Paediatric Respiratory Reviews最新文献

{"title":"A Review Of Host-Specific Diagnostic And Surrogate Biomarkers In Children With Pulmonary Tuberculosis","authors":"Junaid Shaik ,&nbsp;Manormoney Pillay ,&nbsp;Prakash Jeena","doi":"10.1016/j.prrv.2024.01.005","DOIUrl":"10.1016/j.prrv.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) is one of the most common causes of mortality globally with a steady rise in paediatric cases in the past decade. Laboratory methods of diagnosing TB and monitoring response to treatment have limitations. Current research focuses on interrogating host- and/or pathogen-specific biomarkers to address this problem.</div></div><div><h3>Methods</h3><div>We reviewed the literature on host-specific biomarkers in TB to determine their value in diagnosis and treatment response in TB infected and HIV/TB co-infected children on anti-tuberculosis treatment.</div></div><div><h3>Results and Conclusion</h3><div>While no single host-specific biomarker has been identified for diagnosis or treatment responses in children, several studies suggest predictive biosignatures for disease activity. Alarmingly, current data on host-specific biomarkers for diagnosing and assessing anti-tuberculosis treatment in TB/HIV co-infected children is inadequate. Various factors affecting host-specific biomarker responses should be considered in interpreting findings and designing future studies within specific clinical settings.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 44-50"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post viral bronchiolitis obliterans in children: A rare and potentially devastating disease","authors":"Julie Mazenq ,&nbsp;Jean-Christophe Dubus ,&nbsp;Pascal Chanez ,&nbsp;Delphine Gras","doi":"10.1016/j.prrv.2024.04.003","DOIUrl":"10.1016/j.prrv.2024.04.003","url":null,"abstract":"<div><div>Post infectious bronchiolitis obliterans (PIBO) is a rare but severe disease in children. Several respiratory pathogens are incriminated but <em>adenovirus</em> is still the most represented. Risk factors are well described: the male gender, hypoxemia at diagnosis and required mechanical ventilation. No risk factor is linked to the newborn period. The clinical spectrum of PIBO is broad, ranging from asymptomatic patients with fixed airflow obstruction to severe respiratory insufficiency requiring continuous oxygen supplementation. Diagnosis includes a combination of a clinical history, absence of reversible airflow obstructions and ground glass and gas trapping on high resolution computed tomography. PIBO is primarily a neutrophilic pathology of small bronchioles characterized by high levels of pro-inflammatory cytokines leading to tissue remodeling and fibrosis of the small airways. The difficulty is to discriminate between the host’s normal response, an exaggerated inflammatory response and the potential iatrogenic consequences of the initial infection treatment, particularly prolonged mechanical ventilation. Damage to the respiratory epithelium with a possible link to viral infections are considered as potential mechanisms of PIBO. No specific management exists. Much remains to be done in this field to clarify the underlying mechanisms, identify biomarkers, and develop clear monitoring pathways and treatment protocols.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 58-65"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141034922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Go slow with high flow initiation in bronchiolitis","authors":"Dominic A. Fitzgerald","doi":"10.1016/j.prrv.2024.05.005","DOIUrl":"10.1016/j.prrv.2024.05.005","url":null,"abstract":"","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 1-2"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141278422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous magnesium sulfate for asthma exacerbations in children: Systematic review with meta-analysis","authors":"Dominika Ambrożej ,&nbsp;Aleksander Adamiec ,&nbsp;Erick Forno ,&nbsp;Izabela Orzołek ,&nbsp;Wojciech Feleszko ,&nbsp;Jose A. Castro-Rodriguez","doi":"10.1016/j.prrv.2024.01.003","DOIUrl":"10.1016/j.prrv.2024.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Asthma is the most prevalent chronic disease<span> in children and constitutes a significant healthcare burden. First-line therapy for acute asthma exacerbations is well established. However, secondary treatments, including intravenous magnesium sulfate (IV-MgSO4), remain variable due to scarcity of data on its efficacy and safety.</span></div></div><div><h3>Objective</h3><div>To assess the effectiveness and safety of IV-MgSO4 as a second line of treatment in managing children with asthma exacerbations.