Pediatric Pulmonology最新文献

{"title":"A Simplified, Regional Lung Ultrasound Score for Surfactant Administration in Neonatal RDS: A Prospective Observational Study.","authors":"Francesco Raimondi, Pasquale Dolce, Claudio Veropalumbo, Enrico Sierchio, Iuri Corsini, Fabio Meneghin, Silvia Lama, Roberto Raschetti, Silvia Varano, Alessandro Perri, Luca Bonadies, Almudena Alonso Ojembarrena, Javier Rodriguez Fanjul, Rebeca Gregorio Hernandez, Lorena Rodeño Fernandez, Fiorella Migliaro, Serena Salomè, Luca Pierri, Carlo Dani, Gianluca Lista, Fabio Mosca, Virgilio Carnielli, Eugenio Baraldi, Giovanni Vento, Lucio Giordano, Manuel Sanchez Luna, Peter G Davis, Letizia Capasso","doi":"10.1002/ppul.71206","DOIUrl":"10.1002/ppul.71206","url":null,"abstract":"<p><strong>Background: </strong>A total lung ultrasound score (tLUS) is a validated tool to describe parenchymal aeration, evaluate neonatal respiratory distress syndrome (RDS) progression and guide early surfactant replacement. tLUS derives from regional scores (rLUS) from predefined ultrasound views.</p><p><strong>Research question: </strong>This paper explores the relative contribution of rLUS to tLUS and their predictive power of surfactant need for RDS, individually and with additional variables.</p><p><strong>Study design and methods: </strong>This was a secondary analysis of multicenter, prospective, observational study. Preterm neonates with RDS were stabilized on nCPAP. Within 2 h of life, we calculated a tLUS (range 0-18) by summing 6 rLUS (using a 0-3 scale on midclavicular, anterior and posterior axillary line views) and the oxygen saturation/inspired oxygen fraction ratio (SatO₂/FiO₂). The administration of surfactant by a physician masked to the ultrasound results was used as reference test.</p><p><strong>Results: </strong>We enrolled 175 preterm infants. A midclavicular (MC) score ≥ 2 was an early marker of aeration heterogeneity. Prognostic accuracy for surfactant need was high for the left MC score (AUC: 0.86 with sensitivity 0.79 and specificity 0.90) and the right MC score (AUC 0.87 with sensitivity 0.74 and specificity 0.93; optimal Youden cut-off = 2). A combined left + right MC score lead to an AUC: 0.90 (sensitivity 0.82. specificity 0.89; optimal Youden cut-off = 3). A prediction model including gestational age, SatO₂/FiO₂ and the combined MC score had an AUC 0.95.</p><p><strong>Interpretation: </strong>rLUS are not always uniformly distributed in early RDS. The combined MC score is a simplified rapid and accurate predictor of surfactant replacement (alone or in combination with noninvasive variables) reducing stressful manipulations in first hours of life for preterm neonates.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71206"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650084","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":"Elexacaftor/Tezacaftor/Ivacaftor for Mycobacterium abscessus Eradication in a Child With Cystic Fibrosis.","authors":"Marcela Kreslová, Josef Sýkora, Veronika Skalická, Hana Hrdinová, Jana Amlerová, Romana Kaslová, Jan Baxa, Veronika Schwarzová, Václav Koucký","doi":"10.1002/ppul.71208","DOIUrl":"https://doi.org/10.1002/ppul.71208","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71208"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637758","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":"Sensory Processing Disorder Could Be a Comorbidity of Childhood Asthma: A Cross-Sectional Study.","authors":"Berna Uzunoğlu, Emre Fırat, İrem Karadeniz, Figen Çelebi Çelik, Canan Şule Ünsal Karkıner, Özlem Sancaklı, Demet Can","doi":"10.1002/ppul.71203","DOIUrl":"https://doi.org/10.1002/ppul.71203","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a chronic inflammatory disease affecting multiple organ systems, including the central nervous system (CNS). Recent studies suggest an association between asthma and neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Sensory processing disorder (SPD), a neurodevelopmental condition characterized by atypical responses to sensory stimuli, may also be linked to asthma through shared inflammatory mechanisms.</p><p><strong>Objective: </strong>This study aimed to investigate the prevalence of SPD in children with asthma as compared to those without asthma and explore its relationship with asthma severity.