Paediatric Respiratory Reviews最新文献

{"title":"Measles is misery: A brief update for paediatricians","authors":"Nichkamol Lertamornkitti ,&nbsp;Philip N. Britton","doi":"10.1016/j.prrv.2025.10.003","DOIUrl":"10.1016/j.prrv.2025.10.003","url":null,"abstract":"<div><div>Measles is an important vaccine-preventable disease that has re-emerged in recent years. Since the COVID-19 pandemic, interruptions to routine immunisation programs and declining vaccine coverage have altered the incidence and patterns of respiratory virus infections. Global outbreaks have intensified, and vaccine hesitancy is recognised as major health threat. Revisiting the clinical presentation of measles is crucial for early diagnosis and to reduce transmission of this highly contagious infection. As serious respiratory and neurological complications can follow natural infection and no specific antiviral therapy is available, vaccination remains the most effective strategy for prevention and control.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 24-28"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513396","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":"Efficacy of intratracheal budesonide plus surfactant vs. Surfactant alone on bronchopulmonary dysplasia in preterm Infants: A meta-analysis of randomized controlled trials","authors":"Aluisio D’lucas Alves Gomes ,&nbsp;Elísio Bulhões ,&nbsp;Danielle Costa do Amaral ,&nbsp;Luis Felipe Matos de Sousa ,&nbsp;Ely Cavalcante Lima Júnior ,&nbsp;José Airton Alves Ferreira ,&nbsp;Hilderlania Alves de Oliveira ,&nbsp;Maria LR Defante ,&nbsp;Jafar Aljazeeri","doi":"10.1016/j.prrv.2025.02.003","DOIUrl":"10.1016/j.prrv.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Bronchopulmonary dysplasia (BPD) is a </span>chronic pulmonary disease commonly affecting preterm infants. The potential benefits of combining </span>budesonide with surfactant for preterms with early BPD remain uncertain and warrant further exploration.</div></div><div><h3>Objective</h3><div><span>We conducted a systematic review and </span><em>meta</em><span>-analysis of randomized controlled trials<span> (RCTs) to evaluate the efficacy of intratracheal budesonide plus surfactant compared with surfactant alone in preterm infants.</span></span></div></div><div><h3>Methods</h3><div>We searched PubMed, Embase and Cochrane Central databases from inception to November 2024. We conducted a <em>meta</em>-analysis following the PRISMA guidelines. We calculated the risk ratios (RRs) of endpoints of interest with 95% confidence intervals using a random effects model. R software (version 4.3.2) was used for statistical analyses. Heterogeneity was assessed with I² statistics.</div></div><div><h3>Results</h3><div>Eight RCTs including 2029 preterm infants were included. Compared with surfactant alone, a combined intratracheal budesonide plus surfactant significantly reduced the risk of bronchopulmonary dysplasia (RR: 0.70; 95 % CI: 0.54–0.91; p = 0.007; I² = 71.4 %), mortality (RR: 0.81; 95 % CI: 0.66–0.98; p = 0.029; I²<span> = 14.6 %), pulmonary hemorrhage (RR: 0.58; 95 % CI: 0.37–0.90; p = 0.015; I</span>²<span> = 0 %) and patent ductus arteriosus (RR: 0.84; 95 % CI: 0.75–0.94; p = 0.004; I</span>² = 0 %).</div></div><div><h3>Conclusion</h3><div>This <em>meta</em><span>-analysis found that intratracheal budesonide plus surfactant reduces the risk of bronchopulmonary dysplasia, mortality, pulmonary hemorrhage<span> and patent ductus arteriosus compared with surfactant alone. Given its potential to reduce pulmonary complications associated with prematurity, clinicians may consider this combination therapy.</span></span></div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 68-74"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079387","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":"Glue ear: an ongoing global program – closing the audiology gap among First Nations children","authors":"Isabella Ludbrook ,&nbsp;Georgia Tongs Wiradjuri ,&nbsp;Kelvin Kong Worimi ,&nbsp;Hasantha Gunasekera","doi":"10.1016/j.prrv.2025.04.011","DOIUrl":"10.1016/j.prrv.2025.04.011","url":null,"abstract":"<div><div>Most children globally (~80%) are affected by Otitis Media with Effusion (OME; ‘serous otitis media’ or ‘glue ear’) by four years of age. Most episodes resolve in a timely manner are brief and uncomplicated. Chronic, recurrent and complicated OME has been linked to social disadvantage, with poorer educational and employment outcomes and increased criminal justice system contact. Specific populations are particularly at risk, even in High Income Countries, including children with craniofacial abnormalities, immunocompromise and First Nations children in colonised regions (e.g., Australia, New Zealand, and the Arctic Circle).