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RESPIRATORY DISEASES (103 journals)                     

Showing 1 - 104 of 104 Journals sorted alphabetically
Advances in Respiratory Medicine     Open Access   (Followers: 7)
Advances in Thoracic Diseases     Open Access  
American Journal of Respiratory and Critical Care Medicine     Full-text available via subscription   (Followers: 257)
American Journal of Respiratory Cell and Molecular Biology     Full-text available via subscription   (Followers: 20)
American Review of Respiratory Disease     Full-text available via subscription   (Followers: 4)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 17)
Annals of Thoracic Medicine     Open Access   (Followers: 6)
Archives of Pulmonology and Respiratory Care     Open Access   (Followers: 1)
Archivos de Bronconeumología     Full-text available via subscription  
Archivos de Bronconeumología (English Edition)     Full-text available via subscription   (Followers: 1)
Asthma Research and Practice     Open Access   (Followers: 1)
BMC Pulmonary Medicine     Open Access   (Followers: 5)
BMJ Open Respiratory Research     Open Access   (Followers: 6)
Breathe     Open Access   (Followers: 4)
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal   (Followers: 1)
Canadian Respiratory Journal     Open Access   (Followers: 3)
Case Reports in Pulmonology     Open Access   (Followers: 3)
Chest     Full-text available via subscription   (Followers: 102)
Chest Disease Reports     Open Access   (Followers: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 9)
Clinical Lung Cancer     Hybrid Journal   (Followers: 6)
Clinical Medicine Insights : Circulatory, Respiratory and Pulmonary Medicine     Open Access   (Followers: 3)
Clinical Pulmonary Medicine     Hybrid Journal   (Followers: 2)
COPD Research and Practice     Open Access   (Followers: 1)
COPD: Journal of Chronic Obstructive Pulmonary Disease     Hybrid Journal   (Followers: 15)
Current Opinion in Pulmonary Medicine     Hybrid Journal   (Followers: 10)
Current Pulmonology Reports     Hybrid Journal  
Current Research in Tuberculosis     Open Access   (Followers: 3)
Current Respiratory Care Reports     Hybrid Journal   (Followers: 1)
Current Respiratory Medicine Reviews     Hybrid Journal   (Followers: 5)
Der Pneumologe     Hybrid Journal   (Followers: 1)
Egyptian Journal of Chest Diseases and Tuberculosis     Open Access   (Followers: 3)
ERJ Open Research     Open Access   (Followers: 3)
Eurasian Journal of Pulmonology     Open Access  
European Clinical Respiratory Journal     Open Access   (Followers: 3)
European Respiratory Journal     Full-text available via subscription   (Followers: 39)
European Respiratory Review     Open Access   (Followers: 7)
Experimental Lung Research     Hybrid Journal  
Expert Review of Respiratory Medicine     Hybrid Journal   (Followers: 5)
Heart & Lung: The Journal of Acute and Critical Care     Hybrid Journal   (Followers: 13)
Heart, Lung and Circulation     Full-text available via subscription   (Followers: 9)
Indian Journal of Respiratory Care     Open Access   (Followers: 3)
Indian Journal of Tuberculosis     Full-text available via subscription  
Influenza and Other Respiratory Viruses     Open Access   (Followers: 3)
International Journal of Chronic Obstructive Pulmonary Disease     Open Access   (Followers: 3)
Journal of Association of Chest Physicians     Open Access   (Followers: 2)
Journal of Asthma     Hybrid Journal   (Followers: 4)
Journal of Asthma Allergy Educators     Hybrid Journal   (Followers: 4)
Journal of Bronchology & Interventional Pulmonology     Hybrid Journal   (Followers: 4)
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases     Open Access  
Journal of Heart and Lung Transplantation     Hybrid Journal   (Followers: 12)
Journal of Respiratory Medicine     Open Access   (Followers: 4)
Journal of Respiratory Research     Open Access   (Followers: 1)
Journal of Tuberculosis Research     Open Access   (Followers: 1)
Jurnal Respirasi     Open Access  
Karger Kompass Pneumologie     Full-text available via subscription   (Followers: 1)
Kindheit und Entwicklung     Hybrid Journal  
Lung     Hybrid Journal   (Followers: 2)
Lung Cancer     Hybrid Journal   (Followers: 16)
Lung Cancer International     Open Access   (Followers: 2)
Lung Cancer: Targets and Therapy     Open Access   (Followers: 3)
Lung India     Open Access   (Followers: 1)
Multidisciplinary Respiratory Medicine     Open Access   (Followers: 4)
npj Primary Care Respiratory Medicine     Open Access   (Followers: 2)
Open Journal of Respiratory Diseases     Open Access   (Followers: 1)
Open Respiratory Medicine Journal     Open Access   (Followers: 1)
Paediatric Respiratory Reviews     Hybrid Journal   (Followers: 11)
Pediatric Quality & Safety     Open Access  
Pediatric Respirology and Critical Care Medicine     Open Access   (Followers: 1)
Pulmonary Circulation     Open Access   (Followers: 4)
Pulmonary Medicine     Open Access   (Followers: 2)
Pulmonary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 2)
Pulmonary Therapy     Open Access   (Followers: 1)
Pulmonology and Respiratory Research     Open Access   (Followers: 1)
Respiratory Care     Full-text available via subscription   (Followers: 10)
Respiratory Investigation     Full-text available via subscription  
Respiratory Medicine     Hybrid Journal   (Followers: 18)
Respiratory Medicine : X     Open Access  
Respiratory Medicine Case Reports     Open Access  
Respiratory Medicine CME     Hybrid Journal  
Respiratory Medicine Extra     Full-text available via subscription   (Followers: 1)
Respiratory Physiology & Neurobiology     Hybrid Journal   (Followers: 4)
Respiratory Research     Open Access   (Followers: 1)
Respirology     Hybrid Journal   (Followers: 5)
Respirology Case Reports     Open Access  
Revista Americana de Medicina Respiratoria     Open Access  
Revista Chilena de Enfermedades Respiratorias     Open Access  
Revista Inspirar     Open Access  
Revista ORL     Open Access  
Revista Portuguesa de Pneumologia     Open Access  
Sarcoidosis Vasculitis and Diffuse Lung Disese     Full-text available via subscription   (Followers: 3)
Seminars in Respiratory and Critical Care Medicine     Hybrid Journal   (Followers: 14)
Sleep Medicine Reviews     Hybrid Journal   (Followers: 17)
The Clinical Respiratory Journal     Hybrid Journal   (Followers: 3)
