Childhood community-acquired pneumonia: a review of etiology- and antimicrobial treatment studies
Community acquired pneumonia (CAP) is a leading cause of childhood morbidity worldwide. Because of the rising antimicrobial resistance rates and adverse effects of childhood antibiotic use on the developing microbiome, rational prescribing of antibiotics for CAP is important. This review summarizes and critically reflects on the available evidence for the epidemiology, etiology and antimicrobial management of childhood CAP. Larger prospective studies on antimicrobial management derive mostly from low- or middle-income countries as they have the highest burden of CAP. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - July 14, 2017 Category: Respiratory Medicine Authors: Gerdien A. Tramper-Stranders Tags: Review Source Type: research
Oscillating devices for airway clearance in people with cystic fibrosis
Cystic fibrosis (CF) is a common inherited life-limiting genetic disorder in which mucus hypersecretion within the airways leads to airway obstruction and mucus plugging[2]. Airway damage and the progressive loss of respiratory function is a consequence of persistent infection and inflammation within the lungs[3,4]. As respiratory infections are the most common cause of morbidity and mortality, chest physiotherapy in the form of breathing exercises or adjunctive devices is the mainstay of therapies to keep the lungs as free from mucus as possible. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - July 13, 2017 Category: Respiratory Medicine Authors: L. Morrison, S. Milroy Source Type: research
Bronchial hyper-responsiveness after preterm birth
Being born preterm often adversely affects later lung function. Airway obstruction and bronchial hyperresponsiveness (BHR) are common findings. Respiratory symptoms in asthma and in lung disease after preterm birth might appear similar, but clinical experience and studies indicate that symptoms secondary to preterm birth reflect a separate disease entity.BHR is a defining feature of asthma, but can also be found in other lung disorders and in subjects without respiratory symptoms. We review different methods to assess BHR, and findings reported from studies that have investigated BHR after preterm birth. (Source: Paediatri...
Source: Paediatric Respiratory Reviews - June 19, 2017 Category: Respiratory Medicine Authors: Hege H. Clemm, Merete Engeseth, Maria Volls æter, Sailesh Kotecha, Thomas Halvorsen Tags: Review Source Type: research
Treatment of narcolepsy and other organic hypersomnias in children
The comprehensive management of chronic disorders such as hypersomnias of childhood requires combining life-style changes with rational pharmacotherapy that is based on treating the symptoms that are most bothersome, the age, comorbidities, and metabolic and endocrine status of the patient. The excessive sleepiness of narcolepsy and idiopathic hypersomnia is best treated with dextroamphetamine or methylphenidate preparations or modafinil / armodafinil. Cataplexy treatment requires sodium oxybate, tricyclic agents, selective norepinephrine reuptake inhibitors or selective serotonin reuptake inhibitors. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - June 19, 2017 Category: Respiratory Medicine Authors: Suresh Kotagal Tags: Mini-symposium Source Type: research
Presentations from the Edwin L. Kendig Jr. Pediatric Pulmonary Symposium, Richmond Virginia May 25, 2017
Richmond Virginia is, in a way, like the chairs that Goldilocks sits on in the fairy tale. It is not too big, or too small, but just right, at least as it pertains to the development of medical care for children with chest disorders, as they were called when Dr. Edwin Kendig Jr. augmented his primary pediatric practice with a weekly chest clinic beginning in the mid 1940 ’s. The region and its medical needs were large enough that one very observant, disciplined and curious individual could see, care for, describe and study everything in the field over a fifty year career. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - June 16, 2017 Category: Respiratory Medicine Authors: Henry J. Rozycki Tags: Editorial Source Type: research
Childhood Severe Asthma: New Insights on Remodelling and Biomarkers
Severe asthma in children is characterised by severe and multiple aeroallergen sensitisation, food allergy, eosinophilic airway inflammation and airway remodelling. However, it is a heterogeneous disease with considerable variability in the manifestation of each of these characteristics between patients. Recent data from mechanistic studies that have used translational approaches including neonatal mouse models and airway bronchoscopic samples, have shown specific molecular mediators that drive remodelling and steroid resistance in paediatric severe asthma will be discussed. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - June 14, 2017 Category: Respiratory Medicine Authors: Sejal Saglani Tags: Mini-symposium Source Type: research
Comparing Effectiveness and Outcomes in Asthma and Cystic Fibrosis
As technology yields new treatments, pediatric pulmonologists need determine how best to use them and how to decide which ones are best for any specific group or individual patient. Physicians have always customized therapies based upon patient response, but the new concept of “Personalized (or precision) medicine” focuses attention to a greater degree on the individual needs of patients based on their genetic, biomarker, phenotypic, or psychosocial characteristics. The newly developed biologics for treatment of asthma and CFTR modulators for treatment of cystic fibro sis (CF) highlight this newer approach. (Source: Pa...
