Respiratory Diseases In Children Research Articles

Characteristics of infant formula consumed in the first months of life and allergy in the EDEN mother-child cohort.

The evidence regarding the association between infant formula (IF) composition and the prevention of allergy and respiratory diseases remains sparse and inconclusive. This study aimed to evaluate whether some IF characteristics were associated with the risk of allergy or respiratory diseases in childhood. Among1243 formula-fed children from the EDEN mother-child cohort, IF characteristics concerning long-chain polyunsaturated fatty acids (LCPUFAs) enrichment, prebiotic/probiotic enrichment, and hydrolysis of proteins were identified from the ingredients list. Eczema, wheezing, food allergy, asthma, and allergic rhinitis up to age 8 years were prospectively collected and summarized into four allergic and respiratory multimorbidity clusters. Associations between 4-month IF characteristics and risk of allergy or respiratory diseases were tested using logistic regressions adjusted on main confounders. The consumption of LCPUFA-enriched formula was not linked to allergic and respiratory multimorbidity clusters, but to a lower risk of any allergy, eczema, and wheezing. Probiotic-enriched formula consumption was associated with a lower risk of belonging to the 'Allergy without asthma' cluster (odds ratio [OR][95% confidence interval,CI] = 0.63 [0.40-0.99]), and consumption of a formula enriched in Bifidobacterium lactis was associated with a lower risk of any allergy (OR[95% CI] = 0.59 [0.41-0.85]). Partially hydrolysed formula (pHF) consumption was associated with a higher risk of belonging to the 'Allergy without asthma' cluster (OR[95%CI] = 2.73 [1.65-4.51]). This study confirms the positive association between pHFconsumption and the risk of allergy found in previous observational studies and suggests that consumption of LCPUFA-enriched or probiotic-enriched formula was associated with a lower risk of allergy.

Respiratory Syncytial Virus–Associated Respiratory Diseases in Children and Adults.

Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infections (LRTI), particularly in neonates, infants and young children, with approximately 33 million infections worldwide each year. 1-2% of episodes lead to hospitalization. There are hardly any reliable epidemiological figures on hospitalization in adults, whose burden of disease from RSV is probably markedly underestimated. This review is based on publications retrieved by a selective search in PubMed, with particular attention to recommendations for the prevention of RSV infection. There is no approved antiviral therapy for clinical practice, but preventive strategies are increasingly becoming available. Passive immunization in infants is well tolerated and highly effective, as is the active vaccination of pregnant women to prevent severe RSV infection in young infants. The former was found to lower the frequency of severe LRTI (5/4037 in the vaccination group vs. 19/4031 individuals in the placebo group), yielding an efficacy of 75.7%; for the latter, the corresponding findings were a reduction to 19/3682 in the vaccination group vs. 62/3676 in the placebo group, or 69.4% efficacy. For the active vaccination of older adults, both a recombinant vaccine with adjuvant and a bivalent vaccine have recently been approved. These, too, are well tolerated and highly effective: the former lowered the frequency of severe LRTI to 1/12466 in the vaccination group vs. 17/12494 in the placebo group (94.1% efficacy), while the latter lowered the frequency of LRTI with 3 or more manifestations to 2/17215 in the vaccination group vs. 14/17069 in the placebo group (85.7% efficacy). The approval of new RSV-specific monoclonal antibodies and active vaccinations enables targeted prevention of RSV infection in the main population groups at risk.

Clinical characteristics and risk factors of severe human parainfluenza virus infection in hospitalized children

BackgroundHuman parainfluenza viruses (HPIVs) commonly cause childhood respiratory illness requiring hospitalization in Taiwan. This study aimed to investigate clinical severity and identify risk factors predisposing to severe disease in hospitalized children with HPIV infection. MethodsWe included hospitalized patients with lab-confirmed HPIV infection from 2007 to 2018 and collected their demographic and clinical characteristics. Patients with ventilator support, intravenous inotropic agents, and extracorporeal membrane oxygenation were defined as severe cases. ResultsThere were 554 children hospitalized for HPIV infection. The median age was 1.2 years; 518 patients had non-severe HPIV infection, whereas 36 patients (6.5%) had severe HPIV infection. 266 (48%) patients had underlying diseases, and 190 patients (34.3%) had bacterial co-detection. Children with severe HPIV infection were more likely to have bacterial co-detection than those without (52.8% vs 33.0%, p = 0.02). Patients with lung patch or consolidation had more invasive bacterial co-infection or co-detection than those without patch or consolidation (43% vs 33%, p = 0.06). Patients with neurological disease (adjusted OR 4.77, 95% CI 1.94-11.68), lung consolidation/patch (adjusted OR 6.64, 95% CI 2.80-15.75), and effusion (adjusted OR 11.59, 95% CI 1.52-88.36) had significantly higher risk to have severe HPIV infection. ConclusionNeurological disease and lung consolidation/patch or effusion were the most significant predictors of severe HPIV infection.