The International Journal of Tuberculosis and Lung Disease     Full-text available via subscription   (Followers: 8)
The Lancet Respiratory Medicine     Full-text available via subscription   (Followers: 35)
Therapeutic Advances in Chronic Disease     Open Access   (Followers: 7)
Therapeutic Advances in Respiratory Disease     Open Access   (Followers: 1)
Thorax     Hybrid Journal   (Followers: 38)
Translational Respiratory Medicine     Open Access   (Followers: 1)
Tuberculosis     Hybrid Journal   (Followers: 12)
Tuberculosis Research and Treatment     Open Access   (Followers: 3)
Пульмонология     Full-text available via subscription  


Similar Journals
Journal Cover
Paediatric Respiratory Reviews
Journal Prestige (SJR): 0.761
Citation Impact (citeScore): 2
Number of Followers: 11  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1526-0542 - ISSN (Online) 1526-0550
Published by Elsevier Homepage  [3204 journals]
  • Redesign of the Australian Cystic Fibrosis Data Registry: a
           multidisciplinary collaboration
    • Abstract: Publication date: Available online 26 March 2020Source: Paediatric Respiratory ReviewsAuthor(s): Susannah Ahern, Joanne Dean, John Liman, Rasa Ruseckaite, Nettie Burke, Morgan Gollan, Lucy Keatley, Susannah King, Tom Kotsimbos, Peter Middleton, Andre Schultz, Claire Wainwright, Peter Wark, Scott Bell
  • Cochrane corner: Anti-inflammatory medications for the treatment of
           pediatric obstructive sleep apnea
    • Abstract: Publication date: Available online 10 March 2020Source: Paediatric Respiratory ReviewsAuthor(s): Stefan Kuhle, Michael S. Urschitz
  • Contribution of systemic and airway immune responses to pediatric
           obesity-related asthma
    • Abstract: Publication date: Available online 6 March 2020Source: Paediatric Respiratory ReviewsAuthor(s): Laura Chen, Kayla Collado, Deepa Rastogi
  • Weight loss in obese children with asthma - is it important'
    • Abstract: Publication date: Available online 6 March 2020Source: Paediatric Respiratory ReviewsAuthor(s): Rebecca F. McLoughlin, Bronwyn S. Berthon, Lisa G. Wood
  • Preventing Tuberculosis in Children: A Global Health Emergency
    • Abstract: Publication date: Available online 5 March 2020Source: Paediatric Respiratory ReviewsAuthor(s): Anja Reuter, James A Seddon, Ben J Marais, Jennifer Furin
  • Editorial for mini-symposium: Sleep disordered breathing in children:
           Indications, interpretation and implications
    • Abstract: Publication date: Available online 4 March 2020Source: Paediatric Respiratory ReviewsAuthor(s): Dominic A. Fitzgerald
  • Utility of bronchoscopy in immunocompromised paediatric patients:
           Systematic Review
    • Abstract: Publication date: Available online 29 February 2020Source: Paediatric Respiratory ReviewsAuthor(s): Kate Gonski, Richard Cohn, John Widger, Brendan McMullan
  • Tuberculosis treatment in children: the changing landscape
    • Abstract: Publication date: Available online 26 February 2020Source: Paediatric Respiratory ReviewsAuthor(s): Julie Huynh, Guy Thwaites, Ben J Marais, H Simon Schaaf
  • A systematic review of asthma case definitions in 67 birth cohort studies
    • Abstract: Publication date: Available online 21 February 2020Source: Paediatric Respiratory ReviewsAuthor(s): Andrew Dubovyi, Carol Chelimo, William Schierding, Yuriy Bisyuk, Carlos A. Camargo, Cameron C. Grant
  • Clinical papers of the year 2018 – Cystic fibrosis
    • Abstract: Publication date: February 2020Source: Paediatric Respiratory Reviews, Volume 33Author(s): I.M. Balfour-Lynn
  • Exogenous lipoid pneumonia in children: A systematic review
    • Abstract: Publication date: February 2020Source: Paediatric Respiratory Reviews, Volume 33Author(s): Diana Marangu, Diane Gray, Aneesa Vanker, Marco Zampoli
  • Bronchopulmonary dysplasia: Rationale for a pathophysiological rather than
           treatment based approach to diagnosis
    • Abstract: Publication date: November 2019Source: Paediatric Respiratory Reviews, Volume 32Author(s): Benjamin Stoecklin, Shannon J. Simpson, J. Jane Pillow
  • QuantiFERON-TB Gold In-Tube test performance in a large pediatric
           population investigated for suspected tuberculosis infection
    • Abstract: Publication date: November 2019Source: Paediatric Respiratory Reviews, Volume 32Author(s): Elena Chiappini, Flavio Storelli, Chiara Tersigni, Elisabetta Venturini, Maurizio de Martino, Luisa Galli
  • Saline nasal irrigation for acute upper respiratory tract infections in
           infants and children: a systematic review and meta-analysis
    • Abstract: Publication date: Available online 21 February 2020Source: Paediatric Respiratory ReviewsAuthor(s): Aurélie Cabaillot, Philippe Vorilhon, Mathieu Roca, Rémy Boussageon, Bénédicte Eschalier, Bruno Pereira PurposeAcute upper respiratory tract infections are the most common infections in infants and children. Saline nasal irrigation (SNI) is widely prescribed and recommended. We conducted a systematic review to assess the efficacy and safety of SNI in infants and children with acute rhinopharyngitis.MethodsWe searched CENTRAL, Medline, Embase and Two authors selected randomized control trials (RCTs), including infants ≥ 3 months and children ≤ 12 years, comparing the use of isotonic saline solutions, whatever their mode of administration, with one therapeutic abstention, or a therapy deemed less important for nasal lavage. Trial quality was assessed independently by two authors, who, with a third author, extracted and analysed data. Statistical analysis was conducted using Comprehensive Meta-Analysis software. The standard difference in means (SMD) between groups and its 95% confidence interval were estimated.ResultsFour RCTs (569 participants) were included. The analysis showed a benefit of SNI for certain clinical rhinological symptoms (SMD = –0.29 [–0.45; –0.13]) but no significant improvement of respiratory symptoms (SMD= –0.19 [–0.70; 1.08]) or health status (SMD = –0.30 [–0.68; 0.07]). Its use appeared to limit the prescription of other treatments, whether local or systemic, and particularly antibiotics. Long-term use led to a decrease in the incidence of acute rhinosinusitis and its complications. SNI appeared to be a safe treatment.ConclusionsSNI is beneficial for rhinological symptoms but not respiratory symptoms. Further research is needed to address the full benefits/risks of this treatment.