Source: Paediatric Respiratory Reviews - June 14, 2017 Category: Respiratory Medicine Authors: Michael S. Schechter Tags: Mini-symposium Source Type: research
Update on Pathophysiology and Treatment of Childhood Obstructive Sleep Apnea Syndrome
Obstructive sleep apnea syndrome (OSAS) is common in childhood and is characterized by recurrent upper airway obstructive events during sleep that produce significant neurocognitive and cardiovascular sequelae. The pathophysiology of childhood OSAS is complex and involves mechanical airway obstruction often secondary to adenotonsillar hypertrophy. However, neuromotor abnormalities and instability of central ventilatory control are also implicated. Several surgical and non-surgical treatment options for childhood OSAS are available, and will be discussed. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - June 14, 2017 Category: Respiratory Medicine Authors: Justin C. Brockbank Tags: Mini-symposium Source Type: research
Cystic Fibrosis: Priorities and Progress for Future Therapies
Significant improvement in the survival of patients with CF has been achieved in the last decades. The improved clinical status of the patients is mainly the result of a better understanding of the natural course of infection and inflammation in CF that has led to the implementation of strategies that increase the life expectancy and quality of life of the patients. These strategies include prompt diagnosis, timely and aggressive nutritional support, augmentation of MCC and improved mucous drainage, initiation of antimicrobial and anti-inflammatory therapy as soon as possible, early treatment of acute exacerbations, implem...
Source: Paediatric Respiratory Reviews - June 14, 2017 Category: Respiratory Medicine Authors: Eitan Kerem Tags: Mini-symposium Source Type: research
Movement
Primary ciliary dyskinesia is an inherited disease characterized by impaired ciliary function leading to diverse clinical manifestations, including chronic sinopulmonary disease, persistent middle ear effusions, laterality defects, and infertility. Our understanding of the complex genetics and functional phenotypes of primary ciliary dyskinesia has rapidly grown, and over 35 disease-associated genes have been identified, which segregate into genes that encode axonemal motor proteins, regulatory proteins within the cilium, and cytoplasmic proteins involved in ciliary assembly. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - June 14, 2017 Category: Respiratory Medicine Authors: Thomas Ferkol Tags: Mini-symposium Source Type: research
“New” Bronchopulmonary Dysplasia and Chronic Lung Disease
Bronchopulmonary dysplasia (BPD) is the major cause of chronic lung disease and morbidity in preterm infants. Since it was first described fifty years ago, the epidemiology, pathogenesis, and treatment for BPD has changed dramatically. This review summarizes these changes and the clinical outcomes for infants diagnosed with BPD. (Source: Paediatric Respiratory Reviews)
Source: Paediatric Respiratory Reviews - June 14, 2017 Category: Respiratory Medicine Authors: Judith A. Voynow Tags: Mini-symposium Source Type: research
Edwin Lawrence Kendig, Jr. MD DSc (hon) 1911 –2003
Edwin Kendig, MD is considered one of the founders of pediatric pulmonology. Prompted by his own experience with tuberculosis, he opened a ‘chest clinic’ for children, where he worked for 50years. He systematically published his observations and was the original editor of the first textbook in pediatric pulmonology in 1967. His book, now called Kendig and Chernick’s Disorders of the Respiratory Tract in Children will publish its 9th edition in 2018. All of this was in addition to his primary care pediatric practice, his teaching and his work at the national and international level of pediatric care. (Source: Paediatr...
Source: Paediatric Respiratory Reviews - June 11, 2017 Category: Respiratory Medicine Authors: Barry V. Kirkpatrick Tags: Mini-symposium: Kendig pediatric pulmonary symposium Source Type: research
Edwin Lawrence Kendig, Jr. MD DSc (hon) 1911-2003
Edwin Kendig, MD is considered one of the founders of pediatric pulmonology. Prompted by his own experience with tuberculosis, he opened a ‘chest clinic’ for children, where he worked for 40 years. He systematically published his observations and was the original editor of the first textbook in pediatric pulmonology in 1967. His book, now called Kendig and Chernick’s Disorders of the Respiratory Tract in Children will publish its 9th edition in 2018. All of this was in addition to his primary care pediatric practice, his teaching and his work at the national and international level of pediatric care. (Source: Paediat...
Source: Paediatric Respiratory Reviews - June 11, 2017 Category: Respiratory Medicine Authors: Barry V. Kirkpatrick Tags: Mini-symposium Source Type: research
The Weighty Issue of Obesity in Paediatric Respiratory Medicine
Some have observed that developed world is fat and getting fatter. This is even extending into the developing world, and it is important to appreciate that the consequences of childhood obesity last into adulthood and are associated with premature death. From the paediatric respiratory perspective, the deposition of excess adipose tissue in the thoraco-abdominal region begins early in life and is believed to alter diaphragm mobility and chest wall expansion, reduce lung compliance, and result in a rapid shallow breathing pattern with an increased work of breathing and reduction in maximum ventilatory capacity. (Source: Pae...
Source: Paediatric Respiratory Reviews - June 11, 2017 Category: Respiratory Medicine Authors: Dominic A. Fitzgerald Tags: Mini-symposium Source Type: research