Feasibility of Home-Based Pulmonary Rehabilitation of Pediatric Patients with Chronic Respiratory Diseases.

Chronic respiratory diseases in children deteriorate their daily life due to dyspnea and reduced lung function. We aimed to evaluate the feasibility of home-based pulmonary rehabilitation in pediatric chronic respiratory diseases. This prospective, single-arm, cohort study included children with chronic lung disease. They were instructed to perform home-based pulmonary rehabilitation 30 min/session, three sessions/week for three months. Pulmonary function test (PFT) using spirometry, respiratory muscle strength (RMT), cardiopulmonary exercise test (CPET), 6 min walk test (6MWT), dyspnea questionnaires, speech evaluation, and pediatric quality of life inventory (PedsQL) were assessed pre- and post-pulmonary rehabilitation. Compliance and satisfaction of the program were also evaluated. Twenty children (mean age: 11.2 ± 3.1 years) with chronic respiratory diseases without cardiopulmonary instability participated. The overall compliance was 71.1% with no related adverse events. After pulmonary rehabilitation, forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), RMT, 6MWT, dyspnea questionnaire, speech rate, and PedsQL (child) significantly improved (p < 0.05), particularly better in the FEV1 < 60% group than in the FEV1 ≥ 60% group and in the high-compliance group (compliance ≥ 50%) than in the low-compliance group (compliance < 50%). Home-based pulmonary rehabilitation for children with chronic lung disease was feasible with high compliance and effective in terms of objective functions, subjective dyspnea symptom, and quality of life.

Assessing the impact of air pollution on short-term hospital visits for respiratory diseases in Lampang, a city heavily affected by biomass burning in Mainland Southeast Asia: Sex and age considerations

Mainland Southeast Asia has long been confronted with severe air pollution issues caused by open biomass burning. The analysis is conducted from January 2014 to December 2017 in Lampang located in central of Mainland Southeast Asia. The analysis of air pollution revealed significant exceedances of the PM10 (32%) and O3 (29%) air quality guidelines set by the World Health Organization. The major source of PM10 in Lampang is biomass burning, accounting for 97%, and it also experiences a high respiratory disease incidence of 7,276.61 per 100,000 population. A time-series analysis was conducted using generalized linear models based on Poisson regression, considering various lag times, to assess the relative risk (RR) among all age groups (0–14 years, 15–64 years, ≥65 years) and genders. A 10 μg/m3 increase in PM10 and O3 was associated with statistically significant percentage increases at lag 0. Specifically, there was a 0.65% (95% CI: 0.38–0.92) increase in respiratory diseases for PM10 and a 0.72% (95% CI: 0.43–1.01) increase for O3. The impact of PM10 and O3 significantly affects respiratory diseases in children, adults, and the elderly. Elderly males and females both experience the highest impact of PM10, whereas the greatest impact of O3 is observed in elderly males and adult females. Biomass burning is a major source that should be controlled to reduce the health risk of people. Protecting vulnerable groups like adult females, elderly males, and elderly females from high air pollution concentrations is crucial, especially with many countries experiencing an aging demographic shift.

Changes in Cellular and Humoral Immunity of Children with Respiratory Diseases Living in Areas of Kyrgyzstan at Different Altitudes

Immunological aspects of respiratory diseases due to altitude can have a significant impact on the pathogenesis and clinical course of the disease. Research objectives: to study changes in cellular and humoral immunity in children with respiratory diseases living in areas of Kyrgyzstan located at different altitudes above sea level. This study used methods to assess cellular and humoral immunity in 209 children living at various altitudes above sea level in Kyrgyzstan. Research results contribute to a deeper understanding of the immunological mechanisms underlying respiratory diseases in children at high altitudes, which may be of practical importance for the development of more effective methods for diagnosis, prevention and treatment of such diseases. It is assumed that at high altitude the number of allergens in the body decreases, in particular, the number of dust mites, which often act as a provoking factor in allergic respiratory diseases.