  • A clinical guideline for structured assessment of ct-imaging in congenital
           lung abnormalities
    • Abstract: Publication date: Available online 20 February 2020Source: Paediatric Respiratory ReviewsAuthor(s): Sergei M. Hermelijn, Bernadette B.L.J. Elders, Pierluigi Ciet, René M.H. Wijnen, Harm A.W.M. Tiddens, J. Marco Schnater ObjectivesTo develop a clinical guideline for structured assessment and uniform reporting of congenital lung abnormalities (CLA) on Computed Tomography (CT)-scans.Materials and MethodsA systematic literature search was conducted for articles describing CT-scan abnormalities of congenital pulmonary airway malformation (CPAM), bronchopulmonary sequestration (BPS), congenital lobar emphysema (CLE) and bronchogenic cyst (BC). A structured report using objective features of CLA was developed after consensus between a paediatric pulmonologist, radiologist and surgeon.ResultsOf 1581 articles identified, 158 remained after title-abstract screening by two independent reviewers. After assessing full-texts, we included 28 retrospective cohort-studies.Air-containing cysts and soft tissue masses are described in both CPAM and BPS while anomalous arterial blood supply is only found in BPS. Perilesional low-attenuation areas, atelectasis and mediastinal shift may be found in all aforementioned abnormalities and can also be seen in CLE as a cause of a hyperinflated lobe. We have developed a structured report, subdivided into five sections: Location & Extent, Airway, Lesion, Vascularization and Surrounding tissue.ConclusionsCT-imaging findings in CLA are broad and nomenclature is variable. Overlap is seen between and within abnormalities, possibly due to definitions often being based on pathological findings, which is an unsuitable approach for CT imaging. We propose a structured assessment of CLA using objective radiological features and uniform nomenclature to improve reporting.
  • Economic burden of childhood asthma in children attending a follow-up
           clinic in a resource-poor setting of southeast nigeria
    • Abstract: Publication date: Available online 19 February 2020Source: Paediatric Respiratory ReviewsAuthor(s): Ughasoro D. Maduka, Eze N. Joy, Ayuk C. Adaeze, Obumneme-Anyim Ijeoma, Akubuilo Uzoamaka, Oguonu Tagbo BackgroundBeyond its chronicity, childhood asthma carries an economic burden for households. In this study we evaluated the cost of care of childhood asthma in a Nigerian household.MethodsA cross-sectional hospital-based study. Relevant information was obtained through an interviewer-administered questionnaire. The cost of asthma treatment was estimated using direct medical costs and loss in productivity. Data analysis was done with SPSS version 22. A significant value of p < 0.05 was used.ResultsSixty-six participants were enrolled, mean ±SD age (11.6 ±)The average direct cost was USD10.35. , The cost of drug was USD5.8 and accounted for 56% of the direct cost. The loss in productivity was USD16.73. The mean cost per clinic visit was USD27.08, which. was catastrophic in 12 (18.2%) households. The calculated annual cost of asthma treatment was USD162.49, with a cumulative national cost of USD 0.16 billion, which makes up 0.002% of the national GDP.ConclusionThe cost burden of asthma treatment may be low on the households but carries a huge national cost impact. We recommend the inclusion of asthma care in the Nigerian social health insurance as this may help reduce the financial burden due to asthma.
  • Journey towards a personalised medicine approach for OSA: Can a similar
           approach to adult OSA be applied to paediatric OSA'
    • Abstract: Publication date: Available online 14 February 2020Source: Paediatric Respiratory ReviewsAuthor(s): Leon S. Siriwardhana, Gillian M. Nixon, Rosemary S.C. Horne, Bradley A. Edwards The concept of personalised medicine is likely to revolutionise the treatment of adult obstructive sleep apnoea as a result of recent advances in the understanding of disease heterogeneity by identifying clinical phenotypes, pathophysiological endotypes, biomarkers and treatable traits. Children with the condition show a similar level of heterogeneity and paediatric obstructive sleep apnoea would also benefit from a more targeted approach to diagnosis and management. This review aims to summarise the adult literature on the phenotypes and endotypes of obstructive sleep apnoea and assess whether a similar approach may also be suitable to guide the development of new diagnostic and management approaches for paediatric obstructive sleep apnoea.
  • Tuberculosis in pregnant women and neonates: A meta-review of current
    • Abstract: Publication date: Available online 14 February 2020Source: Paediatric Respiratory ReviewsAuthor(s): Snow K.J., Bekker A., Huang G.K., Graham S.M. Pregnant women and their infants are a vulnerable but neglected population in tuberculosis (TB) control efforts. Recent advances in TB prevention, diagnosis and treatment have implications for their care, despite their frequent exclusion from research. We have conducted a meta-review of current evidence and clinical guidelines for TB prevention, diagnosis and management in pregnant women and neonates, focusing on review articles published since 2010.The actual burden of pregnancy-related TB is unmeasured, but has been estimated at 216,500 cases per year. Although the effect of pregnancy on TB risk is uncertain and controversial, two large whole-of-population studies found that pregnancy was associated with a two- to three-fold increase in risk of TB. Congenital TB is rare but extremely serious. Neonates exposed to TB after delivery will be at high risk of disease, and preventive therapy is recommended once disease has been ruled out. At present, there is limited evidence regarding the performance of different screening strategies for pregnant women, appropriate drug dosing for either pregnant women or neonates, and the safety of most second-line drugs in pregnancy. High quality evidence on these topics is needed, as are detailed guidelines to inform efforts by TB control programs and clinicians working with pregnant women and their infants.
  • Expert consensus on palivizumab use for respiratory syncytial virus in
           developed countries
    • Abstract: Publication date: February 2020Source: Paediatric Respiratory Reviews, Volume 33Author(s): Manuel Sánchez Luna, Paolo Manzoni, Bosco Paes, Eugenio Baraldi, Veerle Cossey, Amir Kugelman, Rupesh Chawla, Andrea Dotta, Rosa Rodríguez Fernández, Bernhard Resch, Xavier Carbonell-Estrany Respiratory syncytial virus (RSV) infection is a leading cause of hospitalisation in early childhood and palivizumab is the only licensed intervention for prevention. Palivizumab guidelines should reflect the latest evidence, in addition to cost-effectiveness and healthcare budgetary considerations. RSV experts from Europe, Canada and Israel undertook a systematic review of the evidence over the last 5 years and developed recommendations regarding prophylaxis in industrialised countries. Almost 400 publications were reviewed. This group recommended palivizumab for: preterm infants (
  • Mini-symposium: Transition to adult care: what adult physicians need to
    • Abstract: Publication date: Available online 14 December 2019Source: Paediatric Respiratory ReviewsAuthor(s): Dominic A. Fitzgerald
  • A Systematic Cochrane Review of Antioxidant Supplementation Lung Disease
           for Cystic Fibrosis1
    • Abstract: Publication date: Available online 12 December 2019Source: Paediatric Respiratory ReviewsAuthor(s): Oana Ciofu, Sherie Smith, Jens Lykkesfeldt
  • Transition to adult care for young people with cerebral palsy
    • Abstract: Publication date: Available online 10 December 2019Source: Paediatric Respiratory ReviewsAuthor(s): Lisa L. Myers, Arany Nerminathan, Dominic A. Fitzgerald, Jimmy Chien, Anna Middleton, Mary-Clare Waugh, Simon Paul PagetAbstractCerebral palsy (CP) is associated with a high burden of comorbid respiratory disease subsequent to multiple risk factors associated with increasing levels of disability. Correspondingly, respiratory disease is the leading cause of death in CP, including amongst young people who are transitioning or who have just transitioned between paediatric and adult healthcare services. Therefore, consideration of both preventive and therapeutic respiratory management is integral to transition in patients with CP, as summarised in this review.
