Pediatric Pulmonology最新文献

{"title":"Pulmonary Arterial Hypertension Requiring Medication Is Associated With Higher Prevalence of Thrombocytopenia in Pediatric Patients.","authors":"Tanya Reyna, Catherine Agarwal, Abrar Mamun, Jessica Dae, Yusuf Ozcan, Michael J Angtuaco, Taha Bat, Erhan Ararat","doi":"10.1002/ppul.71252","DOIUrl":"10.1002/ppul.71252","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71252"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874517","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":"Knowledge, Attitudes, and Behaviors of Cystic Fibrosis Patients on Reproductive Health in Turkiye.","authors":"Hande Yuce Ozdemir, Sezcan Mumusoglu, Ali Fuat Kalyoncu, Ebru Damadoglu","doi":"10.1002/ppul.71247","DOIUrl":"10.1002/ppul.71247","url":null,"abstract":"<p><strong>Introduction: </strong>Reproductive health (RH) has become increasingly significant with the growing population of adults with cystic fibrosis (CF). We aimed to investigate the knowledge, attitudes, and behaviors of adult CF patients regarding RH.</p><p><strong>Methods: </strong>In this prospective observational study, participants aged ≥ 18 attending an outpatient clinic completed a RH questionnaire face-to-face with the same respiratory physician.</p><p><strong>Results: </strong>A total of 100 patients were included in the study (men/women: 54/46), with a median age of 22 years (IQR = 19-27). Among the patients 15 (15%) had a partner, 84 (84%) were single, and 1 (1%) was divorced. Six (6%) had children. Of the 40 patients who planned to have a child, 34 (85%) intended to receive genetic counseling. All patients were sexually active; however, 90 (90%) did not use any contraception method. Anti-Müllerian hormone (AMH) levels were obtained from 38 (82.6%) females, while only 7 (13%) males agreed to perform a spermiogram, 17 (31.5%) males had a scrotal ultrasound. Approximately 68.5% of the male participants were unaware of or misunderstood their infertility risk. The source of information about RH in CF did not affect the level of concern about infertility (p = 0.002). However, believing that their knowledge about the relationship between the disease and infertility was sufficient did affect their level of concern (p = 0.007).</p><p><strong>Conclusions: </strong>The findings highlight that accurate knowledge about RH is insufficient among CF patients. More than half of the male patients who underwent sperm analysis did not want to share their results with healthcare providers. This finding is striking because more than 95% of male CF patients are known to be infertile due to vas deferens abnormalities. Our findings suggest that the follow-up of adult CF patients primarily focuses on the respiratory system and other severely affected organs, while RH remains somewhat overlooked. This is significant as it highlights the patients' insufficient knowledge on the topic.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71247"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848255","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":"Effects of Rapid Maxillary Expansion on Urinary Leukotriene E4 and Serum C-Reactive Protein Levels in Children With Obstructive Sleep Apnea and Maxillary Restriction: A Prospective Longitudinal Study.","authors":"Sahal Alforaidi, Maen Zreaqat, Rozita Hassan","doi":"10.1002/ppul.71235","DOIUrl":"10.1002/ppul.71235","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid maxillary expansion (RME) has been advocated as a viable treatment option in pediatric obstructive sleep apnea (OSA) due to its favorable effect in enhancing upper airway and respiratory parameters. This study aimed to evaluate the effect of RME on urine leukotriene E4 (uLTE4) and serum C-reactive protein (CRP) levels in OSA children with maxillary constriction and determine the association between alterations in uLTE4 and serum CRP levels and changes in dentoalveolar and respiratory parameters.</p><p><strong>Methods: </strong>This prospective longitudinal study comprised 47 children, aged 8-12 years, with polysomnography-proven OSA and maxillary constriction, who were treated with the RME appliance and matched with corresponding controls. uLTE4 and serum CRP levels were measured before and after treatment. A second standard overnight polysomnography (PSG) was conducted to assess changes in respiratory parameters.</p><p><strong>Results: </strong>Inter-molar width increased by 5.1 mm (p < 0.001). The RME resulted in a significant increase in the facial height and inferior dislocation of the maxilla (p < 0.05). Respiratory parameters changed significantly in the study group; sleep efficiency increased by 3.41% (p = 0.036), minimum oxygen saturation increased by 5.32% (p < 0.001), arousal index decreased by 7.46 events/h (p < 0.001), and apnea-hypopnea index (AHI) decreased by 3.53 events/h (p < 0.001). There was no significant difference in uLTE4 and serum CRP levels in the study or control group (p > 0.05). There was no association between the AHI and changes in uLTE4 and serum CRP levels after treatment (p > 0.05); however, a positive association was found with the intermolar width (p = 0.019).