</div></div><div><h3>Methods</h3><div><span>We searched five databases from inception until April 2023 on randomized clinical trials of IV-MgSO4 in children with acute asthma exacerbations. The primary outcomes were hospitalization rate and length, and change in the severity score. Secondary outcomes included percentage increase in </span>peak expiratory flow rate<span><span> (PEFR), hospital re-admission rate, need and length for pediatric intensive care unit (PICU) treatment, and </span>adverse effects. Meta-analysis was performed for three outcomes with estimated odds ratios (ORs) or mean differences (MDs) and 95% confidence intervals (CIs).</span></div></div><div><h3>Results</h3><div>Eleven studies met the final criteria. In comparison to control, administration of IV-MgSO4 was associated with a reduced hospitalization risk (OR 0.15; 95%CI: 0.03, 0.73) in four studies, and improvement of lung function (MD 26.77% PEFR; 95%CI: 18.41, 54.79) in two studies. There were no significant differences in the length of stay between groups. Due to heterogeneity, a narrative synthesis of other outcomes was performed.</div></div><div><h3>Conclusion</h3><div>The use of IV-MgSO4 demonstrated a reduction in the hospitalization rate and PEFR improvement in children with asthma exacerbations. Adverse effects were rare. Further well-designed studies are needed to better determine the efficacy and safety profile of IV-MgSO4.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 23-30"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139875941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing high flow overuse in bronchiolitis − Successes and future directions","authors":"Taylor Ford ,&nbsp;Jennifer Lane ,&nbsp;Michelle Noelck ,&nbsp;Courtney Byrd","doi":"10.1016/j.prrv.2024.06.002","DOIUrl":"10.1016/j.prrv.2024.06.002","url":null,"abstract":"<div><div><span><span>The use of high flow nasal cannula (HFNC) in the treatment of </span>bronchiolitis has markedly increased in the last decade, yet </span>randomized controlled trials have reported little clinical benefit with early, routine use. This article provides a concise overview of the current status of HFNC therapy, discusses successful de-implementation strategies to curtail HFNC overuse, and explores future bronchiolitis and HFNC quality improvement and research considerations.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 14-17"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141395405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High flow, low results: The limits of high flow nasal cannula in the treatment of bronchiolitis","authors":"Jennifer E. Lane ,&nbsp;Taylor Ford ,&nbsp;Michelle Noelck ,&nbsp;Courtney Byrd","doi":"10.1016/j.prrv.2024.06.003","DOIUrl":"10.1016/j.prrv.2024.06.003","url":null,"abstract":"<div><div><span>Bronchiolitis continues to be the most common cause of hospitalization in the first year of life. We continue to search for the remedy that will improve symptoms, shorten hospitalization and prevent worsening of disease. Although initially thought to be a promising therapy, large </span>randomized controlled trials<span> show us that high flow nasal cannula<span><span> (HFNC) use is not that remedy. These trials show no major differences in duration of hospital stay, intensive care unit (ICU) admission rates, duration of stay in the ICU, duration of oxygen therapy, </span>intubation rates, heart rate, respiratory rate or comfort scores. Additionally, practices regarding initiation, flow rates and weaning continue to vary from institution to institution and there are currently no agreed upon indications for its use. This reveals the need for evidence based guidelines on HFNC use in bronchiolitis.</span></span></div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 9-13"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141392324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrotizing Pneumonia In Children: A Review","authors":"Helena Teresinha Mocelin ,&nbsp;Gilberto Bueno Fischer ,&nbsp;Júlia Danezi Piccini ,&nbsp;Júlio de Oliveira Espinel ,&nbsp;Cristiano Feijó Andrade ,&nbsp;Andrew Bush","doi":"10.1016/j.prrv.2024.02.003","DOIUrl":"10.1016/j.prrv.2024.02.003","url":null,"abstract":"<div><div>The objective of the review was to determine the long-term outcomes of necrotising pneumonia (NP). Studies published since 1990 in English, Portuguese, or Spanish, published on PubMed and Scielo were evaluated. Our findings showed ultrasound scanning is the diagnostic modality of choice. Despite prolonged hospitalisation (median 13–27 days) and fever (median 9–16 days), most patients recover completely. Empyema and bronchopleural fistulae are frequent in bacterial NP. <em>Streptococcus pneumoniae</em> is the most prevalent cause. Seventeen studies with 497 patients followed for 30 days to 8.75 years showed that most patients were clinically asymptomatic and had normal lung function. X-ray or CT chest imaging demonstrated that almost all lung lesions recovered within 4–6 months. We suggest that it is not necessary to request frequent chest X-rays during the treatment and recovery process. Chest CT scans should be reserved for specific cases not following the expected clinical course.