Pediatric Pulmonology最新文献

{"title":"Upcoming events of interest.","authors":"","doi":"10.1002/ppul.27079","DOIUrl":"https://doi.org/10.1002/ppul.27079","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e27079"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524111","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 Rare Cause of Diffuse Alveolar Hemorrhage in Children: COPA Syndrome.","authors":"Ayyüce Ünlü, Şule Selin Akyan Soydaş, Satı Özkan Tabakçı, Işıl Bilgiç, Meltem Kürtül Çakar, Gamze Akça Dinç, Hande Yetişgin, Çelebi Yıldırım, Muhammet Ali Çetin, Gökçen Dilşa Tuğcu, Dilber Ademhan Tural, Sanem Eryılmaz Polat, Güzin Cinel","doi":"10.1002/ppul.71050","DOIUrl":"https://doi.org/10.1002/ppul.71050","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71050"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606145","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":"Elexacaftor/Tezacaftor/Ivacaftor Treatment Accessibility and Mental Health: Reducing Anxiety in People With Cystic Fibrosis.","authors":"Burcu Uzunoglu, Merve Selcuk Balci, Mine Kalyoncu, Seyda Karabulut, Neval Metin Cakar, Ceren Ayca Yildiz, Gamze Tastan, Damla Kocaman, Almala Pinar Ergenekon, Yasemin Gökdemir, Ela Erdem Eralp, Fazilet Karakoc, Bülent Karadag","doi":"10.1002/ppul.71037","DOIUrl":"10.1002/ppul.71037","url":null,"abstract":"<p><strong>Background: </strong>Although modulator therapies have proven effective in cystic fibrosis (CF) access is limited due to reimbursement issues in Turkey. We aimed to examine anxiety and depression levels of people with CF (pwCF) and their caregivers according to their access to modulator treatment.</p><p><strong>Methods: </strong>Participants genetically eligible for elexacaftor/tezacaftor/ivacaftor (ETI) were divided into Group 1 (access via court decision, not yet on treatment) and Group 2 (unable to access due to reimbursement issues). Genetically ineligible participants formed Group 3. All pwCF and parents of those under 18 were screened for depression by the Patient Health Questionnaire-9 (PHQ-9) and for anxiety by the Generalized Anxiety Disorder-7 (GAD-7). Surveys for Group 1 patients were conducted just before starting ETI. Binary logistic regression analysis was performed to evaluate the effects of independent variables on anxiety and depression in pwCF and their primary caregivers.</p><p><strong>Results: </strong>A total of 389 pwCF and 285 caregivers were included. Group 3 (ineligible) had the highest depression rate (72.9%, n = 35), while Group 1 (pre-ETI) had the lowest (50.0%, n = 35). Median PHQ-9 scores were significantly lower in Group 1 (p < 0.006). Anxiety rates were higher in Groups 2 and 3 compared to Group 1 (p = 0.011 and p = 0.003, respectively). Access to ETI reduced the odds of anxiety by 67.7% (p = 0.029). Caregiver GAD-7 scores showed a weak negative correlation with pwCF age (r = -0.117).</p><p><strong>Conclusion: </strong>Limited access to modulator therapies is associated with higher depression and anxiety symptoms among pwCF. Addressing these barriers is critical to improving their well-being.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71037"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586628","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":"Peripheral Muscle Function and Body Composition in People With Cystic Fibrosis on Elexacaftor/Tezacaftor/Ivacaftor: A Cross-Sectional Single-Centre Study.","authors":"Lauren J Clayton, Anthony I Shepherd, Jo Corbett, Mathieu Gruet, Gary Connett, Mark Allenby, Julian Legg, Thomas Daniels, Don S Urquhart, Zoe L Saynor","doi":"10.1002/ppul.71044","DOIUrl":"10.1002/ppul.71044","url":null,"abstract":"<p><strong>Background: </strong>People with cystic fibrosis (pwCF) often have multifactorial peripheral muscle abnormalities attributed to, for example, malnutrition, steroid use, altered redox balance and, potentially, CF-specific intrinsic alterations. Malnutrition in CF now includes an increasing prevalence of overweight and obesity, particularly in those receiving CF transmembrane conductance regulator (CFTR) modulator therapy (CFTRm). We aimed to characterise peripheral muscle function and body composition in pwCF on Elexacaftor/Tezacaftor/Ivacaftor (ETI) CFTRm, compared to healthy controls.