Rare interstitial lung diseases in infants

The diagnosis of interstitial lung disease in infants (chILD) is challenging due to the fact that the differential range encompasses more than 200 variants of nosologies with an overall estimated prevalence of 1.6–46 per 100,000 according to several studies. Thus, chILDs are 10 times less common than in adults. The chILD disease spectrum differs significantly from that seen in older children and adults. Interest in the topic of chILD has increased over the past 20 years, as evidenced by the published results of numerous studies and reviews. Also, multidisciplinary groups and respiratory societies have been established, such as the American Thoracic Society (ATS), the European Research Collaboration for Children’s Interstitial Lung Disease (ERS CRC chILD-EU), the French National Reference Center for Rare Respiratory Diseases in Children (RESPIRARE), etc. This article discusses recent advances in the study and diagnosis of chILD, with a special focus on rare and ultra-rare types of chILD. In addition, the stages of the diagnostic search and the increasing role of computed tomography are discussed.

Pediatric pulmonology year in review 2023: Physiology.

Application of the principles of pulmonary physiology and lung development to the care and management of respiratory disease in children is a distinguishing feature of pediatric pulmonology. In 2023, this was evident in numerous publications in Pediatric Pulmonology and other journals. This review will highlight some of the papers in this area.

The socioeconomic impact of the COVID-19 lockdown on families affected by childhood respiratory illnesses in Cape Town, South Africa.

The COVID-19 pandemic impacted families globally, directly and indirectly. Children presenting with respiratory illnesses are affected by emerging health systems and socioeconomic changes in the COVID-19 era. We explored the socioeconomic impacts of the COVID-19 lockdown on families with a respiratory illness diagnosed in their child in Cape Town, South Africa. This study was nested in a prospective observational cohort of children presenting with respiratory symptoms presumptive of COVID-19. We conducted 21 semi-structured interviews to explore the socioeconomic impact of the COVID-19 pandemic on families with a child affected by respiratory illnesses. We used case descriptive analysis and thematically organised common and divergent experiences. We found that socioeconomic challenges in low-income communities were exacerbated: 1) loss of pre-COVID sources of income (loss of income, employment and working hours), 2) shrinking employment opportunities due to business closures and strict preventative measures, 3) family network dependence to cope with financial pressures, 4) impact on education, implicating additional pressures due to lack of resources for adequate home schooling and 5) caregivers' mental health and wellbeing being impacted, causing stress and anxiety due to loss of income. This study shows that the COVID-19 lockdown impacted the socioeconomic aspects of families caring for a child with a respiratory illness. Care became more complicated and adversely impacted the family's emotional well-being and health-seeking behaviour. These impacts should be more carefully considered in order to strengthen health services and global health messaging in future pandemics.

Some Aspects Of Acute Bronchitis In Children

The article presents data on the structure of morbidity and features of the modern course of respiratory diseases in children of Andijan. The relevance, place among bronchopulmonary diseases, and features of the course of modern bronchitis in childhood are determined. A brief clinical description is given and the main approaches to the treatment of acute bronchitis are identified. Data from clinical experience with the use of the non-steroidal anti-inflammatory drug fenspiride hydrochloride (Erespal) in children are presented. High anti-inflammatory, bronchodilator, indirect mucoactive and antitussive effects of the drug in the complex treatment of bronchitis in children were noted

The incidence of upper respiratory infections in children is related to the concentration of vanadium in indoor dust aggregates.