</p><p><strong>Methods: </strong>This prospective, cross-sectional study included 182 children aged 5-12 years, with 91 asthmatic children in the study group and 91 nonasthmatic children in the control group. Sensory processing abilities were assessed using the Sensory Processing Measure (SPM) Home-Form. Statistical analyses, including logistic regression and path analysis, were performed to evaluate the association between asthma and sensory processing abnormalities.</p><p><strong>Results: </strong>Atypical sensory processing was significantly more prevalent in asthmatic children compared to the control group across multiple sensory domains, including vision, auditory, tactile, body awareness, balance, and movement (p < 0.005). Logistic regression analysis revealed that asthma was associated with increased risk of atypical sensory processing, particularly in tactile (OR: 5.716, 95% CI: 2.9-11.3 p < 0.001) and balance/movement (OR: 8.8, 95% CI: 2.5-30.7, p = 0.001) domains. However, no significant association was found between asthma severity and SPD prevalence.</p><p><strong>Conclusion: </strong>Our findings suggest that children with asthma exhibit a higher prevalence of SPD, supporting the hypothesis that neuroinflammation may contribute to sensory processing abnormalities. These results highlight the need for multidisciplinary approaches in managing asthmatic children, considering both respiratory and neurodevelopmental aspects. Further research is warranted to explore underlying mechanisms and potential interventions.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71203"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637761","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":"Pulmonary Embolism in Children With Mycoplasma Pneumoniae Pneumonia: Assessment of Risk Factors and Current Prediction Criteria.","authors":"Yiran Xiao, Xinyi Jia, Anni Cao, Deyu Zhao, Baidi Fu, Man Tian, Xiaojun Zhang, Feng Liu","doi":"10.1002/ppul.71149","DOIUrl":"https://doi.org/10.1002/ppul.71149","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary embolism (PE) is recognized as a life-threatening complication of Mycoplasma pneumoniae pneumonia (MPP). We aimed to evaluate the risk factors of MPP with PE and examine the diagnostic accuracy of three adult-validated PE prediction criteria in children.</p><p><strong>Methods: </strong>We retrospectively analyzed MPP patients who underwent computerized tomography pulmonary angiography (CTPA) due to suspicion of PE at the Children's Hospital of Nanjing Medical University from January 2019 to December 2023. The clinical characteristics were retrospectively recorded, and the application of three PE pretest probability strategies was assessed accordingly. We performed univariate analysis and evaluated potential predictors for PE in pediatric MPP patients via logistic regression analysis and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A total of 302 MPP patients were enrolled in this study. The YEARS criteria presented better overall diagnostic accuracy than the Wells and PERC did, with a sensitivity of 96.7% and specificity of 52.6%. Multivariate logistic regression analysis revealed that days of fever before CTPA [OR = 1.159 (95% CI: 1.033-1.301), p < 0.05], d-dimer [OR = 1.000 (95% CI: 1.000-1.001), p < 0.05] and α-HBDH [OR = 1.019 (95% CI: 1.012-1.025), p < 0.05] were independent risk factors for PE in MPP children. The combined metric of those three variables had an AUC of 0.964 (95% CI: 0.932-0.995), indicating better prediction value than the separate metric.</p><p><strong>Conclusions: </strong>Days of fever, d-dimer and α-HBDH were predictive of PE in MPP patients. Compared with the Wells and PERC rule, the YEARS criteria demonstrated relatively better overall diagnostic accuracy in MPP children complicated with PE.