</p><p><strong>Conclusion: </strong>The treatment of pediatric OSA with the RME appliance did not affect uLTE4 or serum CRP levels, despite significant improvements in dentoalveolar features and respiratory sleep parameters.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71235"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855994","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":"Perceptions of Telehealth in Pediatric Pulmonary Clinic Post-Pandemic.","authors":"Jaclyn Davis, Sidney L Gibson, Ryan C Perkins, Jonathan Greenberg, Tregony Simoneau, Gregory S Sawicki","doi":"10.1002/ppul.71237","DOIUrl":"10.1002/ppul.71237","url":null,"abstract":"<p><strong>Introduction: </strong>Providing medical care by telehealth is increasingly common since its widespread adoption during the COVID-19 pandemic. The optimal way to incorporate telehealth into existing care models is unknown. The goal of this study was to understand patient and caregiver experience with telehealth in a large pediatric pulmonary clinic following the COVID-19 pandemic. We hypothesized there would be continued favorable perceptions given its convenience, though concerns around limited in-person assessments may persist.</p><p><strong>Methods: </strong>This was a cross-sectional survey study of patients and caregivers who attended a telehealth visit in our pediatric pulmonary clinic in 2023.</p><p><strong>Results: </strong>Of 992 eligible participants, 185 completed the survey (19% response rate). Seventy-one percent reported their telehealth visit was more convenient than in-person care and 95% felt telehealth was an acceptable alternative. Considering lack of in-person assessments, including physical exam, vital signs, lung function testing, lab studies and imaging, 75% were not concerned, 21% felt somewhat concerned, and 4% felt very concerned. There was no difference in rates of concern by patient's age, visit diagnosis or reason for visit. Considering future use, 94% of respondents reported they would use telehealth again in the future.</p><p><strong>Conclusions: </strong>Attendees of a telehealth visit at a single center pediatric pulmonary clinic report favorable experiences citing convenience, similar acceptability relative to in-person care and a desire for continued access in the future. Concerns remain around limited in-person assessments and further work is needed to understand for whom and in what capacity telehealth leads to optimal outcomes.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71237"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874516","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 Impact of Attention Deficit Hyperactivity Disorder on Home Spirometry and Other Parameters in People With Cystic Fibrosis.","authors":"Aqeem Azam, Peter James Barry, Rowland J Bright-Thomas, Alex Horsley, Andrew M Jones","doi":"10.1002/ppul.71266","DOIUrl":"https://doi.org/10.1002/ppul.71266","url":null,"abstract":"<p><strong>Background: </strong>Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder leading to challenges in treatment adherence. Despite emerging evidence on the prevalence of ADHD in pwCF and its potential impact on treatment adherence, there remains a gap in knowledge regarding the impact of ADHD on disease monitoring behaviours in the telehealth era, particularly through the use of portable home spirometry.</p><p><strong>Methods: </strong>This retrospective study analysed home spirometry data in a large adult CF centre from 2020 to 2024. The study included 17 pwCF with a confirmed ADHD diagnosis and 34 age- and sex-matched controls without ADHD. Home spirometry was conducted using the AirNext device (NuvoAir, Stockholm, Sweden).</p><p><strong>Results: </strong>The prevalence of confirmed ADHD among 463 adult pwCF was 3.67%. PwCF with ADHD demonstrated a higher median number of spirometry sessions than the control group (28 [IQR: 20-55] vs. 22 [IQR: 14-41]; p = 0.31). Longitudinally, the frequency of spirometry performed appears similar in both ADHD and control group, with no observed difference in spirometry quality. Proportions of patients engaging with spirometry were consistently higher in the ADHD group across the study period (p = 0.01). PwCF with ADHD were more likely to perform spirometry outside of standard clinic hours (32.6% vs. 25.5%; p < 0.01) and during weekends (12.3% vs. 9.8%; p < 0.01). Initiation of stimulant ADHD medications was associated with a reduction in spirometry frequency, aligning with non-ADHD controls (p = 0.04).</p><p><strong>Conclusion: </strong>PwCF with ADHD performed spirometry at a similar level to those without ADHD, supporting the feasibility of home spirometry in this subgroup.