Pediatric Pulmonology最新文献

{"title":"Integrating genomics as clinical biomarkers in pediatric pulmonology.","authors":"Erick Forno","doi":"10.1002/ppul.27308","DOIUrl":"10.1002/ppul.27308","url":null,"abstract":"<p><p>Respiratory diseases often result from complex interactions between an individual's genetic predisposition and their exposure to various environmental and other risk factors. Here we will briefly review how various types of \"omics\", particularly epigenomics and transcriptomics, hold promise for translation into clinical biomarkers in pediatric pulmonary medicine, using asthma and cystic fibrosis as examples.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S66-S67"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366177","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":"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":"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":"https://doi.org/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":"Iron Deficiency Anemia in Asthmatic Children.","authors":"Maryam Adnan, Saad Khan, Fatima Sohail, Hiba Thasleem, Junaid Imran","doi":"10.1002/ppul.71045","DOIUrl":"https://doi.org/10.1002/ppul.71045","url":null,"abstract":"<p><p>This letter responds to the article \"The Effect of Iron Deficiency Anemia on Emergency Department Admission in Asthmatic Children\" by Selmanoglu et al. highlighting important limitations in their findings. The authors' retrospective study identified a significant association between iron deficiency anemia (IDA) and increased emergency department admissions for asthma exacerbations in asthmatic children. However, the letter emphasizes the need to consider potential confounding factors such as socioeconomic status and nutritional intake, which may influence both anemia and asthma severity. Additionally, the absence of a control group limits the ability to generalize the findings beyond asthmatic children. There is a need for future research to explore the impact of iron supplementation on asthma control and overall health outcomes, advocating for tailored management strategies in this vulnerable population.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71045"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605472","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 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":"Care Utilization for Acute Respiratory Infections in Children Requiring Invasive Long-Term Mechanical Ventilation.","authors":"Carolyn C Foster, Todd A Florin, Derek J Williams, Katherine L Freundlich, Rebecca L Steuart, Julia A Heneghan, Cara Cecil, Nathan M Pajor, Robert J Graham, Sriram Ramgopal","doi":"10.1002/ppul.71026","DOIUrl":"10.1002/ppul.71026","url":null,"abstract":"<p><strong>Introduction: </strong>Children who use invasive long-term mechanical ventilation (LTMV) are a rare, clinically heterogenous population with relatively high hospitalization rates, most commonly for acute respiratory infection (ARI). We sought to describe patterns of ARI-related utilization and mortality in pediatric patients with LTMV, evaluating the association of a pre-existing neurologic diagnoses with outcomes.</p><p><strong>Methods: </strong>We studied a longitudinal retrospective cohort across 40 U.S. children's hospital emergency department (ED) and hospital encounters for patients (< 21 years) with LTMV and an ARI diagnosis code (10/1/2016-6/30/2023). We examined mortality and ED/hospital utilization outcomes, defining short-stay hospitalizations as ≤ 2 calendar days. We stratified analyses by high intensity neurologic impairment (HINI) using a validated coding algorithm.</p><p><strong>Results: </strong>We included 4866 patients (median age 4.5 years; 58.6% male) with LTMV and ≥ 1 ARI encounter. Most (95.1%) were hospitalized on their index encounter, and among those most received intensive care (71.7%). 4.1% died during the index hospitalization (5.3% with HINI vs. 1.3% without HINI, p < 0.001). Median hospital length of stay was 6 days (interquartile range 3-12). Short stay hospitalizations occurred in 16.9% overall but were as high as 26.6% in children without HINI. ED return visits within 1 year occurred in 60.7%; ARI was the most common reason (40.1%).</p><p><strong>Conclusions: </strong>Pediatric patients using LTMV presenting for ED care with ARI are almost always hospitalized, usually in an intensive care setting. Overall, outcomes were poorer for those with HINI than those without HINI. More precision is needed to align resources with illness severity and comorbidities to improve ARI outcomes.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71026"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557593","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":"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":"https://doi.org/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":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway Anomalies Predict Risk of Pediatric Pulmonary Hypertension.","authors":"Elana R Kriegel, Aditya Srinivasan, Luke Mammen, Harini Venkataganesh, Jess T Randall, Lara Reichert","doi":"10.1002/ppul.71028","DOIUrl":"https://doi.org/10.1002/ppul.71028","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric pulmonary hypertension (PH) significantly contributes to morbidity and mortality due to the progressive nature of the disease in some subtypes, which leads to severe right heart failure, impaired oxygenation, and subsequent complications of chronic hypoxia, and side effects of long-term therapies. Associations between PH and airway anomalies in pediatric patients are complex and multifactorial. Better understanding of these associations will help identify which patients should receive screening for PH by multidisciplinary care teams (pediatric otolaryngology, cardiology, pulmonology).</p><p><strong>Methods: </strong>A retrospective, observational, single institution, cross-sectional study was performed using inpatient and emergency department visit records and operating room reports from January 2021 to January 2023 of pediatric patients. Odds ratios and logistic regression were used to determine the association between PH and other cardiopulmonary anomalies.</p><p><strong>Results: </strong>PH was associated with cardiac and airway anomalies (Odds ratio, 95% CI; 3.26, 1.01-10.5, p < 0.05; Logistic Regression, pseudo-R² = 0.440, p < 0.01), especially bronchopulmonary dysplasia (BPD), atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), chronic lung disease/respiratory failure (CLD), and Down Syndrome (DS).</p><p><strong>Conclusion: </strong>Our findings demonstrate PH is highly co-morbid with other cardiopulmonary anomalies and provide an estimate of the risk of having a concurrent congenital disease and PH. Patients with multiple comorbidities are at high risk for developing PH and should receive screening for PH via coordinated care by multidisciplinary care teams. Our results, with further quantification at other sites, could help further development of PH screening guidelines.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71028"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658045","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 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":"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}