It has been reported that the disease-initiated and disease-mediated effects of aerosol pollutants can be related to concentration, site of deposition, duration of exposure, as well as the specific chemical composition of pollutants. To investigate the microelemental composition of dust aggregates in primary schools of Vilnius and determine trace elements related to acute upper respiratory infections among 6-to 11-year-old children. Microelemental analysis of aerosol pollution was performed using dust samples collected in the classrooms of 11 primary schools in Vilnius from 2016 to 2020. Sites included areas of its natural accumulation behind the radiator heaters and from the surface of high cupboards. The concentrations of heavy metals (Pb, W, Sb, Sn, Zr, Zn, Cu, Ni, Mn, Cr, V, and As) in dust samples were analyzed using a SPECTRO XEPOS spectrometer. The annual incidence rates of respiratory diseases in children of each school were calculated based on data from medical records. The mean annual incidence of physician-diagnosed acute upper respiratory infections (J00-J06 according to ICD-10A) among younger school-age children was between 25.1 and 71.3% per school. A significant correlation was found between vanadium concentration and the number of episodes of acute upper respiratory infections during each study year from 2016 to 2020. The lowest was r = 0.67 (p = 0.024), and the highest was r = 0.82 (p = 0.002). The concentration of vanadium in the samples of dust aggregates varied from 12.7 to 52.1 parts per million (ppm). No significant correlations between the other trace elements and the incidence of upper respiratory infections were found, which could be caused by a small number of study schools and relatively low concentrations of other heavy metals found in the samples of indoor dust aggregates. A significant and replicable correlation was found between the concentration of vanadium in the samples of natural dust aggregates collected in primary schools and the incidence of acute upper respiratory infections in children. Monitoring the concentration of heavy metals in the indoor environment can be an important instrument for the prevention and control of respiratory morbidity in children.

Procalcitonin and Presepsin as Markers of Infectious Respiratory Diseases in Children: A Scoping Review of the Literature.

Procalcitonin and presepsin have been suggested to be able to discriminate bacterial and viral infections, also in children. This scoping review aims to better explore the available evidence around the potential role of these biomarkers in the subgroup of children with respiratory infectious diseases. We performed a systematic scoping review of studies published until March 2023 in the following bibliographic databases: PubMed, EMBASE, Cochrane and SCOPUS. In children with bacterial infection, procalcitonin values ranged from 0.5 ng/mL to 8.31 ng/dL, while in those hospitalized in an intensive care unit ranged from 0.6 ng/dL to 452.8 ng/dL with PCR from 2 ng/dL to 51.7 ng/dL. In children with viral infections, procalcitonin value values ranged from 0.2 ng/dL to 0.84 ng/dL, while in those hospitalized in an intensive care unit ranged from 0.61 ng/dL to 46.6 ng/dL. No studies on presepsin in children with respiratory infections were retrieved. Although the available literature is highly heterogeneous, evidence does not suggest a role of procalcitonin in accurately differentiating bacterial and viral infections in children with respiratory infections. In future, new approaches based on multiple markers may better help determine which febrile children require antibiotics.

Multiplex PCR in Diagnosing Respiratory Tract Infections in Hospitalized Children.

To elaborate the utility of multiplex quantitative polymerase chain reaction (multiplex qPCR) for the accurate diagnosis of severe respiratory tract infections (RTIs) in hospitalized children. In two separate periods during 2022, 76 respiratory specimens (combined throat/nasopharyngeal swabs) were submitted for multiplex qPCR regarding 26 respiratory pathogens. The specimens were obtained from children with severe RTIs hospitalized in the Institute for Respiratory Diseases in Children, Skopje. Multiplex qPCR detected at least one respiratory pathogen in all examined specimens (76/76), with 83% (63/76) rate of co-infections. Considering that positive results are only the ones with Ct value below 28, the rates of detected pathogens and co-infections decrease to 75% and 22%, respectively. The most commonly detected pathogens during the spring period were Parainfluenza type 3 (PIV3) followed by Adenovirus (AdV) and Respiratory syncytial virus type B (RSVB) with frequency rate of 23%, 19% and 19%, respectively. During the autumn period, the most common were RSVB and Streptococcus pneumoniae with frequency rate of 31% and 17%, respectively. Multiplex qPCR is a powerful tool for diagnosing RTIs. Semi-quantification of the viral load by reporting Ct values added higher level of evidence for accurate diagnosis. Seasonal detection of the examined viruses was notable with higher prevalence of PIV3 in spring and RSVB in autumn period.