  • Pediatric Pulmonary Lymphatic Flow Disorders: Diagnosis and Management
    • Abstract: Publication date: Available online 29 November 2019Source: Paediatric Respiratory ReviewsAuthor(s): David M. Biko, Yoav Dori, Melanie Savoca, Ganesh Krishnamurthy, Christopher L. Smith, Pablo Laje, Jonathan J. Rome, Fernando EscobarAbstractPulmonary lymphatic flow disorders involve the abnormal lymphatic flow via lymphatic channels to the lungs and pleural space. Plastic bronchitis and chylothorax are the main complications of this abnormal lymphatic perfusion, which has been termed pulmonary lymphatic perfusion syndrome (PLPS). Following lymphatic access, dynamic contrast MR lymphangiography is the imaging modality of choice to diagnose these disorders. Management includes medical therapy, percutaneous interventions under fluoroscopy, and surgical interventions.
  • Upper airway visualization in pediatric obstructive sleep apnea
    • Abstract: Publication date: November 2019Source: Paediatric Respiratory Reviews, Volume 32Author(s): Courtney M. Quinlan, Hansel Otero, Ignacio E. TapiaAbstractPediatric Obstructive Sleep Apnea (OSA) is a condition that may lead to a variety of comorbidities in adolescence and adulthood. The gold standard of diagnosing OSA is polysomnography (PSG). Over the past fifteen years numerous publications have explored how to better visualize the upper airway to further assess OSA in the pediatric population, and eventually institute personalized treatment. Lateral neck radiograph, cephalometry, computed axial tomography, and magnetic resonance imaging are all unique imaging techniques that are used in the diagnosis of OSA. Drug Induced Sleep Endoscopy is a direct visualization technique that is gathering momentum in pediatrics. Each approach has respective benefits and weaknesses. However, none of them at this time can replace PSG. They are a helpful supplement in those patients with complicated upper airway anatomy and in those with residual OSA.
  • Quantification of the source, amount and duration of aspiration in the
           lungs of infants using gamma scintigraphy
    • Abstract: Publication date: November 2019Source: Paediatric Respiratory Reviews, Volume 32Author(s): Beth L. Laube, Richard Katz, Gerald M. Loughlin, Jeanne M. Pinto, Maureen A. Lefton-GreifAbstractBackgroundAspiration can cause acute symptoms and chronic lung disease in the developing lung. However, the source of aspiration in infants is often unclear, making the choice of intervention difficult.ObjectiveTo quantify the source, amount and duration of lung aspiration in infants using gamma scintigraphy.MethodsTwo infants with clinical evidence of gastroesophageal reflux and oropharyngeal dysphagia swallowed formula radiolabeled with 99mtechnetium on Visit 1. Radiolabeled-formula was instilled by nasogastric tube on Visit 2. Lung aspiration was quantified over four hours and expressed as percent of total radioactivity administered.ResultsAspiration was greatest with swallowing, compared to instillation, peaking between 2.0% and 2.4% within 30 min and between 0.40% and 0.65% within 20 min, respectively. Radioactivity remained above zero four hours after either administration.ConclusionsQuantification of the source, amount and duration of lung aspiration in infants is feasible using gamma scintigraphy. The impact of aspiration accrual on clinical care deserves further investigation.
  • Immune biomarkers predicting bronchiolitis disease severity: A systematic
    • Abstract: Publication date: November 2019Source: Paediatric Respiratory Reviews, Volume 32Author(s): David G. Hancock, Elena C. Cavallaro, Elizabeth Doecke, Molly Reynolds, Billie Charles-Britton, Dani-Louise Dixon, Kevin D. ForsythAbstractBronchiolitis is one of the leading causes of hospitalisation in infancy, with highly variable clinical presentations ranging from mild disease safely managed at home to severe disease requiring invasive respiratory support. Identifying immune biomarkers that can predict and stratify this variable disease severity has important implications for clinical prognostication/disposition. A systematic literature search of the databases Embase, PubMed, ScienceDirect, Web of Science, and Wiley Online Library was performed. English language studies that assessed the association between an immune biomarker and bronchiolitis disease severity among children aged less than 24 months were included. 252 distinct biomarkers were identified across 90 studies. A substantial degree of heterogeneity was observed in the bronchiolitis definitions, measures of disease severity, and study designs. 99 biomarkers showed some significant association with disease severity, but only 18 were significant in multiple studies. However, all of these candidate biomarkers had comparable studies that reported conflicting results. Conclusion: The heterogeneity among included studies and the lack of a consistently significant biomarker highlight the need for consensus on bronchiolitis definitions and severity measures, as well as further studies assessing their clinical utility both in isolation and in combination.
  • Mask interfaces for home non-invasive ventilation in infants and children
    • Abstract: Publication date: November 2019Source: Paediatric Respiratory Reviews, Volume 32Author(s): Maria L. Castro-Codesal, Deborah L. Olmstead, Joanna E. MacLeanAbstractThe selection of the mask interface for non-invasive ventilation (NIV) is recognized to be an essential part for therapy success. While nasal masks are the first recommended option in children and adults, there are indications for other mask types such as intolerance or complications from nasal masks. Evidence comparing performance, adherence and complication risk among mask interfaces in pediatrics is, however, scarce and information is often extrapolated from adult studies. Given this gap in knowledge and the lack of guidelines on NIV initiation in children, mask selection often relies on the clinicians’ knowledge and expertise. Careful mask selection, a well-fitting headgear and time investment for mask desensitization are some important recommendations for adequate mask adaptation in children. Frequent mask-related complications include nasal symptoms, unintentional leak, mask displacement, skin injury, and midface hypoplasia. Close monitoring and a pro-active approach may help to minimize complications and promote the optimal use of home NIV.
  • The role of objective tests to support a diagnosis of asthma in children
    • Abstract: Publication date: Available online 28 February 2019Source: Paediatric Respiratory ReviewsAuthor(s): Lesley Danvers, David K.H. Lo, Erol A. GaillardAbstractIn many healthcare settings asthma in children is a clinical diagnosis based on parental reported symptoms. These include intermittent episodes of wheezing, breathlessness and periodic nocturnal dry cough. Increased symptoms often coincide with colds. Confirming a diagnosis of asthma in children can be difficult and recent reports highlight that misdiagnosis, including over- and under-diagnosis of asthma are common. Recent UK National Institute of Health and Care Excellence guidelines recommend diagnostic algorithms for children from five years and adults to support a clinical suspicion of asthma. Spirometry, bronchodilator reversibility and fractional exhaled nitric oxide testing are the first line tests to diagnose asthma in children. The introduction of these tests across all healthcare settings has the potential to reduce misdiagnosis, improve asthma management and reduce healthcare spending for asthma.