</p><p><strong>Methods: </strong>Fifteen pwCF on ETI, and 15 healthy age- and sex-matched controls (CON), underwent whole-body dual-energy X-ray absorptiometry scans, and a comprehensive evaluation of peripheral muscle function. Tests included quadriceps maximal isometric force measurement, an intermittent isometric quadriceps fatiguing protocol, handgrip strength dynamometry, squat jump height assessment, and 1-min sit-to-stand testing.</p><p><strong>Results: </strong>No significant differences in quadriceps maximal isometric force (CON: 181.60 ± 92.90 Nm vs. CF: 146.15 ± 52.48 Nm, p = 0.21, d = 0.47), handgrip strength (CON: 34 ± 15 kg vs. CF: 31 ± 11 kg, p = 0.62, d = 0.18), peripheral muscle endurance, fatigue, or power were observed between the groups. Moreover, no significant differences in whole-body, trunk or limb lean mass, fat-free mass, fat mass, or whole-body bone mineral density were evident.</p><p><strong>Conclusion: </strong>Comparable peripheral muscle mass and function has been demonstrated in pwCF on ETI, albeit a group with good lung function. Research is needed to confirm these findings longitudinally in pwCF, including those with more severe lung disease, who are less physically active, and have less optimal nutrition and exercise support.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71044"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605620","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":"Survey Health Data on Allergic Rhinitis (AR) and Asthmatic Symptoms and Blood Samples (IgE Sensitizations) in Preschool Children: An Observational Study.","authors":"Susanne Kutzora, Jonas Mehrl, Jonas Huß, Jeroen Buters, Joana Candeias, Renate Effner, Lana Hendrowarsito, Alisa Weinberger, Caroline Quartucci, Caroline Herr, Stefanie Heinze","doi":"10.1002/ppul.71030","DOIUrl":"https://doi.org/10.1002/ppul.71030","url":null,"abstract":"<p><strong>Background: </strong>Aim of the study was to investigate the association of IgE sensitizations in serum and self-reported allergic rhinitis (AR) and asthmatic symptoms.</p><p><strong>Methods: </strong>Between 2015 and 2018, parents of 1190 children in Günzburg, Germany participated in the study by completing a questionnaire. Settings were the Health-Monitoring-Units (HMU) during the obligatory school entry examinations and a medical examination for all German children at the age of 60-64 months (U9). Random serum samples from 340 children were analyzed for IgE-sensitizations. For possible associations of sensitization and six health outcomes (symptoms of AR, dry cough at night, wheeze, asthma diagnosis, physician-diagnosed asthma, and physician-diagnosed AR), a regression analysis was performed.</p><p><strong>Results: </strong>The parents of 1190 children completed the questionnaire. Parental asthma and physician-diagnosed asthma (OR 4.79; 95%-CI [2.16-10.65]) and underweight at birth/preterm delivery showed the highest associations with asthma based on the German ISAAC definition (OR 3.58; 95%-CI [1.77-7.22]). Out of 340 children blood samples 118 children were sensitized against at least one allergen (airborne pollen allergens, non-seasonal airborne allergens, or food allergens). Sensitized children reported more frequently from symptoms of AR, wheeze, and asthma based on the German ISAAC definition than children without sensitization.</p><p><strong>Conclusion: </strong>This observational study identified the prevalence of AR, asthma and existing sensitization among the participating children. Parental asthma and underweight at birth were identified as risk factors for allergic symptoms and asthma.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71030"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573643","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":"Dornase Alfa Instillation via Flexible Fiberoptic Bronchoscopy to Treat Atelectasis in Children.","authors":"Birce Sunman, Ebru Yalcin, Raziye Atan, Halime Nayir Buyuksahin, Ismail Guzelkas, Didem Alboga, Meltem Akgul Erdal, Ipek Demir, Burcu Capraz Yavuz, Nagehan Emiralioglu, Deniz Dogru, Uğur Özçelik, Nural Kiper","doi":"10.1002/ppul.71049","DOIUrl":"https://doi.org/10.1002/ppul.71049","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71049"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606149","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":"Impact