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71149"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601192","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 Curious Case of Recurrent Respiratory Compromise in the NICU.","authors":"Abdulaziz Abul, Ioana Bratu, Michelle Noga, Anne Hicks, Matthew Hicks","doi":"10.1002/ppul.71204","DOIUrl":"10.1002/ppul.71204","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71204"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650083","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":"Air Pollution and Child Health in India: Policy Recommendations and Future Directions.","authors":"Kurvatteppa Halemani, Asha P Shetty, Latha T, Surya Kant Tiwari","doi":"10.1002/ppul.71196","DOIUrl":"https://doi.org/10.1002/ppul.71196","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71196"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601187","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":"Blood Neutrophils in Infants Admitted for Bronchiolitis and Subsequent Lung Function Impairment.","authors":"Raffaella Nenna, Laura Petrarca, Maria Giulia Conti, Enrica Mancino, Domenico Paolo La Regina, Francesca Maria Pulcinelli, Alessandra Pierangeli, Enea Bonci, Fabio Midulla, Fernando D Martinez","doi":"10.1002/ppul.71058","DOIUrl":"10.1002/ppul.71058","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71058"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609025","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":"Assessing the Impact of Nirsevimab Immunization on RSV Bronchiolitis Hospital Admissions and Their Severity: A Case-Control Study and Comparison With Pre- and Post-COVID-19 Seasons in a Tertiary Pediatric Hospital.","authors":"Fuensanta Guerrero-Del-Cueto, Sara Lobato-Lopez, Diego Lozano-Duran, Blanca Sanchez-Duran, Lucia Ramirez-Martin, Begoña Esteban-San-Narciso, Sara Sosa-Hernandez, Laura Martin-Pedraz, David Moreno-Perez, Isabel Leiva-Gea, Esmeralda Nuñez-Cuadros","doi":"10.1002/ppul.71059","DOIUrl":"10.1002/ppul.71059","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates nirsevimab's real-world effectiveness in preventing respiratory syncytial virus (RSV) bronchiolitis hospitalizations after its introduction in Andalusia's immunization schedule, compares clinical outcomes between immunized and non-immunized infants (2023-2024), and examines RSV seasonality pre- and post-COVID-19.</p><p><strong>Methods: </strong>Retrospective single-center case-control study conducted at a tertiary pediatric hospital (Malaga Regional University Hospital). Infants hospitalized for PCR-confirmed RSV bronchiolitis during the first season after nirsevimab introduction were matched with two controls born on the same day. Immunization status, demographic data, and clinical outcomes were analyzed. As a secondary analysis, clinical characteristics and adverse outcomes of immunized and non-immunized RSV bronchiolitis cases from the 2023-2024 season were compared with four previous periods: pre-pandemic decade (04/2010-03/2020), first pandemic season (04/2020-03/2021), second pandemic season (04/2021-03/2022) and third pandemic season (04/2022-03/2023).</p><p><strong>Results: </strong>Nirsevimab showed 91.5% effectiveness (95% CI: 71.8%-97.4%) in reducing RSV bronchiolitis hospitalizations, which decreased 72.4% from the pre-pandemic average and 82.4% from 04/2022-03/2023. Intensive-care-unit admissions were significantly higher in non-immunized infants (60.0% vs. 26.1%, p = 0.04), with no differences in bacterial superinfection, oxygen requirement and length-of-stay.</p><p><strong>Conclusions: </strong>Nirsevimab significantly reduced RSV bronchiolitis hospitalizations during its first season of use. The study also highlights shifts in RSV seasonality trends influenced by the COVID-19 pandemic, highlighting the need for ongoing surveillance to adapt public health strategies.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71059"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637756","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":"Exploring Bone Health in Cystic Fibrosis: A Study From a Lung Transplantation Center and Strategy for Clinical Care.","authors":"Gökçen Kartal Öztürk, Ece Halis, Ece Ocak, Aykut Eşki, Damla Gökşen, Samim Özen, Fevziye Çoksüer, Esen Demir, Figen Gülen","doi":"10.1002/ppul.71210","DOIUrl":"10.1002/ppul.71210","url":null,"abstract":"<p><strong>Background: </strong>Cystic Fibrosis Bone Disease (CFBD) is a known complication in children with CF and may cause serious problems in adulthood or transplantation processes. This study aimed to identify potential predictable risk factors for the development of low BMD by evaluating pediatric patients screened with DXA as a \"Heart-Lung Transplantation Center\" and created new strategic plans to improve our CFBD screening program by evaluating our results in literature and guidelines recommendations.