Раціональна антибіотикотерапія при інфекціях дихальних шляхів у дітей: сучасні рекомендації

Diseases of the respiratory tract remain relevant in pediatrics. Purpose - to provide modern recommendations for the prescription of rational antibiotic therapy for respiratory tract infections in children to improve clinical practice and preserve the effectiveness of antibacterial drugs. The principles of optimal use of antibacterial drugs in the treatment of respiratory diseases in pediatric practice are discussed. The data of the study of the pharmacological profile of azithromycin, its effectiveness and safety in the treatment of respiratory diseases are presented. A detailed analysis of the drug's spectrum of action, its pharmacokinetics, and the possibility of side effects is provided. The study includes the results of clinical trials and meta-analyses, emphasizing the importance of choosing the right dosage and duration of treatment. The presented results contribute to the understanding of optimal approaches to the use of azithromycin in the treatment of respiratory diseases in children, contributing to the improvement of clinical practice and maintaining the effectiveness of antibiotic therapy. No conflict of interests was declared by the author.

Impact of "Long Covid" on Children: Global and Hong Kong Perspectives.

The coronavirus disease (COVID-19) pandemic spares no nation or city, and the virus is responsible for the escalating incidence and mortality worldwide. This article reviews the impact of "Long Covid" on Children. A PubMed search was conducted in December 2021 in Clinical Queries using the key terms "COVID-19" OR "long COVID". The search was restricted to children and adolescent aged < 18 years and English literature. Many large-scale studies have provided strong scientific evidence as to the detrimental and irreversible sequelae of COVID-19 on the health, psychology, and development of affected children. Many insights into managing this disease can be obtained from comparing the management of influenza. COVID-19 is generally a mild respiratory disease in children. Several syndromes, such as multisystem inflammatory syndrome in children (MIS-C) and COVID toe, are probably not specific to SARS-CoV-2. "Long COVID", or the long-term effects of SARS-CoV-2 infection, or the prolonged isolation and containment strategies on education and psychosocial influences on children associated with the pandemic, are significant. Healthcare providers must be aware of the potential effects of quarantine on children's mental health. More importantly, healthcare providers must appreciate the importance of the decisions and actions made by governments, non-governmental organizations, the community, schools, and parents in reducing the possible effects of this situation. Multifaceted age-specific and developmentally appropriate strategies must be adopted by healthcare authorities to lessen the negative impact of quarantine on the psychological well-being of children.

Air pollution and childhood respiratory consultations in primary care: a systematic review

BackgroundOutdoor air pollution is a known risk factor for respiratory morbidity worldwide. Compared with the adult population, there are fewer studies that analyse the association between short-term exposure to air...

Clinical practice guidelines for bronchoalveolar lavage in Chinese children (2024)

Bronchoalveolar lavage (BAL) has become an important technique in the diagnosis and treatment of respiratory diseases in children. In order to standardize the clinical application of BAL in children, the Branch of Pediatric Critical Care Physicians of Chinese Medical Association, in collaboration with other institutions, has developed the "Clinical practice guidelines for bronchoalveolar lavage in Chinese children (2024)" based on the principles of the World Health Organization guidelines and the formulation/revision principles of the Chinese clinical practice guidelines (2022 edition). This guideline provides 30 recommendations to guide the operational procedures of BAL in children.

Prenatal dietary exposure to mixtures of chemicals is associated with allergy or respiratory diseases in children in the ELFE nationwide cohort

IntroductionPrenatal exposure to environmental chemicals may be associated with allergies later in life. We aimed to examine the association between prenatal dietary exposure to mixtures of chemicals and allergic or respiratory diseases up to age 5.5 y.MethodsWe included 11,638 mother-child pairs from the French “Étude Longitudinale Française depuis l’Enfance” (ELFE) cohort. Maternal dietary exposure during pregnancy to eight mixtures of chemicals was previously assessed. Allergic and respiratory diseases (eczema, food allergy, wheezing and asthma) were reported by parents between birth and age 5.5 years. Associations were evaluated with adjusted logistic regressions. Results are expressed as odds ratio (OR[95%CI]) for a variation of one SD increase in mixture pattern.ResultsMaternal dietary exposure to a mixture composed mainly of trace elements, furans and polycyclic aromatic hydrocarbons (PAHs) was positively associated with the risk of eczema (1.10 [1.05; 1.15]), this association was consistent across sensitivity analyses. Dietary exposure to one mixture of pesticides was positively associated with the risk of food allergy (1.10 [1.02; 1.18]), whereas the exposure to another mixture of pesticides was positively but slightly related to the risk of wheezing (1.05 [1.01; 1.08]). This last association was not found in all sensitivity analyses. Dietary exposure to a mixture composed by perfluoroalkyl acids, PAHs and trace elements was negatively associated with the risk of asthma (0.89 [0.80; 0.99]), this association was consistent across sensitivity analyses, except the complete-case analysis.ConclusionWhereas few individual chemicals were related to the risk of allergic and respiratory diseases, some consistent associations were found between prenatal dietary exposure to some mixtures of chemicals and the risk of allergic or respiratory diseases. The positive association between trace elements, furans and PAHs and the risk of eczema, and that between pesticides mixtures and food allergy need to be confirmed in other studies. Conversely, the negative association between perfluoroalkyl acids, PAHs and trace elements and the risk of asthma need to be further explored.

