Pediatric Pulmonology最新文献

{"title":"The threat of vaping in youths.","authors":"Thomas Ferkol","doi":"10.1002/ppul.27361","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","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":"Infection and Inflammation in the Cystic fibrosis (CF) airway.","authors":"Malena Cohen-Cymberknoh","doi":"10.1002/ppul.27355","DOIUrl":"https://doi.org/10.1002/ppul.27355","url":null,"abstract":"<p><p>Cystic fibrosis (CF) airway disease is characterized by chronic infection and neutrophil-driven inflammation, leading to progressive airway damage and early mortality. Infection with Pseudomonas aeruginosa significantly impacts morbidity and mortality, requiring early detection and aggressive antibiotic treatment. Controlling inflammation remains difficult due to the limited availability of effective anti-inflammatory treatments. CFTR modulators show potential in reducing inflammation, but further research is needed. Effective management of CF lung disease requires a comprehensive approach addressing both infection and inflammation.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505723","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":"PTB airway compression complicated by vascular abnormalities and cardiac involvement: A case series demonstrating diagnosis and management.","authors":"P Goussard, E Eber, J Janson, A G Gie, B Fourie, C M Jacobs, S S B Venkatakrishna, S Andronikou, S Van der Westhuizen, P Schubert, C Burger, J Verster, L Ebert, E Deininger-Czermak","doi":"10.1002/ppul.27351","DOIUrl":"https://doi.org/10.1002/ppul.27351","url":null,"abstract":"<p><strong>Introduction: </strong>Lymphobronchial tuberculosis (LBTB) is a tuberculous lymphadenopathy causing airway compression in young children. While it can occur in older children due to factors such as airway size, wall weakness, and immune reconstitutions, severe airway obstruction is more common in younger children.</p><p><strong>Methods: </strong>Chest X-rays show airway compression, while bronchoscopy is the gold standard for confirming TB-induced airway compression. Previous research has demonstrated that drug resistance and HIV have no effect on the outcome of children with significant airway compression caused by TB.</p><p><strong>Results: </strong>This case series describes the management and outcome of three young children who had simultaneous vascular abnormalities and airway obstruction due to pulmonary tuberculosis (PTB). Concomitant PTB and vascular abnormalities are uncommon, even in high-TB-intensity areas, and affected children may present differently and require individualised treatment.</p><p><strong>Conclusions: </strong>Advanced imaging is critical for detecting complicated cases of airway compression due to PTB in young children, as vascular abnormalities are uncommon. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) may show metabolically active intracardiac lesions. Individualised management plans are required for these children, and echocardiography is critical for patients with disseminated disease.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522562","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":"Langerhans cell histiocytosis in an infant.","authors":"Diya Ye, Tianming Yuan, Mizu Jiang","doi":"10.1002/ppul.27352","DOIUrl":"https://doi.org/10.1002/ppul.27352","url":null,"abstract":"<p><p>A 2-month-old male infant presented with a persistent mild cough and a pink papule beneath the left eyelid. Imaging studies revealed diffuse lung opacities and a cystic shadow in the right middle lobe, with no evidence of bacterial or fungal infection. Skin biopsy demonstrated positive immunohistochemical staining for CD207/Langerin and CD1a, leading to a diagnosis of Langerhans-cell histiocytosis (LCH). The infant's pulmonary bullae resolved following chemotherapy, and the patient is under surveillance for recurrence. LCH, recognized for its inflammatory and malignant characteristics, often presents with multisystemic involvement, including pulmonary manifestations. Timely diagnosis and treatment are crucial for managing this rare disorder in infants.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522559","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 advances in RSV: Is prevention attainable?","authors":"Heather J Zar","doi":"10.1002/ppul.27310","DOIUrl":"https://doi.org/10.1002/ppul.27310","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection (LRTI), hospitalization, and mortality in infants and young children globally. The greatest burden of severe disease and mortality occurs in low-middle income countries (LMICs), with large and vulnerable childhood populations. The highest rates of RSV-hospitalization occur in healthy-term infants under 3 months of age. Preterm infants, children with chronic lung disease of prematurity, Down's syndrome, congenital heart disease, or immunodeficiency also have a higher risk of severe RSV-LRTI. Early-life RSV-LRTI has also been associated with chronic sequelae, including recurrent LRTI, recurrent wheezing, asthma, and lung function impairment. A RSV pre-fusion (F) maternal vaccine and long-acting monoclonal antibody (nirsevimab) have been licensed for the prevention of RSV-LRTI in infants and young children. Studies show high efficacy and effectiveness particularly for preventing severe RSV-LRTI. Maternal RSV vaccine given at 24-36 weeks of pregnancy was effective in preventing RSV medically attended LRTI and severe RSV-LRTI through 6 months after birth in a phase 3 study conducted in 18 countries over two RSV seasons. Vaccination was safe with no significant difference in adverse events between infants born to mothers who received RSV preF vaccine compared to placebo. A numerical imbalance in preterm births that occurred predominantly in South Africa, unrelated to vaccine timing or gestational age at vaccination and unassociated with mortality, coincided with COVID-19 delta and omicron waves. Nirsevimab, given as a single dose prior or during the RSV season, had high efficacy in preventing RSV-LRTI hospitalization in infants in preterm and in full-term infants, as well as in young children with underlying conditions through 150 days post administration in phase 2 and 3 trials. High effectiveness against hospitalization or severe disease in infants and in at-risk children up to 2 years of age has also been reported in several countries where implementation has occurred. RSV-LRTI is now a preventable disease in infants and young children. Rapid implementation of these highly effective interventions has occurred in many high-income countries, but access remains very limited in LMICs. Access to such RSV preventive interventions is urgently needed for all children to strengthen child health and promote global equity.