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71266"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964752","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":"Cystic Fibrosis Year in Review 2024.","authors":"Adrienne P Savant","doi":"10.1002/ppul.71222","DOIUrl":"10.1002/ppul.71222","url":null,"abstract":"<p><p>In 2024, important advances for people with cystic fibrosis (CF) were published. Important guidelines for newborn screening and care of infants diagnosed with CF transmembrane conductance regulator (CFTR)-Related Metabolic Syndrome/Cystic Fibrosis Screen Positive Inconclusive Diagnosis (CRMS/CFSPID) were published alongside related key lessons from individual programs. Work continues to improve growth and nutrition and treat pulmonary exacerbations. New position papers on care delivery and the care team in the post-CFTR modulator era were developed next to continued information related to CFTR modulator use on treatment burden simplification and side effects, such as mental health and use during pregnancy. The aim of this review is to provide high-level information that may lead to changes in clinical care.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71222"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799820","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":"Impact of Number of Pharmacies on Dornase Alfa Medication Possession Ratio in Children With Cystic Fibrosis.","authors":"Rebecca S Pettit, Katie Howell, Julie Langhorst, Chelsea C Flora, Hilary Vogt","doi":"10.1002/ppul.71231","DOIUrl":"https://doi.org/10.1002/ppul.71231","url":null,"abstract":"<p><strong>Introduction: </strong>Medication adherence in cystic fibrosis (CF) has been shown to slow disease progression. Integrated pharmacy services can help increase medication access. The objective of this study was to compare the medication possession ratio (MPR) of dornase alfa between people with cystic fibrosis (PwCF) filling maintenance CF medications at one integrated health system specialty pharmacy (IHSSP) to those filling at multiple pharmacies.</p><p><strong>Methods: </strong>This retrospective study included PwCF < 18 years of age who were prescribed dornase alfa from January 1 to December 31, 2019. The primary endpoint was the MPR for dornase alfa. Subgroup analyses were performed for those with Medicaid and those with private insurance.</p><p><strong>Results: </strong>A total of 85 patients were included, with 29 (34.1%) filling all medications at IHSSP and 56 (65.9%) filling at multiple pharmacies. The median MPR of dornase alfa was 0.98 (IQR: 0.76-1) and 0.64 (IQR: 0.34-0.85), (p < 0.001), and ppFEV1 changed by -1% (IQR: -7% to 5%) compared to -5% (IQR: -10% to -1%), (p = 0.03) for the IHSSP group and multiple pharmacies groups, respectively. There was no difference in the number of hospitalizations or length of stay. Improved MPR for PwCF in the IHSSP group was sustained in the Medicaid and private insurance subgroups.</p><p><strong>Conclusions: </strong>The MPR of dornase alfa was higher, and pulmonary function was maintained in PwCF who were able to use the IHSSP for CF medications. Some insurance policies require specific pharmacies for specialty medications, requiring PwCF to fill prescriptions at multiple pharmacies and potentially worsening adherence and clinical outcomes.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71231"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799821","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":"Correlation of High Resolution CT Findings With Lung Function in Adolescents With Perinatally Acquired HIV on Anti-Retroviral Therapy.","authors":"Du Plessis Anne-Marie, Githinji Leah, N M Nyathi, Griffith Richards Stephanie, M Gray Diane, S Andronikou, J Zar Heather","doi":"10.1002/ppul.71234","DOIUrl":"10.1002/ppul.71234","url":null,"abstract":"<p><strong>Rationale: </strong>Chronic lung disease is common in adolescents with perinatally acquired HIV (PHIV). HRCT provides delineation of chronic changes. Our aim was to investigate the association of HRCT findings with lung function in PHIV.</p><p><strong>Methods: </strong>Prospective evaluation of participants in the Cape Town Adolescent Antiretroviral Cohort (CTAAC); perinatally infected YLHIV established on cART. HRCT was performed in participants with abnormal lung function (forced expiratory volume in 1 s [FEV1] of < 80% predicted and/or lung diffusion capacity [DLCO] < 80% predicted) or for clinical symptoms. Spirometry (pre and post bronchodilator) and DLCO (diffusion capacity) was correlated with HRCT findings.</p><p><strong>Results: </strong>There were 100 participants, (median [IQR] age 13.8 (IQR = 12.8, 15.1) years) 46% males. Median age at HIV diagnosis of 3.7 years (IQR = 1.6, 6.9). Median cART duration was 9.9 years (IQR = 7.1;11.5). CD4 count was > 500 cells/mm³ in 83%. HIV-viral load was < 50 copies/mL in 72%. All participants had abnormal HRCT findings; mosaic attenuation (73/100) was most prevalent. Bronchiectasis occurred in 39/100. Correlation was found between the extent of mosaic attenuation and reduced FEV₁ (r_s = -0.5; p < 0.001), consistent with airflow obstruction. Extent of bronchiectasis and reduced FEV₁ (r_s = -0.5; p < 0.001) were strongly correlated. No correlation found between extent of mosaic attenuation or bronchiectasis and DLCO. Most (90%) patients with mosaic attenuation or bronchiectasis were not bronchodilator responsive.