</div><div>OME is a significant cause of childhood morbidity, particularly during infancy. Mortality should not occur in High-Income-Countries. However, in Low-Middle-Income Countries, lack of access to health programs can lead to devastating, preventable complications, including death from meningitis, brain abscesses, and sepsis. This emphasises the importance of equitable access to medical resources globally, a universal and ongoing problem for First Nations people.</div><div>Upper respiratory tract infections (including OME), are the most common reason for children to present to healthcare services, be prescribed antibiotics, and undergo surgery. Although OME is often managed by with antibiotics, guidelines recommend observation for uncomplicated cases, given potential harms for the child (e.g., rash and diarrhoea), and for healthcare (e.g., cost and antibiotic resistance). OME is also the most common reason for hearing impairment among children, and peaks at the time that auditory processing neural pathways, the foundations of cognitive development, are being laid down. Causative effect between OME and impaired cognitive function is hard to prove because of the challenges of designing and analysing rigorous observational studies to emulate clinical trials.</div><div>Recurrent OME cannot be left untreated due to the potential for its effect on hearing loss and both severe physical harm and significant long-term social consequences. Clinicians should be aware that children’s behavioural and developmental outcomes and balance disturbance may indicate middle ear disease or its sequelae and remain vigilant. Children’s ears should be checked and findings documented at every healthcare visit to ensure close surveillance for this insidious condition, particularly for those most at-risk.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 15-23"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187554","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 ,&nbsp;Patricio Astudillo ,&nbsp;Sandeep Puranik ,&nbsp;Mark A. Brown ,&nbsp;Adnan Custovic ,&nbsp;Erick Forno","doi":"10.1016/j.prrv.2024.10.004","DOIUrl":"10.1016/j.prrv.2024.10.004","url":null,"abstract":"<div><div><span><span><span><span>Viral bronchiolitis is the most common pediatric </span>acute respiratory infection leading to hospitalization, and it causes a significant healthcare burden worldwide. Current guidelines recommend supportive management after many </span>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 </span>patient characteristics<span>, 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 </span></span>rhinovirus<span><span>. Recent randomized trials have shown that some subgroups of children may benefit from the use of systemic corticosteroids and/or </span>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.</span></div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 29-36"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","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":"Genetics of childhood tuberculosis: A scoping review","authors":"Michely Alexandrino Pinheiro Mascarenhas ,&nbsp;Rafaela Baroni Aurilio ,&nbsp;Gustavo Guida Godinho da Fonseca ,&nbsp;Gilberto Bueno Fischer ,&nbsp;Clemax Couto Sant’Anna ,&nbsp;Paulo Camargos","doi":"10.1016/j.prrv.2025.02.002","DOIUrl":"10.1016/j.prrv.2025.02.002","url":null,"abstract":"<div><div>The social determinants of tuberculosis (TB) are well established. However, evidence indicates that genetic variants may also significantly influence an individual’s susceptibility to or resistance to TB.</div><div>The risk of TB is connected to polymorphisms in genes related to immunity and inflammation. While there is a growing body of evidence regarding the effect of candidate genes on the host immune response to Mycobacterium tuberculosis <em>(Mtb)</em> in adults, available information on children remains limited.</div><div>To investigate this topic, we searched electronic databases, including PubMed Central, the Virtual Health Library (encompassing MEDLINE, Lilacs, and WPRIM), Scopus, Scielo, EBSCOhost, and Embase. After applying the relevant inclusion and exclusion criteria, we identified 24 eligible studies.</div><div>These studies aimed to explain how specific genetic variations may affect predisposition to <em>Mtb</em> infection, their critical role in modulating the immune response, and their impact on the clinical progression of TB.