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505726","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":"Objective detection of wheeze at home by parents through a digital device: usage patterns and relationship with SABA administration.","authors":"Yen Hoang Do, Wim van Aalderen, Ellen Dellbrügger, Claude Grenzbach, Jonathan Grigg, Ulrike Grittner, Eric Haarman, Camilo José Hernandez Toro, Bulent Karadag, Siri Roßberg, Tina-Maria Weichert, Abigail Whitehouse, Antonio Pizzulli, Stephanie Dramburg, Paolo Maria Matricardi","doi":"10.1002/ppul.27295","DOIUrl":"https://doi.org/10.1002/ppul.27295","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Wheezing is an important indicator of exacerbated respiratory symptoms in early childhood and must be monitored to regulate pharmacological therapy. However, parents' subjective perception of wheezing in their children is not always precise. We investigated the objective identification of children's wheezing by parents using a digital wheeze detector (WheezeScan&lt;sup&gt;TM&lt;/sup&gt;, OMRON Healthcare Co. Ltd), its longitudinal usage patterns, and its relationship with SABA administration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a secondary nested analysis of data from the intervention arm of a multi-center randomized controlled trial completed in 2021-2022 in Berlin (Germany), London (United Kingdom), and Istanbul (Turkey). Children aged 4 to 84 months with doctor's diagnosed wheezing (GINA step 1 or 2) were included. Using an electronic diary (Wheeze-Monitor&lt;sup&gt;TM&lt;/sup&gt;, TPS), parents monitored and recorded for 120 days at home the presence or absence of their child's wheezing, detected both, with WheezeScan&lt;sup&gt;TM&lt;/sup&gt; (\"objective\" wheezing), and subjective (\"perceived\" wheezing). Parents also recorded the child's symptoms, medication intake, and family quality of life. Questionnaires regarding symptom control, quality of life, and parental self-efficacy were answered at baseline and after 90 and 120 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eighty-one/87 families completed the intervention arm of the study. WheezeScan&lt;sup&gt;TM&lt;/sup&gt; was on average used 0.7 (SD 0.6) times a day, with each patient reporting a positive, negative, or \"error\" outcome on average in 57%, 39%, and 5% of measurements, respectively. The use of WheezeScan&lt;sup&gt;TM&lt;/sup&gt; declined slightly during the first 90 days of monitoring and steeply thereafter. Repeated usage of WheezeScan&lt;sup&gt;TM&lt;/sup&gt; in the same day was more frequent after a \"wheeze\" (HR 1.5, 95% CI 1.37-1.65, p &lt; 0.001) and an \"error\" (HR 2.01, 95% CI 1.70-2.38, p &lt; 0.001) result, compared to a \"no wheeze\" outcome. The average per-patient daily agreement between \"objective\" and \"perceived\" wheezing/non-wheezing was 75% at the start of the monitoring period and only weakly persisted as time passed (Spearman's rho=0.09). The frequency of short-acting beta-2-agonists (SABA) administration was lower in days with closely interspaced consecutive device uses during which the patient's status was perceived as \"never wheeze\" (32/455, 7%) than in those perceived as \"persistent wheeze\" (53/119, 44%; OR 36.6, 95% CI [14.3, 94.1]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Daily use of a digital WheezeScan&lt;sup&gt;TM&lt;/sup&gt; at home allows parents to detect their child's unperceived wheezing and discloses to caregivers the longitudinal patterns of a child's wheezing disorder. Digital monitoring of wheezing also highlights poor adherence to guidelines in SABA administration for wheezing children, with under-treatment being much more frequent than over-treatment. This pioneering study opens new perspectives for furt","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505727","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":"Isolated heart transplantation in an adolescent with cystic fibrosis-A case report.","authors":"J Westhoff, S Barth, A Bagheri-Potthoff, S Skrzypek, L Naehrlich","doi":"10.1002/ppul.27342","DOIUrl":"https://doi.org/10.1002/ppul.27342","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505724","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 disappearing lesion in the cricopharynx: A hypopharyngeal cushion.","authors":"Sarath Balaji, Saravanamuthu Thirunavukkarasu, Thangaraj Chellakutti, Manoj Madhusudan","doi":"10.1002/ppul.27369","DOIUrl":"https://doi.org/10.1002/ppul.27369","url":null,"abstract":"<p><p>A 2-year-old girl presented to our aero-digestive clinic with complaints of dysphagia to solids. On awake endoscopy, a bluish, expansile lesion was noticed. posterior to the arytenoids, which became prominent when crying. During the airway evaluation under general anesthesia, the lesion completely disappeared, revealing a normal posterior cricoid region. Upon closer examination, a small venous malformation was noted in the posterior pharyngeal wall. A diagnosis of a \"hypopharyngeal cushion\" was made.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505731","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":"Congenital lobar overinflation, from antenatal diagnosis to long-term follow-up: A single-center experience.","authors":"I Testa, N Muthialu, A Beeman, P Aurora","doi":"10.1002/ppul.27346","DOIUrl":"https://doi.org/10.1002/ppul.27346","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505717","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":"Predicting exacerbations in severe preschool wheezers.","authors":"Michael Fayon, Fabien Beaufils","doi":"10.1002/ppul.27338","DOIUrl":"https://doi.org/10.1002/ppul.27338","url":null,"abstract":"<p><p>Simple clinical indices, complex composite phenotyping/endotyping and telehome monitoring now allow us to evaluate the risk of preschool wheezing on a population or individual level. We herein discuss the usefulness of clinical markers which involve underlying issues such as in utero smoke exposure, the pathophysiology of viral-immunological-allergic interactions, and changes in airway epithelium, mesenchyme and smooth muscle cells. The most important unmet need in this age group remains disease-modifying interventions.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505729","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}