  • Sustained Inflation: The Lung Recruitment Maneuvers for Neonates
    • Abstract: Publication date: Available online 21 November 2019Source: Paediatric Respiratory ReviewsAuthor(s): Ke-Yun Chao, Yu-Wen Lin, Chen-En Chiang, Chi-Wei Tseng, Shu-Chi MuAbstractEstablishing effective respiration is vital in the transition from fetal to neonatal life. Respiratory support mainly facilitates and creates functional residual capacity and maintains adequate gas exchange. Sustained inflation (SI) delivers prolonged inflation and rapidly creates and establishes the functional residual capacity. The use of SI in preterm infants in the delivery room is still controversial. The optimum settings of SI remain unknown. Animal studies and clinical reports have demonstrated the advantages and disadvantages of SI. In this article, the current literature was reviewed to examine the efficacy of SI in infants.
  • Question 4: Is there a role for antibiotics in infantile wheeze'
    • Abstract: Publication date: Available online 11 November 2019Source: Paediatric Respiratory ReviewsAuthor(s): Fernando M. de Benedictis, Ines Carloni, Roberto GuidiAbstractAcute wheezing episodes are frequent in young children and are associated with high morbidity and healthcare utilization. The role of respiratory viruses in triggering acute wheezing is well known. There is also accumulating evidence that airway bacteria, either alone or as part of bacteria-virus interaction, are important determinants of acute asthma exacerbations. Targeting airway bacteria with antibiotics to reduce the severity of acute wheezing episodes and prevent recurrent wheezing among preschool children has been recently evaluated in three randomized, double-blind, placebo-controlled trials. The results of these studies are controversial. An interventional approach with azithromycin in young children during acute wheezing episodes cannot be generically incorporated into the clinical practice, due to the potential consequences of widespread use of antibiotics in such a common clinical setting. This intervention may be reserved for children with really severe, recurrent wheezing episodes. Future research should focus on risk factors that facilitate acquisition of bacterial airway infection in young children and better understanding how virus and bacteria interact with each other during wheezing attacks. Identifying objective biomarkers that may direct the treatment to specific groups of children may represent a significant step forward in the clinical approach of acute wheezing.
  • Pediatric Polysomnography—A Review of Indications, Technical
           Aspects, and Interpretation
    • Abstract: Publication date: Available online 30 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Robert C. Stowe, Olufunke Afolabi-BrownAbstractPolysomnography is an elaborate diagnostic test composed of numerous data-collecting sensors working concomitantly to aid in the evaluation of varied sleep disorders in all age groups. Polysomnography is the study of choice for the assessment of pediatric sleep-disordered breathing, including obstructive sleep apnea syndrome, central apnea, and hypoventilation disorders, and is used to help determine treatment efficacy. Beyond the purview of snoring and breathing pauses, polysomnography can elucidate the etiology of hypersomnolence, when associated with a multiple sleep latency test, and abnormal movements or events, whether nocturnal seizure or complex parasomnia, when a thorough patient history cannot provide clear answers. This review will highlight the multitudinous indications for pediatric polysomnography and detail its technical aspects by describing the multiple neurophysiologic and respiratory parametric sources. Knowledge of these technical aspects will provide the practitioner with a thoughtful means to understand the limitations and interpretation of polysomnography.
  • Sleep disordered breathing (SDB) in neonates and implications for its
           long-term impact
    • Abstract: Publication date: Available online 30 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Bhavesh Mehta, Karen Waters, Dominic Fitzgerald, Nadia BadawiAbstractSleep-disordered breathing (SDB) is a significant cause of morbidity in neonates and young infants. SDB occurs more commonly in preterm infants and in neonates with underlying syndromes. Recent evidence shows that infants with obstructive sleep apnoea (OSA) or SDB have greater health care resource utilization, including longer hospital stay. Management of SDB includes non-invasive ventilation or surgical interventions tailored to the patient. Screening high risk newborns should allow for early diagnosis and timely therapeutic intervention for this population. However, the thresholds for diagnosing SDB and for guiding and implementing treatment in neonates remain unclear. A collective effort is required to standardize the practice worldwide. This article will discuss neonatal sleep physiology and characteristics of neonatal sleep, with an emphasis on the epidemiology and diagnosis of SDB in neonates and its implications for long term outcomes.
  • Cerebral oxygenation in children with sleep-disordered breathing
    • Abstract: Publication date: Available online 23 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Laurence Tabone, Sonia Khirani, Alessandro Amaddeo, Guillaume Emeriaud, Brigitte FaurouxAbstractSleep-disordered breathing (SDB) is associated with neurocognitive and behavioural dysfunction, and structural brain abnormalities. Near infrared spectroscopy allows a continuous and non-invasive monitoring of brain tissue oxygenation, giving insight in some pathophysiological mechanisms potentially associated with SDB-related neurocognitive dysfunction. The present review summarizes the finding of studies describing brain tissue oxygenation in adults and children with SDB. Contrary to adults, mean nocturnal tissue oxygenation index (TOI) during sleep does not seem to be different in children with SDB as compared to healthy controls. During respiratory events such as apnoeas and hypopnoeas, the decrease in TOI precedes the peripheral, systemic desaturation. The decrease in TOI has been shown to be greater during apnoeas as compared to hypopnoeas, during rapid-eye movement sleep as compared to other sleep stages, in younger children as compared to their older counterparts, and in those with a high apnoea-hypopnoea index as compared with a low apnoea-hypopnoea index. Studies analyzing the association between repetitive changes in TOI and neurocognitive and behavioural dysfunction may help to decipher the pathophysiology of neurocognitive dysfunction associated with SDB in children.
  • Carole Marcus Award
    • Abstract: Publication date: Available online 21 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Dominic Fitzgerald, Ignacio Tapia
  • Understanding the Immunology of Asthma: Pathophysiology, Biomarkers, and
           Treatments for Asthma Endotypes
    • Abstract: Publication date: Available online 9 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Melissa D. Gans, Tatyana GavrilovaAbstractAsthma is a common disease in paediatrics and adults with a significant morbidity, mortality, and financial burden worldwide. Asthma is now recognized as a heterogeneous disease and emerging clinical and laboratory research has elucidated understanding of asthma’s underlying immunology. The future of asthma is classifying asthma by endotype through connecting discernible characteristics with immunological mechanisms. This comprehensive review of the immunology of asthma details the currently known pathophysiology and clinical practice biomarkers in addition to forefront biologic and targeted therapies for all of the asthma endotypes. By understanding the immunology of asthma, practitioners will be able to diagnose patients by asthma endotype and provide personalized, biomarker-driven treatments to effectively control patients’ asthma.
