Pediatric Pulmonology最新文献

{"title":"Eminence-Based Versus Evidence-Based Imaging of Lung Infection (Pneumonia) in Children - Diagnostic Accuracy of Lung Ultrasound.","authors":"Shyam Sunder B Venkatakrishna, Laith R Sultan, Kristina McShea, Jennifer Lege-Matsuura, Antrea Zouvani, Karen I Ramirez Suarez, Levy C Onyango, Pierre Goussard, Hansel J Otero, Savvas Andronikou","doi":"10.1002/ppul.27372","DOIUrl":"10.1002/ppul.27372","url":null,"abstract":"<p><strong>Purpose: </strong>Lung ultrasound (LUS) has been widely used for detecting pneumonia in children. Although LUS offers multiple advantages, its diagnostic accuracy compared to an imaging gold standard, e.g., computed tomography (CT) is in question. We evaluated the existing literature comparing the use of LUS for diagnosing pneumonia in children to CT.</p><p><strong>Methods: </strong>PubMed, EMBASE and Scopus databases were searched for relevant studies published from inception to June 13, 2024, using controlled vocabulary (MESH, EMTREE) with keywords.</p><p><strong>Results: </strong>The initial search identified 1065 articles. After the removal of duplicates (n = 350), the abstracts and titles of 715 studies were screened. 34 relevant studies were reviewed in detail for eligibility and shortlisted to 19 studies. Only 5 usable studies were identified. Of the five studies, three were published in journals that are not indexed in MEDLINE. The study with largest sample size (949 children) reported a sensitivity of LUS of 0.906 with 0.661 accuracy in comparison to chest CT.</p><p><strong>Conclusion: </strong>There was very limited and relatively low-quality current evidence regarding the accuracy of LUS in comparison to CT for diagnosing pneumonia in children.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S94-S98"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731613","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":"Effects of Therapeutic Antibiotic Exposure on the Oropharyngeal and Fecal Microbiota in Infants With Cystic Fibrosis.","authors":"Hillary S Hayden, Maria T Nelson, Sydney E Ross, Adrian J Verster, Drake C Bouzek, Alex Eng, Adam Waalkes, Kelsi Penewit, Benjamin T Kopp, Christopher Siracusa, Michael J Rock, Stephen J Salipante, Lucas R Hoffman, Don B Sanders","doi":"10.1002/ppul.71024","DOIUrl":"10.1002/ppul.71024","url":null,"abstract":"<p><strong>Background: </strong>Systemic antibiotics can impact all microbes inhabiting patients, regardless of the intended target organism(s). We studied the simultaneous effects on respiratory and fecal microbiomes of β-lactam antibiotics administered for respiratory symptoms in infants with cystic fibrosis (IWCF).</p><p><strong>Objective: </strong>To compare the magnitude and duration of intended (respiratory) and unintended (fecal) antimicrobial action by analyzing oropharyngeal (OP) and fecal microbiota in IWCF.</p><p><strong>Design: </strong>Shotgun metagenomic sequencing and qPCR were performed on OP and fecal samples collected longitudinally from 14 IWCF (ages 1-17 months) during (\"On Antibiotics\") and after (\"Off Antibiotics\") β-lactam therapy, and from 5 IWCF (3-16 months) never treated with antibiotics.</p><p><strong>Results: </strong>Total bacterial loads (TBL) for On Antibiotics samples were lower than for both Never (OP and fecal) and Off Antibiotics samples (fecal only). α-diversities (within-sample) for OP On Antibiotics samples were lower than for Never and Off Antibiotics samples but did not differ between fecal sample groups. β-diversity (between-sample) differed between all OP sample groups and between fecal On and Never Antibiotics and Off and Never antibiotics samples; however, fecal On and Off Antibiotics sample β-diversities did not differ. Patterns of change in antibiotic resistance gene abundances reflected shifts in microbial community composition.</p><p><strong>Conclusions: </strong>β-lactam antibiotic exposure was followed by marked alterations in both OP and fecal microbiota. While microbiota appeared to rebound after treatment in both sample types, our results suggest that fecal microbiota recovered less than OP. The clinical consequences of these findings should be studied in IWCF and other populations frequently treated with antibiotics.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71024"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557598","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":"The bidirectional interplay of obstructive sleep apnea and viral respiratory infections in children: A novel opportunity for primary prevention.","authors":"Gustavo Nino, Elizabeth Chorvinsky, Surajit Bhattacharya, Maria J Gutierrez","doi":"10.1002/ppul.27314","DOIUrl":"10.1002/ppul.27314","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) and viral respiratory infections are highly prevalent conditions in children and a major cause of respiratory morbidity in this age group. Severe viral respiratory infections are a known risk factor for pediatric OSA, which is primarily caused by hypertrophy of upper airway lymphoid tissues (adenoids and tonsils). This review examines recent progress in understanding early-life development of lymphoid tissues in the human upper airway, with a particular focus on how respiratory viruses may influence this process and contribute to OSA pathogenesis. It also explores the bidirectional relationship between OSA and severe viral infections, highlighting the need for ongoing monitoring and novel primary prevention strategies to address these interconnected conditions.