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"52 ","pages":"Pages 51-57"},"PeriodicalIF":4.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139927153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New paradigms in acute viral bronchiolitis: Is it time to change our approach?","authors":"Jose A Castro-Rodriguez, Patricio Astudillo, Sandeep Puranik, Mark A Brown, Adnan Custovic, Erick Forno","doi":"10.1016/j.prrv.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.prrv.2024.10.004","url":null,"abstract":"<p><p>Viral bronchiolitis is the most common pediatric acute respiratory infection leading to hospitalization, and it causes a significant healthcare burden worldwide. Current guidelines recommend supportive management after many clinical trials on specific therapies failed to demonstrate benefits. However, several studies in the past decade have revealed that bronchiolitis may not be a homogeneous disease, but instead may constitute an umbrella comprised of different \"endotypes\" and \"phenotypes\" based on patient characteristics, etiology, pathophysiological mechanisms, and clinical presentation. In this extensive review, we summarize the current evidence that several different types of bronchiolitis (\"bronchiolitides\") coexist, with different short- and long-term consequences on respiratory health and the risk of asthma development. Disease pathobiology, immune response, and clinical characteristics may differ between the two most prevalent viral agents, respiratory syncytial virus and rhinovirus. Recent randomized trials have shown that some subgroups of children may benefit from the use of systemic corticosteroids and/or bronchodilators. These findings also suggest that some children may benefit from individualized therapeutical approaches for viral bronchiolitis rather than following broad recommendations for treating all patients uniformly using only supportive management.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142730969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addition of long-acting beta-agonists to inhaled corticosteroids for asthma in preschool children: A systematic review.","authors":"Dominika Ambrożej, Maja Cieślik, Wojciech Feleszko, Carlos E Rodriguez-Martinez, Jose A Castro-Rodriguez","doi":"10.1016/j.prrv.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.prrv.2024.09.002","url":null,"abstract":"<p><p>Inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) are essential in asthma management, but the guidelines for treatment in preschool children remain heterogeneous worldwide. This systematic review evaluates the efficacy and safety of LABA + ICS therapy in asthmatic children under six years. We searched four databases, identifying six eligible studies (n = 1415 preschoolers), and in all the LABA used was salmeterol. Due to high heterogeneity, quantitative analysis was not feasible. Three before-and-after studies demonstrated significant reductions in unscheduled visits and hospitalizations due to asthma exacerbations with LABA + ICS. One RCT showed fewer exacerbations in the LABA + ICS group compared to ICS alone. Night-time awakenings decreased significantly in two studies but not in one RCT. Improvements in lung function using impulse oscillometry and FeNO levels were noted with LABA+ICS in one RCT. No significant adverse effects were reported. Despite positive findings, high-quality trials are needed to confirm these results, particularly using formoterol as LABA, aligning with the recommendations. Further research is imperative to optimize asthma management in preschool children.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential effects of climate change on non-cystic fibrosis bronchiectasis in children.","authors":"Grigorios Chatziparasidis, Ahmad Kantar, Maria Rafailia Chatziparasidi, Sotirios Fouzas, Andrew Bush, Anne Chang","doi":"10.1016/j.prrv.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.prrv.2024.10.002","url":null,"abstract":"<p><p>Climate change may have devastating effects on the pathogenesis of non-cystic fibrosis bronchiectasis in children since it affects the biological cycle of the respiratory pathogens and alters the human respiratory defense mechanisms. Bronchiectasis in children has been identified as an emerging global epidemic that has attracted the attention of the medical community over recent years. Pediatric pulmonologists should be aware of the consequences of climate change on children with bronchiectasis and plan strategies to ameliorate these effects.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142730974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}