  • Bronchodilators and Steroids Should Not Be Given in Viral Bronchiolitis
           – CON
    • Abstract: Publication date: Available online 8 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Michael A. Wall
  • Mini-symposium: Lung Diseases in children living in poverty
    • Abstract: Publication date: Available online 8 October 2019Source: Paediatric Respiratory ReviewsAuthor(s):
  • Bronchodilators and Steroids Should Not Be Given in Viral Bronchiolitis
           – PRO
    • Abstract: Publication date: Available online 8 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Mark A Brown
  • Genetic factors in isolated and syndromic laryngeal cleft
    • Abstract: Publication date: Available online 8 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Youjin Li, Xiaoqing Rui, Niu LiAbstractA laryngotracheoesophageal cleft (LC) is a rare congenital anomaly of the upper aerodigestive tract resulting from the absence of fusion of the posterior cricoid lamina, which affects an abnormal communication between the larynx, trachea and esophagus. The genetic etiology of LC remains elusive. The involvement of genetic factors in the development of LC is suggested by reports of familial occurrence, and the increased prevalence of component features among first-degree relatives of affected individuals and murine knockout models. No consistent pattern of inheritance has been found in nonsyndromic patients, except for cases associated with described syndromes. Once the syndrome related to the laryngeal cleft is considered, an active search for the cleft must be initiated. The genetic evaluation of patients with LCs should be guided by the type and location of the malformation, specific medical history and a detailed physical examination. The application of genetic approaches, such as microarrays and exome sequencing might lead to elucidating the etiology of LCs.Educational Aims-The reader will be able to appreciate:•The importance of clinical features in patients with isolated and syndromic laryngotracheoesophageal clefts•No consistent pattern of inheritance has been identified•The underlying genetic etiology of LCs is currently unknownFuture research directions•Further LC genetic research is needed•Research efforts should focus on the evidence for the genetic effects on LCs to highlight the requirement of advanced airway management. Strategies for the application of genetic approaches are needed to elucidate the etiology of LCs.
  • EDITORIAL: “Evidence based medicine and common sense: The case of
    • Abstract: Publication date: Available online 4 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Anastassios C. Koumbourlis
  • Transition to adult care in sleep medicine
    • Abstract: Publication date: Available online 3 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Mimi Lu, Brendon J. Yee, Dominic A. FitzgeraldAbstractMore children with chronic and complex care needs are transitioned to adulthood due to advancements in medical technology including the use of non-invasive ventilation [NIV] at home and innovative medical therapies. Sleep medicine is becoming a common and at times vital component of the management plan. Various challenges are experienced in transitioning sleep patients depending on the underlying condition. These include the direct conflict between the desires of a young person for independence and their declining ability to provide self-care in neuromuscular patients, the behavioural challenges inherent in the management of children with various syndromes and the funding of equipment, care needs and multidisciplinary team input in an already resource limited adult setting. These patients should be transitioned in an early and coordinated approach following core principles of transition. Ongoing advocacy is required to raise awareness of the increased trend for technology supported young people being transitioned. Further research is required to track and assess the transition process in patients with various sleep conditions.
  • Effects of inhaled corticosteroids on growth in children with persistent
           asthma: impact of drug molecules and delivery devices - an overview of
           Cochrane reviews
    • Abstract: Publication date: Available online 1 October 2019Source: Paediatric Respiratory ReviewsAuthor(s): Inge Axelsson, Estelle Naumburg, Sílvio OM. Prietsch, Linjie Zhang
  • Lung ultrasound in children: What does it give us'
    • Abstract: Publication date: Available online 30 September 2019Source: Paediatric Respiratory ReviewsAuthor(s): Sara Bobillo-Perez, Monica Girona-Alarcon, Javier Rodriguez-Fanjul, Iolanda Jordan, Monica Balaguer GargalloAbstractLung ultrasound (LUS), a non-invasive non-ionizing radiation tool, has become essential at bedside in both adults and children, particularly in the critically ill. This manuscript reviews normal LUS patterns and the most important pathologies that LUS allows to diagnose. Normal LUS is represented by the pleural line, the lung-sliding and the A-lines and B-lines. These two last findings are artifacts derived from the pleural line. Pleural effusion appears as an anechoic collection. Pneumothorax is suspected when only A-lines are present, without lung-sliding and B-lines. Alveolo-interstitial syndrome is characterized by different degrees of confluent B-lines and can be present in different pathologies such as pulmonary edema and acute respiratory distress syndrome. The distribution of B-lines helps to differentiate between them. LUS is useful to evaluate the response to lung recruitment in pathologies such as acute respiratory distress syndrome or acute chest syndrome. The distribution of B-lines also appears to be useful to monitor the response to antibiotics in pneumonia. However, further studies are needed to further ascertain this evidence. LUS is also useful to guide thoracocentesis.
  • Pro Con debates in clinical medicine Infection prevention and control in
           cystic fibrosis: one size fits all' The argument against
    • Abstract: Publication date: Available online 21 August 2019Source: Paediatric Respiratory ReviewsAuthor(s): A.R. Smyth, S. Smith, N.J. RobothamAbstractAs awareness of the risks of cross infection has increased, infection prevention and control measures have become more draconian. Infection control measures can have a profound effect of the organisation and delivery of CF services and on the lives of people with CF outside the hospital. However, the consequences of inadequate infection control measures may be the permanent acquisition of a chronic infection which is virtually untreatable. Recommendations for infection prevention and control therefore must protect patients but should also be evidence-based and proportionate. This article will review the literature, juxtaposing evidence and popular practice.
  • Azithromycin is the answer in Paediatric Respiratory Medicine, but what
           was the question'
    • Abstract: Publication date: Available online 16 August 2019Source: Paediatric Respiratory ReviewsAuthor(s): Andrew BushAbstractThe first clinical indication of non-antibiotic benefits of macrolides was in the Far East, in adults with diffuse panbronchiolitis. This condition is characterised by chronic airway infection, often with Pseudomonas aeruginosa, airway inflammation, bronchiectasis and a high mortality. Low dose erythromycin, and subsequently other macrolides, led in many cases to complete remission of the condition, and abrogated the neutrophilic airway inflammation characteristic of the disease. This dramatic finding sparked a flurry of interest in the many hundreds of macrolides in nature, especially their anti-inflammatory and immunomodulatory effects. The biggest subsequent trials of azithromycin were in cystic fibrosis, which has obvious similarities to diffuse panbronchiolitis. There were unquestionable improvements in lung function and pulmonary exacerbations, but compared to diffuse panbronchiolitis, the results were disappointing. Case reports, case series and some randomised controlled trials followed in other conditions. Three trials of azithromycin in preschool wheeze gave contradictory results; a trial in pauci-inflammatory adult asthma, and a trial in non-cystic fibrosis bronchiectasis both showed a significant reduction in exacerbations, but none matched the dramatic results in diffuse panbronchiolitis. There is clearly a huge risk of antibacterial resistance if macrolides are used widely and uncritically in the community. In summary, Azithromycin is not the answer to anything in paediatric respiratory medicine; the paediatric respiratory community needs to refocus on the dramatic benefits of macrolides in diffuse panbronchiolitis, use modern –omics technologies to determine the endotypes of inflammatory diseases and discover in nature or synthesise designer macrolides to replicate the diffuse panbronchiolitis results. We must now find out how to do better!