of Elexacaftor/Tezacaftor/Ivacaftor on Microbiology and Antibiotic Utilization in People With Cystic Fibrosis.","authors":"Cindy L Williams, Joanna Billings, Harriet McGowan, Rebecca McDevitt, Charles R Esther, Cameron J McKinzie, William S Wilson, Charissa W Kam","doi":"10.1002/ppul.71038","DOIUrl":"https://doi.org/10.1002/ppul.71038","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis (CF) is a multisystem disease characterized by persistent lung infection. Treatment with elexacaftor/tezacaftor/ivacaftor (ETI) improves respiratory-related quality of life and reduces rates of infection and antibiotic treatments. Reduced antibiotic use may alter bacterial drug resistance patterns.</p><p><strong>Methods: </strong>This was a single center, retrospective, observational study analyzing respiratory cultures obtained from people with CF (pwCF) before and after starting ETI therapy. Antibiotic courses and culture data, including susceptibilities, were obtained from the electronic medical record.</p><p><strong>Results: </strong>There were 312 pwCF on ETI included, with an average age at ETI initiation of 20.9 ± 12.0 years and an average length of time on ETI 2.48 ± 0.69 years. Compared to the pre-ETI period, pwCF post-ETI had reductions in the number of antibiotic courses per year (2.5 to 0.7, p < 0.001), antibiotics utilized per course (1.4 to 1.0, p < 0.001), and percentage of courses including intravenous antibiotics (59% to 38%, p < 0.001). The fraction of pwCF with at least one culture positive for Pseudomonas aeruginosa, Burkholderia species, or Stenotrophomonas maltophilia decreased after ETI initiation, though changes were not significant for Staphylococcus aureus. Antibacterial resistance patterns were similar for most antibiotics in pre- and post-ETI periods, with P. aeruginosa exhibiting more resistance to fluoroquinolones post-ETI. Individuals with resistant organisms pre-ETI were less likely to clear the pathogen post-ETI.</p><p><strong>Conclusion: </strong>Treatment with ETI significantly decreased antibiotic utilization and the prevalence of gram-negative organisms. Although fewer antibiotics were used, antibiotic resistance remained unchanged or even increased post-ETI due largely to the greater persistence of resistant organisms.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71038"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606151","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":"Hidden in Plain Sight: An Unusual Case of Chronic Cough and Dyspnea in an Adolescent Boy.","authors":"Kalyana Prabhakaran, Samireddi B V Meghana, Taruna Yadav, Prawin Kumar, Jagdish P Goyal","doi":"10.1002/ppul.71036","DOIUrl":"https://doi.org/10.1002/ppul.71036","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71036"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557603","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":"\"Evaluation of Different Inspiratory Efforts in a Pediatric Model of Healthy Lung and Pediatric Acute Respiratory Distress Syndrome During Optimized Pressure Support Ventilation and Proportional Assist Ventilation Plus (PAV+): A Bench Study.","authors":"G Spinazzola, G Ferrone, R Costa, O Festa, M Piastra, G Bello, M F Amato, M Rossi, G Conti","doi":"10.1002/ppul.71027","DOIUrl":"10.1002/ppul.71027","url":null,"abstract":"<p><strong>Introduction: </strong>While proportional ventilator modes have gained popularity in adult patients' ventilatory management, Proportional Assist Ventilation (PAV+) use in pediatric patients with Pediatric Acute Respiratory Distress Syndrome (PARDS) remains unexplored. This study aims to evaluate the effects of optimized PSV and PAV+ on patient-ventilator interaction and respiratory pattern in two pediatric simulated lung models.</p><p><strong>Methods: </strong>The study utilized an active lung simulator to replicate two pediatric lung models: one healthy and one with mild PARDS. Each model was ventilated using PAV+ and optimized PSV at four different levels, assessing simulated patient-ventilator interaction and mechanical response to increase inspiratory effort.