Shu Mei Teo, Peter D Sly, Patrick G Holt, Michael Inouye
Asthma is a genetically complex, chronic lung disease defined clinically as episodic airflow limitation and breathlessness that is at least partially reversible, either spontaneously or in response to therapy. Whereas asthma was rare in the late 1800s and early 1900s, the marked increase in its incidence and prevalence since the 1960s points to substantial gene × environment interactions occurring over a period of years, but these interactions are very poorly understood (1-6). It is widely believed that the majority of asthma begins during childhood and manifests first as intermittent wheeze...
2014: Frontiers in Immunology
Daniel Chang, Weiguo Yao, Christina J Tiller, Jeffrey Kisling, James E Slaven, Zhangsheng Yu, Mark H Kaplan, Robert S Tepper
Childhood asthma is often characterised by elevated exhaled nitric oxide (eNO), decreased lung function, increased airway reactivity and atopy; however, our understanding of when these phenotypic airway characteristics develop remains unclear. This study evaluated whether eNO, lung function, airway reactivity and immune characteristics during infancy are risk factors of asthma at age 5 years. Infants with eczema, enrolled prior to wheezy illness (n=116), had eNO, spirometry, airway reactivity and allergen sensitisation assessed at entry to the study and repeated at age 5 years (n=90)...
January 2015: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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