  • Applying a Biopsychosocial Model to Inner City Asthma: Recent Approaches
           to Address Paediatric Asthma Health Disparities
    • Abstract: Publication date: Available online 13 August 2019Source: Paediatric Respiratory ReviewsAuthor(s): Hilary Stempel, Monica J. Federico, Stanley J. SzeflerAbstractPaediatric asthma in inner cities is often severe and children living in these urban locations with socioeconomic disadvantage experience greater asthma morbidity. There are many interconnected risk factors that individually, and in combination, enhance asthma morbidity. These include biologic factors innate to the child, such as genetics and allergen susceptibility, as well as factors related to the family and neighborhood context. The biopsychosocial model can be used to frame these risk factors and develop interventions specific to the inner city. Successful inner city asthma interventions exist and key characteristics include multi-tiered components that operate within the community to coordinate disease management resources between patients, families and health care systems.
  • An Introduction to Clinical Trial Design
    • Abstract: Publication date: Available online 26 June 2019Source: Paediatric Respiratory ReviewsAuthor(s): A. Schultz, BR. Saville, JA. Marsh, TL. SnellingAbstractClinicians and other decision makers in healthcare use results from clinical trials to inform practice. Interpretation of clinical trial results can be challenging, as weaknesses in trial design, data collection, analysis or reporting, can compromise the usefulness of results. A good working knowledge of clinical trial design is essential to expertly interpret and determine the validity and generalizability of the results. This manuscript will give a brief overview of clinical trial design including the strengths and limitations of various approaches. The focus will be on confirmatory clinical trials.
  • Ultrafine Particles and Children’s Health: Literature Review
    • Abstract: Publication date: Available online 26 June 2019Source: Paediatric Respiratory ReviewsAuthor(s): Juliana Regis da Costa e Oliveira, Luis Henrique Base, Luiz Carlos de Abreu, Celso Ferreira Filho, Celso Ferreira, Lidia MorawskaAbstractThe aim of this study was to review and synthesize the existing knowledge of the effects of ultrafine particles [UFPs] with a specific focus on children’s health. An extensive literature search identified 16 studies fulfilling the criteria set for the review. One of the most important findings of the review was that, in general, there is an association between children’s health and exposure to UFPs, especially among children with respiratory diseases, who commonly experience alterations in inflammatory biomarkers and deterioration in lung function as a result of UFP exposure. Notably, the health effects of UFPs are related to their ability to penetrate through different systems of the body due to their small size.
  • Childhood pneumonia in Low-and-Middle-Income countries: an update
    • Abstract: Publication date: Available online 26 June 2019Source: Paediatric Respiratory ReviewsAuthor(s): Diana Marangu, Heather J ZarAbstractObjectivesTo review epidemiology, aetiology and management of childhood pneumonia in low-and-middle-income countries.DesignReview of published English literature between 2013 and 2019.ResultsPneumonia remains a major cause of morbidity and mortality. Risk factors include young age, malnutrition, immunosuppression, tobacco smoke or air pollution exposure. Better methods for specimen collection and molecular diagnostics have improved microbiological diagnosis, indicating that pneumonia results from several organisms interacting. Induced sputum increases microbiologic yield for pertussis or M.tuberculosis, which has increasingly been associated with pneumonia in high TB prevalence areas. The proportion of cases due to S.pneumoniae and H influenzae b has declined with new conjugate vaccines; S aureus and H influenzae non-type b are the commonest bacterial pathogens; viruses are the most common. Effective interventions comprise antibiotics, oxygen and non-invasive ventilation. New vaccines have reduced severity and incidence of disease, but disparities exist in uptake.ConclusionMorbidity and mortality from childhood pneumonia has decreased but a considerable preventable burden remains. Widespread implementation of available, effective interventions and development of novel strategies are needed.
  • Janus looks Both Ways: How do the Upper and Lower Airways Interact'
    • Abstract: Publication date: Available online 26 June 2019Source: Paediatric Respiratory ReviewsAuthor(s): Fernando M. de Benedictis, Andrew BushAbstractOur understanding of the relationship between the upper and lower airways has greatly increased as a consequence of epidemiologic and pharmacologic studies. A consistent body of scientific evidence supports the concept that rhinitis, rhinosinusitis and asthma may be the expression of a common inflammatory process, which manifests at different sites of the respiratory tract, at different times. This paradigm states that allergic reactions may begin at the local mucosa, but tend to propagate along the airway. Central to the allergic diathesis is the eosinophil and its interaction with the airway epithelium. The implications of the interplay between upper and lower airway are not only academic, but are also important for diagnostic and therapeutic reasons. Furthermore, there is significant overlap in symptomatology and pathophysiology for childhood sleep disordered breathing (SDB) and asthma. Recent evidence supports an association between these two conditions, but causality has not been demonstrated. Regardless, it is important to recognize the overlap and evaluate for the other condition when one is present. In children with poorly controlled asthma, the presence of SDB may significantly contribute to asthma morbidity and, as such, should be actively excluded. On the other hand, clinical evaluation for asthma should be considered in children with SDB.Future robust longitudinal research is needed to explore the association between upper and lower airway diseases using objective measures in children. When you have two alternatives, the first thing you have to do is to look for the third that you didn’t think about, that doesn’t exist. Shimon PeresIn ancient Roman religion and myth, Janus was the god of beginnings, duality and endings. He is usually depicted as having two faces, thus symbolizing the transition from one vision to another.Rhinitis, sleep disordered breathing (SDB) and asthma are common conditions in childhood, that can coexist and impact on quality of life. [1], [2] Here we critically review the possible interactions between these conditions. Obesity as an underlying cause of SDB and asthma is beyond the scope of this article.Some or all of the following criteria should be satisfied to infer a causal link between two conditions: 1) Condition A should be more frequent in patients with condition B; 2) There should be biological plausibility for the association between underlying conditions A and B; 3) Prevention of condition A should abolish condition B; and 4) Treatment of condition A should improve condition B. Causality may of course be bi-directional. But a note of caution – apparent association may merely be a manifestation of Berkson’s Fallacy (a type of selection bias, which can arise when the sample is taken from a subpopulation, not the general population).
  • The ethics of publishing in medical journals
    • Abstract: Publication date: Available online 11 May 2019Source: Paediatric Respiratory ReviewsAuthor(s): David Isaacs, Chris Elliot, Henry Kilham, Anne PreiszAbstractEthics has been defined as the way we ought to behave. Medical publishing essentially exists to broadcast current and new medical knowledge to aid in the practice of medicine. In this review article we consider many of the aspects of medical publishing with regard to ‘what we ought to do’ and, equally, ‘what we ought not to do’ from the perspective of various ethical frameworks. Although ethics is not the law or a set of rules, nor a code of conduct, an ethical lens can be useful when developing good general guidelines for medical publishing.