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 61-67"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586631","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":"Management of acute rhinosinusitis in children","authors":"Yanisa Wannasuphoprasit ,&nbsp;Mahmood F. Bhutta","doi":"10.1016/j.prrv.2025.04.004","DOIUrl":"10.1016/j.prrv.2025.04.004","url":null,"abstract":"<div><div>Acute rhinosinusitis (ARS) is a common condition in children, usually preceded by a viral upper respiratory tract infection (URTI). Diagnosing ARS can be challenging, relying primarily on clinical history and examination. Differentiating between viral URTI, post-viral ARS and acute bacterial rhinosinusitis (ABRS) is crucial for guiding appropriate antibiotic treatment.</div><div>Antibiotics have been showed to be effective in improving symptom scores and cure rates in ABRS. Adjunct therapies, including corticosteroids, nasal saline irrigation and analgesics, may provide symptomatic relief. While viral ARS is self-limiting, bacterial ARS can lead to severe complications, including orbital and intracranial involvement, necessitating timely diagnosis and treatment.</div><div>This review highlights current evidence on the diagnosis and management of ARS in children, emphasising best practices to optimise patient outcomes and prevent complications.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 3-9"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079388","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 wicked problem of otitis media: summary of recent systematic reviews on otitis media with effusion","authors":"Hasantha Gunasekera","doi":"10.1016/j.prrv.2025.04.008","DOIUrl":"10.1016/j.prrv.2025.04.008","url":null,"abstract":"<div><div>Otitis media (OM) is a wicked problem. Millennia ago, middle ear disease was described in the ancient Egyptian Ebers Papyrus and Indian Sushruta Samhit (‘Compendium’). Centuries ago, Italian anatomists (Bartholomaeus Eustachius ∼ 1563; and Antonio Valsalva ∼ 1704) described the structures and technique for draining middle ear pus that still bear their names. Recently, immunological studies have broadened our understanding of the important inflammatory and immune responses in middle ear disease. Despite all of this knowledge, we have made no real progress eliminating this disease that nearly every child will still experience, although the severe life threatening forms are much less common.</div><div>Colonised High Income Countries have recorded evidence of middle ear disease among the indigenous populations for centuries and the massive disparities in disease burden persist. We have made little progress, indeed may have gone backwards, managing OM with priority populations, such as First Nations children. More broadly, OM is one of the commonest reasons for children to attend healthcare, be prescribed antibiotics and undergo surgery. Therefore, it has a significant impact on health-spending and antibiotic resistance as well as morbidity for children, including hearing impairment, balance disturbance, behavioural disruption, speech and language and other delays with all the consequent life-course impacts, including justice system contact. Perhaps OM is not eradicable, but we must do better to contain the recurrent, persistent and severe forms.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 10-14"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180587","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":"Diagnostic and interventional paediatric bronchoscopy in low and middle-income countries","authors":"Pierre Goussard ,&nbsp;Ernst Eber ,&nbsp;Lisa Frigati ,&nbsp;Leonore Greybe ,&nbsp;Shyam Sunder B. Venkatakrishna ,&nbsp;Jacques Janson ,&nbsp;Zane Ismail ,&nbsp;Andre Gie ,&nbsp;Delano Rhode ,&nbsp;Pawel Schubert ,&nbsp;Marc Merven ,&nbsp;Savvas Andronikou","doi":"10.1016/j.prrv.2025.01.005","DOIUrl":"10.1016/j.prrv.2025.01.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the role of both diagnostic and interventional paediatric bronchoscopy in the management of respiratory diseases in children in low- and middle-income countries (LMICs).</div></div><div><h3>Design</h3><div>A review of published English literature from January 2014 to February 2024.</div></div><div><h3>Results</h3><div>Indications for bronchoscopy in LMICs will vary depending on the burden of infectious diseases like tuberculosis (TB) and HIV, and the expertise and equipment available. TB diagnosis<span><span> in children remains challenging due to the paucibacillary nature of the disease and its overlap with other infectious diseases like actinomycosis and </span>echinococcosis<span>. Acquired conditions, such as foreign body (FB) inhalation, present late with a high complication rate, making them challenging to manage. Paediatric bronchoscopy has an important role in the diagnoses, management and follow-up of many of these conditions. Interventional procedures like endobronchial ultrasound<span> (EBUS), radial EBUS and cryotherapy enhance diagnostic and management capabilities.