Multidisciplinary Approach To The Problem Of Managing Children With Frequent Respiratory Infections Of The Upper Respiratory Tract: Key Results

Background. Recurrent upper respiratory diseases in children are an urgent and common issue in pediatrics. Comorbidities often lead to prolonged, complicated, or chronic course of the inflammatory process in the upper airways.Objective. The aim of the study — scientific evidence and complex technology development for the management of children with recurrent upper respiratory diseases according to implemented multidisciplinary personalized approach, complex of modern methods for diagnosing and health monitoring to achieve long-term remission.Materials and methods. The study included 115 children aged from 2 years 6 months to 17 years 11 months with recurrent upper respiratory diseases. Examination included: nasal cavity, nasopharynx and larynx endoscopy, abdomen ultrasound with aqueous-siphon test, tympanometry, and laboratory tests (total and specific IgE levels, antistreptolysin-O, microbiological study of nasopharynx and oropharynx discharge, enzyme-linked immunosorbent assay of feces on Helicobacter pylori.Results. The study has revealed high prevalence of associated allergic pathology in children with recurrent upper respiratory diseases. Allergic rhinitis was the most common (55 (48%) children). There was also a high prevalence of gastroesophageal reflux disease (GERD) (37 (32%) children). Clinical signs of GERD were revealed in patients with chronic diseases significantly more often than in children with acute ENT pathology (27 (38%) and 10 (23%) children, respectively). It confirms the role of this comorbid condition in the development and course of chronic inflammatory process of the upper airways. Obtained data analysis has shown high prevalence of allergic and gastrointestinal pathology in children with recurrent upper respiratory diseases. Diagnostic and management algorithm for patients with recurrent upper respiratory diseases as well as practical guidelines were prepared based on the study data. This algorithm will allow to implement the personalized multidisciplinary approach for the management of prior and comorbid diseases via modern informative diagnostic methods. The complex approach to timely physical examination and pathogenetic treatment will ensure control of the patient’s condition and prevent the development of chronic ENT organ pathology in children.

Nurses’ Role and Participation in the Management in Children Respiratory Diseases

Pediatric respiratory pathology has its unique characteristics and requires specialized approaches in diagnostics, treatment, and care. In many countries, programs are being developed and implemented to optimize nursing care for children with such diseases, which can serve as a valuable source of experience for nurses. The current review aims to describe the existing data on the role of nurses in the management of respiratory diseases in children in primary care settings. Literature searches were conducted in electronic databases including PubMed/Medline, CINAHL, Cochrane Database of Systematic Reviews, and ProQuest for the period from 2012 to 2023. The following key search queries were used: nurses, nursing roles, primary health care, pediatrics, respiratory diseases. Inclusion criteria were peer-reviewed studies, including quantitative and qualitative studies, as well as mixedmethods research. Numerous studies demonstrate that nurses significantly improve the quality of life for patients by reducing the number of acute disease episodes and decreasing the need for hospitalization. This is achieved through the effective use of clinical protocols and continuous improvement of their knowledge and skills. Educational programs developed by nurses increase children's and their parents' awareness of the diseases, aiding in better inhalation techniques and overall disease management. This highlights the importance of nurses' roles in education and consultative support. Thus, extensive research confirms the importance of nursing in managing respiratory diseases in children and underscores the need for further development of nurse role in the healthcare system. Strengthening and expanding the competencies of nurses in this area can lead to more effective and high-quality care for children with respiratory diseases.