Journal of Pediatric Pulmonology最新文献

{"title":"Fleeting pneumonia in a child: Necrotizing sarcoid granulomatosis","authors":"RashmiRanjan Das, HariniChowdary Jaladi, KrishnaMohan Gulla, Pritinanda Mishra, BikashaBihary Tripathy, ManojKumar Mohanty","doi":"10.4103/jopp.jopp_39_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_39_23","url":null,"abstract":"An 8-year-old boy presented with history of recurrent fever, chest pain, and occasional dry cough since the age of 5 years. There was recent onset of oral aphthous ulcers without any breathlessness or activity limitation. His anthropometry parameters were preserved. He never required any oxygen support. Chest X-rays showed fleeting opacities involving left lung mainly and computed tomography showed necrotizing pneumonia of the left upper lobe. Open lung biopsy was suggestive of necrotizing sarcoid granulomatosis. Angiotensin converting enzyme (ACE) was elevated. He responded to steroid and was started on azathioprine in view of recurrence of symptoms following tapering of steroid. Currently, he is under follow-up with normal ACE level.","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135447617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of cell culture-derived influenza vaccines for children: A systematic review and meta-analysis","authors":"Meenu Singh, Kulbir Kaur, Meenakshi Sachdeva, Monika Rana, Anil Chauhan, Ragini Bhatia, Pranita Pradhan, Shivani Saini","doi":"10.4103/jopp.jopp_17_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_17_23","url":null,"abstract":"Objectives: The objective of the study was to evaluate whether cell culture-derived influenza vaccines are safe and effective in preventing influenza/flu in healthy children. Materials and Methods: Embase, PubMed, Cochrane, and clinical trials were searched. Fourteen randomized controlled trials in children were selected. The current systematic review was done as per the PRISMA guidelines. The pooled estimate of seroconversion and geometric mean titer (GMT) rate was calculated as mean difference. Data were analyzed using the Cochrane Collaboration Review Manager Version software. Risk of bias was done as per Cochrane risk of bias tool. The quality of evidence was adjudged using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) using the GRADEpro software (GRADEpro GDT [Computer program], Hamilton (ON), McMaster University (developed by Evidence Prime). Results: Significant results for efficacy were reported for half-dose MF59 influenza vaccine control group for GMT at day 1 with a mean difference of 0.78, 95% confidence interval (CI), 0.50–1.07, P < 0.00001, as compared to full-dose MF59 influenza vaccine experimental group. No significant results were reported in half-dose MF59 influenza vaccine for GMT at day 43 (mean difference: 151.57, 95% CI, −29.36–332.50, P = 0.10). Significant results were reported for seroconversion rate for half-dose MF59 influenza vaccine control group at day 22 with a mean difference of 17.92, 95% CI, 10.08–25.75, P < 0.00001. Conclusion: The current systematic review demonstrated that half-dose cell-derived influenza vaccines were well tolerated and more immunogenic and resulted in high seroconversion rate and GMT rate in pediatric population.","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135447905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergen immunotherapy practice in India","authors":"GayatriSubray Pandit, BV Balachandra","doi":"10.4103/jopp.jopp_27_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_27_23","url":null,"abstract":"Allergen immunotherapy (AIT) is the only “disease-modifying therapy,” i.e., available in the management of allergic disorders. The success of AIT depends on appropriate patient selection, allergen selection, as well as the quality of allergen extracts and compliance. Challenges that we face with immunotherapy practice in India are different from the Western world due to various causes discussed in this chapter.","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135447919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a need for transition of care for asthmatic adolescents in India? A physician-based survey and analysis","authors":"KR. Bharath Kumar Reddy, Sebastian Gray","doi":"10.4103/jopp.jopp_18_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_18_23","url":null,"abstract":"Background and Objective: Transition in a health-care context is defined as “the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from a child-centered to an adult-oriented health-care system.” Despite some countries and conditions having guidelines on the transition process, it can still be haphazard. A failure to optimally transfer ongoing medical care during this vulnerable period of adolescence increases the risk of lifelong worse health outcomes. Materials and Methods: This qualitative study was an online survey conducted through a predesigned response recorded system (Survey Monkey). The period of the study was from January to March 2022. Results: Of 320 doctors, we received responses from 212 (66.2%). Of these, 99 were pediatricians, and 113 were adult respiratory physicians. Of 99 pediatricians, 23% were exclusively trained in pediatric pulmonology. Around 94% of adult physicians were trained in respiratory medicine. There is an appetite for change and improvement. A majority of comments focused on joint working and collaboration between adult and pediatric pulmonologists. Stakeholder engagement involving all groups equally was found to be the need of the hour to formulate a guideline that both pediatricians and adult physicians are happy with. Conclusions: This study highlights the differences and similarities between pediatricians and adult physicians in their approach to asthma and the transition process. We hope this study will serve as the foundation to collaborate and co-produce with young people, national transition guidelines, improving the transition process and augmenting the health benefits for young people both acutely and longer term.","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135448181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pollution and child health","authors":"NK Kalappanavar","doi":"10.4103/jopp.jopp_49_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_49_23","url":null,"abstract":"Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year.[1,2] Ambient air pollution (AAP) alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.