</span></span></span></div></div><div><h3>Conclusion</h3><div>Children in LMICs are affected by both infectious and acquired conditions. Bronchoscopy remains expensive with limited training offered in LMICs but is increasingly recognised for its important diagnostic and therapeutic role.</div></div>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":"56 ","pages":"Pages 37-54"},"PeriodicalIF":4.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414738","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":"Cardiovascular complications in children with Down syndrome and sleep disordered breathing.","authors":"Wiktoria Gocal, Katarina Zeder, Bradley A Maron, Amal Isaiah","doi":"10.1016/j.prrv.2025.11.008","DOIUrl":"10.1016/j.prrv.2025.11.008","url":null,"abstract":"<p><strong>Study objectives: </strong>Children with Down syndrome (DS) often present with craniofacial and neuromuscular features that increase the risk of sleep-disordered breathing (SDB), which may lead to cardiovascular morbidity. We conducted a scoping review to profile the current evidence base describing cardiovascular complications in children with DS and SDB. Findings from this work are expected to identify knowledge gaps that could inform future research and clinical care.</p><p><strong>Methods: </strong>We performed a systematic scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Comprehensive searches of Embase, Scopus, and MEDLINE were conducted, and eligible studies included children aged 1-18 with DS and SDB reporting cardiovascular outcomes.</p><p><strong>Results: </strong>Seven studies involving 1,437 participants were included. Across various study designs, children with DS and SDB showed blunted autonomic responses to apneic events, impaired nocturnal dipping of heart rate and blood pressure, increased hypoxic burden even with mild OSA severity, and early signs of left ventricular diastolic dysfunction and bi-ventricular remodeling.</p><p><strong>Conclusions: </strong>SDB and DS are linked to a constellation of clinical signs consistent with cardiopulmonary end-organ dysfunction and elevated clinical risk. Ongoing cardiac monitoring and use of physiologic measures beyond the apnea-hypopnea index are necessary. Addressing persistent upper airway obstruction with multimodal treatments, including surgery, positive airway pressure, and new therapies like hypoglossal nerve stimulation, may be crucial to lowering long-term cardiovascular risk in this vulnerable group.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12877430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743670","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":"Optimizing infant and toddler sleep: a review on evidence-based approaches to promote sleep consolidation.","authors":"Juliana Acosta, Katherine M Schmarder, Ignacio E Tapia","doi":"10.1016/j.prrv.2025.11.009","DOIUrl":"https://doi.org/10.1016/j.prrv.2025.11.009","url":null,"abstract":"<p><p>Consolidated nighttime sleep is a critical milestone in infant development, underpinning physical, cognitive, and socioemotional growth. Despite being a normative maturational process, fragmented sleep and difficulties initiating/maintaining sleep are common parental concerns. This review synthesizes developmental and behavioral science to elucidate mechanisms and evidence-based strategies that foster healthy sleep consolidation in infants and toddlers. First, we describe the evolution of sleep architecture and the interaction between circadian and homeostatic processes that regulate sleep-wake cycles. Then, we highlight how environmental and caregiving factors support these biological systems. Lastly, we describe behavioral strategies and the influence of environmental elements on circadian entrainment and independent sleep initiation. Across approaches, we emphasize the importance of family-centered implementation, where caregivers can both promote and benefit from optimal infant sleep. This review provides clinicians, researchers, and caregivers with a comprehensive framework to promote sleep consolidation and well-being during early childhood.</p>","PeriodicalId":19658,"journal":{"name":"Paediatric Respiratory Reviews","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669372","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}