</p><p><strong>Methods: </strong>This retrospective cohort study includes 86 children ages 6-18 years with CF who underwent at least one DXA scan between August 2016 and October 2024. Participants were compared according to BMD z scores and the relationship between BMD and disease-related parameters was evaluated.</p><p><strong>Results: </strong>The rate of DXA screening in our center was 81.1% over 8 years of age and 72.8% over 6 years of age. 41.8% of our population had abnormal BMD (z scores < -1), and the rate of very low BMD (z scores < -2) was 17.4%. The frequency of abnormal BMD was higher in children with BMI< 50th percentile, SKS ≤ 70, low FEV₁ z score, respiratory microorganism colonization, ≥ 2 annual pulmonary exacerbations, required respiratory support, low albumin, and high CRP levels. Systemic inflammation marker CRP increase was the most predictable parameter for low BMD.</p><p><strong>Conclusion: </strong>This study informs clinical practice by highlighting the need for multidisciplinary interventions, such as earlier evaluation of DXA scans due to the risk factors and poor clinical conditions, a consistent follow-up protocol, individualized nutrition programs with the dietitian, and enhanced physical therapy.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71210"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650101","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":"Baseline Characteristics and Self-Reported Use of Chronic Daily Therapies of the Home Reported Outcomes With CFTR Modulator Therapy (HERO-2) Cohort.","authors":"Georgene E Hergenroeder, Kevin J Psoter, Cynthia D Brown, Josh Ostrenga, Christine Ford, Lisa Bendy, Bradley H Rosen, Nell Meosky Luo, Connie Zhang, Kathryn A Sabadosa, Clement L Ren","doi":"10.1002/ppul.71190","DOIUrl":"https://doi.org/10.1002/ppul.71190","url":null,"abstract":"<p><strong>Background: </strong>The HERO-2 study is a prospective, observational study investigating chronic daily therapy (CDT) changes among people with cystic fibrosis (PwCF) ≥ 12 years of age taking elexacaftor/tezacaftor/ivacaftor (ETI). The goal of this analysis was to describe baseline characteristics and patterns of CDT discontinuation reported at study enrollment and identify clinical features associated with CDT discontinuation.</p><p><strong>Methods: </strong>Study participants were recruited through their CF center, community engagement, or a smartphone application (Folia Health). Study enrollment and participation took place remotely through Folia Health. Participants gave consent to link their data with the CF Foundation Patient Registry (CFFPR). At enrollment, participants completed a baseline survey describing CDT use since starting ETI. Descriptive statistics were used to summarize HERO-2 participant characteristics. Logistic regression evaluated the association of selected individual characteristics with odds of CDT discontinuation.</p><p><strong>Results: </strong>A total of 860 PwCF enrolled in HERO-2, and 755 (87.8%) completed the enrollment survey and were linked to the CFFPR. At enrollment, 313 participants (41.5%) reported discontinuation of at least one CDT. The most frequently discontinued CDT was airway clearance (22.4%). Intravenous (IV) antibiotic treatment for a pulmonary exacerbation in the prior year and public insurance were associated with lower odds of CDT discontinuation.</p><p><strong>Conclusions: </strong>In this large cohort of PwCF taking ETI, approximately 42% reported discontinuation of at least one CDT. Providers should be aware of these CDT discontinuation patterns and engage in open dialogue with PwCF and their families about CDT de-escalation.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 7","pages":"e71190"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637757","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}