</p><p><strong>Results: </strong>In terms of simulated patient-ventilator interaction, in a healthy and mild PARDS lung model and all setting tested, the optimized PSV presented the better patient-ventilator interaction with the shortest values of Inspiratory trigger delay (Delay_trinsp), Pressurization time (Time_press) and Expiratory trigger delay (Delay_trexp) and the highest values of Synchrony time (Time_synch). Only in the lung model with PARDS, during high assistance levels and high Pmus, no significant differences were found in terms of patient ventilation interaction between the two modalities.</p><p><strong>Conclusions: </strong>In a healthy lung model, optimized PSV allows optimal simulated patient-ventilator interaction and assistance levels compared to PAV+. On the contrary, in a simulated lung with mild PARDS, PAV+ appears as a valid alternative to PSV, especially under conditions of intense inspiratory effort and high assistance levels.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71027"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557585","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":"What to Look for in Chest X-Rays of Pediatric Patients With COVID-19: Insights From a Colombian Cohort.","authors":"Claudia Burgos, Laura Melissa Mendez, María Margarita Rodriguez, Arianna Martinez, Paola Sanchez, Carolina Tovar, Melisa Naranjo Vanegas, Gabriela Friedrich, Pablo Vásquez-Hoyos, María Lucía Mesa-Rubio, Gustavo Adolfo Triana-Rodriguez, Mónica Royero-Arias, Jessica Echeverry, Tamara Gamo, Luz Ángela Moreno, Olga Lucía Baquero, Luz Marina Mejía, Sonia Restrepo-Gualteros, Luis Miguel Navarro-Ramirez, Sergio Moreno-Lopez, Juan Gabriel Piñeros, Carlos Álvarez-Moreno, Alejandro Díaz-Díaz, Iván Felipe Gutierrez, Clara Galvis-Diaz, José Manuel Nieto, Irati Gastesi, Cinta Moraleda, Alfredo Tagarro García, Andrea Ramirez Varela","doi":"10.1002/ppul.27495","DOIUrl":"https://doi.org/10.1002/ppul.27495","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in vaccination and the transition from pandemic to endemic, SARS-CoV-2 continues to pose a medical challenge, particularly among children. In this context, imaging diagnostics, such as chest x-rays, are crucial to the initial treatment of patients. This study aims to characterize the radiological findings in pediatric patients with confirmed SARS-CoV-2 infection in Colombia between April 2020 and November 2021, as well as describe the clinical presentation, including those admission to intensive care.</p><p><strong>Methods: </strong>In Colombia, a multicenter cohort comprised patients aged 29 days to 17 years with confirmed SARS-CoV-2 infection and chest X-ray taken within 72 h of hospitalization. In two separate groups, four radiologists evaluated the images. A fifth radiologist reviewed all the X-rays; and subsequently, these readings were used to calculate the kappa coefficient and to solve discrepancies among the other radiologists. The results were compared from admission to intensive care.</p><p><strong>Results: </strong>Analysis was conducted on 392 patients with a median age of 2 years, the majority of whom (42%) were infants. Sixty-eight percent of the radiographs had normal results. Peribronchial thickening and interstitial opacity were the most common aberrant findings (59%), followed by alveolar opacity (12%). 88 percent of findings were bilateral. In our cohort, peribronchial thickening was the most common radiological pattern found in patients admitted the PICU and with ventilatory failure. Interobserver agreement was low for peribronchial thickening (kappa = 0.1), but higher for consolidations and alveolar opacities (kappa = 0.4 and 0.5, respectively).</p><p><strong>Conclusion: </strong>In pediatric patients with SARS-CoV-2, radiological findings are nonspecific and interobserver agreement is minimal. Although consolidation and alveolar opacities demonstrated greater concordance, they did not appear to reflect the clinical presentation; therefore, our results can suggest chest radiography is not considered useful for determining the severity of COVID-19 in children. There is a need for more investigations.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e27495"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524112","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}