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S70-S72"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372516","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":"A Joint Conversation: People With Cystic Fibrosis' Perception of Healthcare Teams' Knowledge, Comfort, and Barriers in Discussing Substance Use.","authors":"Sanaz Vaziri, Meghan E McGarry, Addison A Cuneo, Shaina M Willen, Kensho Iwanaga, Fatima Neemuchwala, Elizabeth R Gibb, Marilynn Chan, Ngoc P Ly","doi":"10.1002/ppul.71017","DOIUrl":"10.1002/ppul.71017","url":null,"abstract":"<p><strong>Background: </strong>Substance use has increased among people with CF (pwCF), yet communication about use remains understudied between pwCF and their healthcare providers.</p><p><strong>Objective: </strong>Investigate pwCF's perceptions regarding their healthcare team's discussions surrounding substance use, comfort level discussing such usage, and barriers encountered during these discussions.</p><p><strong>Methods: </strong>This cross-sectional study used a one-time electronic survey to assess communication regarding substance use between pwCF aged 13 years and older and their CF healthcare team.</p><p><strong>Results: </strong>Of 226 participants, 74% (n = 167) reported being asked about marijuana, 57% (n = 128) about CBD, 70% (n = 150) about e-cigarettes, and 88% (n = 189) about cigarettes by their CF healthcare team. Fewer providers discussed the risks and benefits of each substance: 47% (n = 107) for marijuana, 40% (n = 90) for CBD, 44% (n = 99) for e-cigarettes, and 61% (n = 138) for cigarettes. Provider knowledge was rated higher for cigarettes and e-cigarettes compared to marijuana and CBD. Most participants felt comfortable discussing substance use, though a minority expressed discomfort, mainly due to concerns about documentation in medical records and perceived lack of support.</p><p><strong>Conclusion: </strong>This study highlights variability in communication between pwCF and their healthcare teams regarding substance use, particularly when it comes to marijuana and CBD. The findings suggest a need for standardized guidelines and educational resources to improve recreational substance screening and discussion in CF clinical care, especially given the changing landscape of marijuana regulations and increasing use among pwCF.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71017"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524108","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":"Natural course of CPAM and pulmonary sequestration: to operate or not to operate, this is the question.","authors":"Karin M de Winter-de Groot","doi":"10.1002/ppul.27307","DOIUrl":"10.1002/ppul.27307","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S64-S65"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472196","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":"A Curious Confluence: Acquired Tracheal Web in a Child With Mounier-Kuhn Syndrome.","authors":"Kalyana Prabhakaran, Nithish Kumar, Taruna Yadav, Prawin Kumar, Jagdish Prasad Goyal","doi":"10.1002/ppul.71033","DOIUrl":"https://doi.org/10.1002/ppul.71033","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71033"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658039","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":"Changing Epidemiology of Pediatric Pulmonary Exacerbations in Cystic Fibrosis.","authors":"Yaron Fireizen, Mohamoud Ahmed, Timothy Vigers, Kathryn Akong, Julie Ryu, Andrea Hahn, Hani Fanous, Anastassios Koumbourlis, Pornchai Tirakitsoontorn, Antonio Arrieta, Elizabeth B Burgener, Jonathan Koff, Jonathan D Cogen, Drake C Bouzek, Elin Hanley, Allison Keck, Dayna Stout, John Bradley, Scott D Sagel","doi":"10.1002/ppul.71019","DOIUrl":"10.1002/ppul.71019","url":null,"abstract":"<p><strong>Rationale: </strong>The introduction of elexacaftor/tezacaftor/ivacaftor (ETI), a highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy, to younger ages and the COVID-19 pandemic have significantly reduced pulmonary exacerbations requiring hospitalization among children with CF.</p><p><strong>Objective: </strong>To assess demographic and clinical characteristics of children and young adults with CF hospitalized for pulmonary exacerbations before and after pediatric ETI approval.</p><p><strong>Methods: </strong>A retrospective chart review was conducted at five United States CF Foundation-accredited care centers. Hospitalization data from children and young adults with CF in 2018 and 2022 were analyzed.</p><p><strong>Results: </strong>Hospitalizations decreased from 471 cases (241 individuals) in 2018 to 163 cases (110 individuals) in 2022. The racial distribution shifted, with more hospitalized patients identifying as people of color in 2022 (28% vs. 14%; p = 0.018). A greater proportion of hospitalized children in 2022 had two non-F508del mutations compared with children hospitalized in 2018 (38% vs. 19%) and were less likely to be infected with methicillin-resistant Staphylococcus aureus (MRSA). Comparing 2022-2018, children on CFTR modulator therapy, including ETI (76%), showed reduced infections with Pseudomonas aeruginosa and Achromobacter xylosoxidans.