[3] Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines. More than one in every four deaths of children under 5 years of age is directly or indirectly related to environmental risks.[4] Both AAP and household air pollution contribute to respiratory tract infections that resulted in 543,000 deaths in children under 5 years of age in 2016.[1] It is estimated that, by 2030, climate change will be responsible for 250,000 deaths each year.[5] As many of the same pollutants that threaten health, such as black carbon and ozone (O3), are also the important agents of atmospheric warming, interventions that reduce their emissions are likely to result in benefits for both children’s health and the climate. We must seize this opportunity to create healthy, sustainable environments for our children. Everyone has a role to play, at every level: individuals, families, pediatricians, family doctors, nurses, obstetricians and gynecologists, primary health-care providers and other community workers, communities, medical students, national governments, and international agencies. Pollution can also be classified into indoor air pollution (indoor air pollution is the degradation of indoor air quality by harmful chemicals and other materials. It can be up to 10 times worse than outdoor air pollution because contained areas enable potential pollutants to build up more than open spaces) and outdoor pollutions (outdoor pollution primarily results from the combustion of fossil fuels by industrial plants and vehicles. This releases carbon monoxide (CO), sulfur dioxide (S02), particulate matter, nitrogen oxides, hydrocarbons, and other pollutants). The measurement of air quality is based on eight pollutants: particulate matter (size <10 pm), particulate matter (size <2.5 pm), nitrogen dioxide, S02, CO, O3, ammonia (NH3), and lead (Pb). The air quality index values and their associated health impacts for outdoor activities: good (0–50), satisfactory (51–100), moderate (101–200), poor (201–300), very poor (301–400), and severe (401–500). The common clinical manifestations of environmental pollution in children are new-onset asthma, bronchitis, deficits of lung growth, respiratory infections, eczema, and behavioral disorders. Simple measures to safeguard our children are as follows: At home: Keep your home as clean as possible. Dust, mold, pests, secondhand smoke, dust from soft toys, woolen rugs and pets, and dander can trigger asthma attacks and","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135448182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The current scope of pediatric pulmonology in India","authors":"BhagwanSahai Sharma","doi":"10.4103/jopp.jopp_44_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_44_23","url":null,"abstract":"Pediatric respiratory diseases are one of the most common reasons for which children visit hospitals for care. They range from simple viral upper respiratory tract infections to complex diseases, namely cystic fibrosis, interstitial lung diseases, and complex airway problem. In contrast to other organ systems, the lungs are directly exposed to the environment, making them susceptible to various diseases, including infections, toxins, allergens, and extreme temperatures. The disease patterns in infants and children are entirely different as compared to adults due to rapidly growing lungs. The damage in the lung during early life makes an individual susceptible to lung diseases in adults. Therefore, it is of paramount importance to understand the physiology of the lungs in children.[1,2] Pediatric pulmonology encompasses a wide variety of practice options, from acute respiratory failure in the neonatal or pediatric intensive care unit to long-term care of patients with chronic respiratory disorders. Pediatric pulmonologists may provide facilities for procedures, such as flexible fiber-optic bronchoscopy. They can also provide facilities for pulmonary investigations, including spirometry, impulse oscillometry, sweat chloride, and fractional exhalation of nitric oxide. With the increased number of sleep-related breathing disorders in children, pediatric pulmonologists may include sleep medicine as an important part of their practice. Most general pediatricians see a lot of respiratory diseases in children; however, they are not able to understand rare and complex diseases. In addition, general pediatricians require updates for the management of common respiratory diseases.[3] The Indian Academy of Pediatrics National Respiratory Chapter (IAPNRC) is the most dynamic and fastest-growing subchapter of the IAP. The IAPNRC is actively involved in enriching and expanding the knowledge and practice in the field of pediatric respiratory medicine across the country. The IAPNRC has developed numerous training modules. These module-based training programs have helped to improve the care of children with a wide range of respiratory problems. The IAPNRC also took the initiative to develop India-specific guidelines to treat common respiratory problems, including asthma, acute respiratory infections, and tuberculosis. Recently, IAPNRC has published evidence-based guidelines on the management of asthma with allergic bronchopulmonary aspergillosis.[4] The IAPNRC started a fellowship program in pediatric pulmonology last year to cater to the increase in the need for pediatric pulmonologists. Currently, ten centers are offering fellowships in pediatric pulmonology. This year the entrance examination for fellowship was successfully conducted in the month of May. A good number of postgraduate students across the country participated in the entrance examination, which shows the growing interest in pediatric pulmonology. Currently, five Institutes of National Importance ar","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"139 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135750614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which steroid regimen (low dose or high dose) should be used for the treatment of allergic bronchopulmonary aspergillosis in children with asthma? A systematic review of literature and evidence-based guideline recommendation","authors":"JosephL Mathew, Pallab Chatterjee, Hema Mittal, Sonia Bhatt, RashmiRanjan Das, SanjivSingh Rawat","doi":"10.4103/jopp.jopp_34_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_34_23","url":null,"abstract":"Background: Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder caused by immunological response to Aspergillus fumigatus antigen. Untreated patients develop recurrent exacerbations