</p><p><strong>Conclusion: </strong>Mosaic attenuation and bronchiectasis were the most common abnormality on HRCT. The extent of these changes strongly correlated with reduced FEV₁. The extent of disease on HRCT is useful for inferring functional airway obstruction.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71234"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822212","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":"Risk Factors for Severe Respiratory Morbidity at 2 Years of Life in Children Born Extremely Preterm With Bronchopulmonary Dysplasia.","authors":"Sophie Holcik, Lamia Hawayi, Naomi Dussah, Nick Barrowman, Nadya Ben Fadel, Bernard Thébaud, Sherri Lynne Katz","doi":"10.1002/ppul.71258","DOIUrl":"https://doi.org/10.1002/ppul.71258","url":null,"abstract":"<p><strong>Background: </strong>Bronchopulmonary dysplasia (BPD), defined as need for oxygen/respiratory support at 36 weeks gestational age (GA) is associated with increased risk of post-prematurity respiratory disease (PRD). We hypothesize that BPD, higher pCO2, and pulmonary hypertension (PH) before NICU discharge will predict PRD.</p><p><strong>Objectives: </strong>(1) Identify clinical factors before NICU discharge associated with PRD by 2 years of age; (2) Identify clinical factors associated with emergency room (ER) visits by 2 years of age; (3) Compare predictive performance for PRD of individual and multivariable clinical factors.</p><p><strong>Methodology: </strong>Children born < 29 weeks GA with ≥ 1 echocardiogram before NICU discharge at two tertiary centers were included. Retrospective chart review included clinical factors at NICU discharge, ER visits, and respiratory-related hospitalizations by 2 years. Analysis of predictors included logistic regression and ROC.</p><p><strong>Results: </strong>We included 125 premature infants, of whom 53 (42%) had BPD, and 24 (19%) experienced PRD. All who experienced PRD had BPD. More severe BPD (OR: 96.1, CI: 12.4, 12, 383), but not hypercapnia or PH, were associated with PRD. On ROC analysis, combination of BPD severity, pCO2 and PH demonstrated 70% chance of PRD (AUC: 0.68 (95% CI: 0.55, 0.81). Presence of ≥ 2 factors had sensitivity of 50% and specificity of 97% for prediction of PRD. Children with BPD had 2.6 times as many ER visits as those without.</p><p><strong>Conclusion: </strong>Combination of BPD severity, pCO2, and PH best predicted PRD. Identifying extremely preterm infants at high risk of developing PRD can guide counseling of families and early intervention.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71258"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964782","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":"Qualitative Experiences and Depression/Anxiety Scores in Parents of Children With Cystic Fibrosis Transmembrane Conductance Regulator Related Metabolic Syndrome.","authors":"Lynne Carty, Rebecca Dobra, Jackie Francis, Michele Puckey, Andy Bush, Jane C Davies","doi":"10.1002/ppul.71224","DOIUrl":"https://doi.org/10.1002/ppul.71224","url":null,"abstract":"<p><strong>Background: </strong>Cystic Fibrosis Transmembrane Conductance Regulator Related Metabolic Syndrome/Cystic Fibrosis Screen Positive, Inconclusive Diagnosis (CRMS/CFSPID) describes children with a positive newborn screen for whom follow-up tests neither confirm, nor definitively rule-out, a CF diagnosis. Many are healthy carriers, but some will reclassify to a CF diagnosis; the natural history is not yet well understood. In children with chronic illnesses, unpredictable disease process and limited knowledge of long-term consequences present significant challenges to parental mental health. We wanted to understand the emotional wellbeing of parents with children with CRMS/CFSPID to guide the mental health support offered within the service.</p><p><strong>Methods: </strong>Parents were invited to complete validated depression and anxiety screening questionnaires and answer an open-ended question in writing or during a short interview. Qualitative responses were transcribed and analysed using thematic analysis.</p><p><strong>Results: </strong>Thirteen parents from nine families completed questionnaires and/or the interview. Two of the mothers had mildly raised scores on the questionnaires. Our interviews revealed five themes: difficulty adjusting to the label; concern about the future and its uncertainty; fluctuating states of anxiety; difficulty explaining the label; and satisfaction with the CRMS/CFSPID service.</p><p><strong>Conclusion: </strong>Our data reveal benign scores using objective screening tools, but the qualitative data paints a picture of potentially more significant impact on emotional wellbeing. We recommend screening parents from the time their child receives the label, and later the children themselves, for depression and anxiety and signposting to existing resources. Ultimately, a better understanding of the CRMS/CFSPID trajectory may enable us to better support families.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71224"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964811","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}