  • Striving for Perfection, Accepting the Reality: A Reflection on Adherence
           to Airway Clearance and Inhalation Therapy for Paediatric Patients with
           Chronic Suppurative Lung Disease
    • Abstract: Publication date: Available online 13 April 2019Source: Paediatric Respiratory ReviewsAuthor(s): Dixon Emma, Puckey Michele, Collins Nicola, Marsh Gemma, Pabary RishiAbstractNon-adherence to prescribed treatment is considered the foremost cause of treatment failure in chronic medical conditions. Airway clearance techniques (ACT) play a key role in the management of chronic suppurative lung disease yet, along with inhaled therapies such as nebulised antibiotics, adherence to these is often lower than to other treatments. In this review we discuss methods of monitoring adherence to these therapies and potential barriers and outline suggestions for improving adherence in the paediatric population.
  • Respiratory complications of metabolic disease in the paediatric
           population: a review of presentation, diagnosis and therapeutic options
    • Abstract: Publication date: Available online 12 April 2019Source: Paediatric Respiratory ReviewsAuthor(s): A. Broomfield, J. Kenth, I.A. Bruce, Tan HL, Wilkinson SAbstractInborn errors of metabolism (IEMs) whilst individually rare, as a group constitute a field which are placing increasing demands on pulmonologists. With the advent of new therapies such as enzyme replacement and gene therapy, early diagnosis and treatment of these conditions can impact on long term outcome, making their timely recognition and appropriate investigation increasingly important. Conversely, with improved treatment, survival of these patients is increasing, with the emergence of previously unknown respiratory phenotypes. It is thus important that pulmonologists are aware of and appropriately monitor and manage these complications. This review aims to highlight the respiratory manifestations which can occur. It is divided into conditions resulting primarily in obstructive airway and lung disease, restrictive lung disease such as interstitial lung disease or pulmonary alveolar proteinosis and pulmonary hypertension, while acknowledging that some diseases have the potential to cause all three. The review focuses on general phenotypes of IEMs, their known respiratory complications and the basic metabolic investigations which should be performed where an IEM is suspected.
  • The impact of viral bronchiolitis phenotyping: is it time to consider
           phenotype-specific responses to individualize pharmacological
    • Abstract: Publication date: Available online 12 April 2019Source: Paediatric Respiratory ReviewsAuthor(s): Carlos E. Rodríguez-Martínez, Jose A. Castro-Rodriguez, Gustavo Nino, Fabio MidullaAbstractAlthough recent guidelines recommend a minimalist approach to bronchiolitis, there are several issues with this posture. First, there are concerns about the definition of the disease, the quality of the guidelines, the method of administration of bronchodilators, and the availability of tools to evaluate the response to therapies. Second, for decades it has been assumed that all cases of viral bronchiolitis are the same, but recent evidence has shown that this is not the case. Distinct bronchiolitis phenotypes have been described, with heterogeneity in clinical presentation, molecular immune signatures and clinically relevant outcomes such as respiratory failure and recurrent wheezing. New research is critically needed to refine viral bronchiolitis phenotyping at the molecular and clinical levels as well as to define phenotype-specific responses to different therapeutic options.
  • Mitochondrial bioenergetics and pulmonary dysfunction: current progress
           and future directions
    • Abstract: Publication date: Available online 12 April 2019Source: Paediatric Respiratory ReviewsAuthor(s): Vadim S. Ten, Veniamin RatnerAbstractThis review summarizes current understanding of mitochondrial bioenergetic dysfunction applicable to mechanisms of lung diseases and outlines challenges and future directions in this rapidly emerging field. Although the role of mitochondria extends beyond the term of cellular “powerhouse”, energy generation remains the most fundamental function of these organelles. It is not counterintuitive to propose that intact energy supply is important for favorable cellular fate following pulmonary insult. In this review, the discussion of mitochondrial dysfunction focuses on those molecular mechanisms that alter cellular bioenergetics in the lungs: a) inhibition of mitochondrial respiratory chain, b) mitochondrial leak and uncoupling, c) alteration of mitochondrial Ca2+ handling, d) mitochondrial production of reactive oxygen species and self-oxidation. The discussed lung diseases were selected according to their pathological nature and relevance to pediatrics: Acute lung injury (ALI), defined as acute parenchymal lung disease associated with cellular demise and inflammation (Acute Respiratory Distress Syndrome, ARDS, Pneumonia), alveolar developmental failure (Bronchopulmonary Dysplasia, BPD or chronic lung disease in premature infants), obstructive airway diseases (Bronchial asthma) and vascular remodeling affecting pulmonary circulation (Pulmonary Hypertension, PH). The analysis highlights primary mechanisms of mitochondrial bioenergetic dysfunction contributing to the disease-specific pulmonary insufficiency and proposes potential therapeutic targets.
  • Inhaled Corticosteroid-phobia and Childhood Asthma: Current Understanding
           and Management Implications
    • Abstract: Publication date: Available online 11 April 2019Source: Paediatric Respiratory ReviewsAuthor(s): Rex Wan Hin HuiAbstractAsthma is the most prevalent chronic disease in children. Inhaled corticosteroids (ICS) is the first-line controller therapy for children with persistent asthma, however, suboptimal compliance to ICS therapy remains as a major obstacle in paediatric asthma management. Steroid-phobia, the fear of side-effects and subsequent aversion of ICS, has been widely reported in parents of asthmatic children. The reported prevalence of steroid-phobia varies widely from 19-67% in different populations. The concerns about ICS frequently raised by parents include growth suppression, weight gain, bone weakness, addiction and psychiatric disturbances. Outside of growth suppression, which is statistically significant yet mild in clinical studies, the other concerns are not evidence-based and are misconceptions. Conflicting results have been reported regarding the impact of steroid-phobia on ICS compliance. In contrast, steroid-phobia has consistent and negative effects on asthma control in children. While asthma educational programmes have demonstrable benefits in general paediatric populations, the generalisability of such programmes to steroid-phobic parents remain undetermined. There is a paucity of data on specific educational programmes to clear misconceptions and reduce steroid-phobia. Given the continually raising prevalence of paediatric asthma, high-quality studies are warranted to investigate the prevalence and impact of steroid-phobia, with an ultimate goal of developing effective strategies to tackle steroid-phobia and improve asthma care in children.
  • Transition of patients with neuromuscular disease and chronic
           ventilator-dependent respiratory failure from pediatric to adult pulmonary
    • Abstract: Publication date: Available online 5 April 2019Source: Paediatric Respiratory ReviewsAuthor(s): Pi Chun Cheng, Howard B. Panitch, John Hansen-FlaschenAbstractImprovements in medical care have allowed many children with neuromuscular disease and chronic respiratory failure to survive into adulthood. There are currently no published guidelines to facilitate transition from pediatric to adult respiratory care in this population. The transition process in neuromuscular disease and chronic respiratory failure is uniquely challenging in that the patients are often declining in health and losing independence as they approach adulthood. Barriers to transition include lack of access to adult providers, incompatible health insurance, loss of resources within patients’ medical structures, absence of transition preparation, and patient and family insecurity with a new healthcare system. The six core elements and optimal time frame of transition should be applied, with special consideration of the psychosocial aspects associated with neuromuscular disease. Successful transition revolves around information, open communication between young adults and their medical care team, and individualized planning to ensure optimal health and quality of life.
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Heriot-Watt University
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