of respiratory symptoms, bronchiectasis, and even respiratory failure. Oral glucocorticoids are currently the mainstay of treatment in acute ABPA and prednisolone is the most commonly used medication. Different regimes have been used for treating ABPA. Objective: This systematic review was undertaken to identify the most appropriate steroid treatment regimen for acute ABPA in children with asthma, by comparing the efficacy and safety of lower dose vs. higher dose; in order to develop an evidence-based recommendation. Methods: We undertook a comprehensive literature search for high quality guidelines addressing the issue. Finding none, we conducted a systematic review of randomized controlled trials (RCTs) to compare low dose versus high dose steroid regimens for the treatment of ABPA in children with asthma. Results: We identified one randomized controlled trial addressing the review question. However, it was conducted in adult patients. It showed no statistically significant difference in efficacy between low dose vs high dose regimens; however, adverse effects were more frequent with higher doses and duration. The available evidence was graded as ‘very low certainty’ due to methodological limitations. Conclusions: We recommend using low dose steroid therapy regimen (0.5 mg/kg/day for the first 2 weeks, followed by a progressive tapering) for treatment of ABPA in children with asthma (conditional recommendation, very low certainty of evidence). Larger studies are urgently needed to identify the optimal regimen for treating children with asthma having ABPA.","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135750272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro Diagnosis of allergic diseases","authors":"SowmyaArudi Nagarajan, SuneelaH Nayak","doi":"10.4103/jopp.jopp_47_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_47_23","url":null,"abstract":"Allergic diseases are on the rise, and it is important to diagnose them accurately for proper management. A thorough clinical history, augmented by appropriate tests, will help optimize treatment in patients with allergic diseases. Hence, it is important for clinicians to have background knowledge of the spectrum of tests available for the diagnosis of allergic diseases.","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135447601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should antifungal agents be prescribed to asthmatic children with ABPA? A systematic review and evidence-based guideline recommendation","authors":"JosephL Mathew, Shetanshu Srivastava, Rashmi Kapoor, Somu Sivabalan, Pawan Kalyan, Sanjay Bafna, Hardeep Kaur","doi":"10.4103/jopp.jopp_30_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_30_23","url":null,"abstract":"Background: Allergic bronchopulmonary aspergillosis (ABPA) is a complication of bronchial asthma. Many physicians routinely administer antifungal agents along with corticosteroids to children with ABPA, based on a few adult studies. Objective: We examined the evidence on efficacy and safety of antifungal agents in asthmatic patients with ABPA, to develop a guideline recommendation. Methods: Our research question was: What is the efficacy of antifungal agents in asthmatic children with ABPA, on various clinical outcomes? We conducted a systematic review (SR), with a stepwise evidence search for any preexisting guidelines whose recommendations could be adopted or adapted; followed by a search for existing SRs, followed by randomized controlled trials (RCTs). The evidence was collated, critically appraised, and synthesized. We then worked through the Evidence to Decision (EtD) framework, to formulate recommendations, using the Grading of Recommendations Assessment, Development and Evaluation approach. Results: There were no preexisting evidence-based guidelines or SRs addressing our question. Our new SR identified five RCTs in adults. These, had different designs, were limited in methodological quality, and examined different interventions. The body of evidence suggested that antifungal agents alone may not be efficacious in adults with ABPA. The certainty of evidence had to be downgraded for methodological limitations and indirectness for almost all outcomes in the five trials. Based on the considerations in the EtD framework, we were unable to formulate an evidence-based recommendation, either in favor of, or against, the intervention. Therefore, individual clinicians need not consider a change in their existing practice, i.e., those using antifungals may continue to do so and vice versa (until additional evidence becomes available). Conclusion: We offer a conditional recommendation that antifungal agents may or may not be added to steroid therapy in asthmatic children with ABPA (low certainty of evidence).","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135750607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Present and future of allergy practice in India","authors":"Saibal Moitra, ShamboS Samajdar","doi":"10.4103/jopp.jopp_40_23","DOIUrl":"https://doi.org/10.4103/jopp.jopp_40_23","url":null,"abstract":"Allergy is an immune-mediated disorder that affects millions of people worldwide. In India, the prevalence of allergies has been increasing rapidly, affecting individuals of all ages and socioeconomic backgrounds. Allergy practice in India is currently evolving, and there are several promising developments on the horizon. The prevalence of allergies is expected to increase in the coming years, making it more important than ever to improve allergy management in India. The future of allergy in India looks promising but requires significant efforts in various areas, including improving awareness and diagnosis, advancing allergen immunotherapy, developing pollen calendars, implementing training programs, and exploring new therapies. It is crucial to address the challenges faced in allergy management and work toward developing a more comprehensive approach for the diagnosis, treatment, and management of allergic diseases in India. With better research, collaboration, and innovation, there is a good chance to improve the quality of life for millions of people affected by allergies in India. In this review, we will discuss the current state of allergy practice in India, as well as future directions and potential advancements.","PeriodicalId":473926,"journal":{"name":"Journal of Pediatric Pulmonology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135447918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}