</p><p><strong>Conclusions: </strong>The decline in hospitalizations for pulmonary exacerbations likely reflects the benefits of ETI therapy, as a higher proportion of children and young adults hospitalized in 2022 had two non-F508del mutations and were not eligible for ETI. A greater percentage of those hospitalized in 2022 identified as belonging to minority racial groups, highlighting ongoing health disparities in the ETI era. Additionally, there were notable changes in the microbiological characteristics between 2018 and 2022.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71019"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524109","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":"The threat of vaping in youths.","authors":"Thomas Ferkol","doi":"10.1002/ppul.27361","DOIUrl":"10.1002/ppul.27361","url":null,"abstract":"<p><p>Electronic cigarettes are driving a new epidemic of nicotine dependence among youths and are now the dominant tobacco product used by adolescents in the United States and other countries. Candy and fruit flavorings have driven their use, and many products contain higher nicotine concentrations, which contributed to their addictive potential. Numerous epidemiologic studies have described increased rates of respiratory symptoms in adolescent electronic cigarette users, and in vitro and in vivo studies showed that electronic cigarette vapors exert extensive biological effects on human airways, different from tobacco smoke, leading to epithelial cell dysregulation, inflammation, mucus hypersecretion, and apoptosis. Severe acute lung injury has been reported in adolescents and young adults, particularly in those using tetrahydrocannabinol (THC)-containing products, underscoring the threats of electronic cigarettes to lung health.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S88-S89"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505733","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":"Welcome to Asthma Neverland.","authors":"Fernando M de Benedictis, Attilio L Boner, Andrew Bush","doi":"10.1002/ppul.71016","DOIUrl":"10.1002/ppul.71016","url":null,"abstract":"<p><p>Asthma is a multifactorial disease with heterogeneous clinical and pathophysiological phenotypes. Classical symptoms of asthma are wheeze, cough and breathlessness, and occasionally chest tightness. These symptoms are common to many respiratory and non-respiratory conditions, and misdiagnosis of asthma is frequent. There is no definitive test for the diagnosis of asthma, but a combination of a suggestive medical history, physical examination, lung function tests, and additional investigations will maximize the chances of making a correct diagnosis. Despite clear statements in international asthma guidelines, there are many gaps when performing diagnostic steps in current medical practice. An incomplete medical history, poor attention to the nature of respiratory sounds, failure to carry out objective tests, and inadequate estimation of the response to anti-asthma therapy are the main factors responsible for misdiagnosis of asthma. The use of wrong and potentially dangerous therapies, and high consumption of healthcare resources are the inevitable consequences of misdiagnosis. The main alternative diagnoses to asthma, clinical clues and objective tests useful for specific diagnoses are critically discussed.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71016"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573608","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":"Back to basics: lung volumes on pediatric chest X-rays-pitfalls and diagnostic implications.","authors":"Antrea Zouvani, Shyam Sunder B Venkatakrishna, Sean Schoeman, Onur Simsek, Pravinkumar Bharde, Karen I Ramirez Suarez, Pierre Goussard, Hansel J Otero, Savvas Andronikou","doi":"10.1002/ppul.27292","DOIUrl":"10.1002/ppul.27292","url":null,"abstract":"<p><p>Evaluating lung \"volumes\" when interpreting pediatric chest radiographs is useful for supporting the diagnosis of lung pathology in children. Lung volumes can be estimated using semi-objective criteria such as anterior rib counting. Estimating lung volumes is one advantage plain radiographs have over other imaging modalities such as ultrasound or even cross-sectional imaging (Computed Tomography and Magnetic Resonance Imaging, where volumes can be calculated, but remain difficult to quickly be appreciated subjectively or semi-objectively in clinical practice). Lung hyperinflation is often a surrogate of air-trapping and may be suggestive of diseases such as bronchiolitis. Identifying under-inspired chest radiographs is also important to avoid misinterpreting findings related to low lung volumes as pathology, which is a significant diagnostic pitfall in children. This pictorial review will demonstrate the method for evaluating lung volumes, specifically for identifying lung hyperinflation as a surrogate of air-trapping and under-inspiration for avoiding false positive diagnoses.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S42-S47"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351748","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}