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Foti Randazzese S, Toscano F, Gambadauro A, La Rocca M, Altavilla G, Carlino M, Caminiti L, Ruggeri P, Manti S. Neuromodulators in Acute and Chronic Cough in Children: An Update from the Literature. Int J Mol Sci 2024; 25:11229. [PMID: 39457010 PMCID: PMC11508565 DOI: 10.3390/ijms252011229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 10/14/2024] [Accepted: 10/16/2024] [Indexed: 10/28/2024] Open
Abstract
Cough is one of the most common reasons leading to pediatric consultations, negatively impacting the quality of life of patients and caregivers. It is defined as a sudden and forceful expulsion of air from the lungs through the mouth, typically triggered by irritation or the stimulation of sensory nerves in the respiratory tract. This reflex is controlled by a neural pathway that includes sensory receptors, afferent nerves, the brainstem's cough center, efferent nerves, and the muscles involved in coughing. Based on its duration, cough in children may be classified as acute, lasting less than four weeks, and chronic, persisting for more than four weeks. Neuromodulators have shown promise in reducing the frequency and severity of cough by modulating the neural pathways involved in the cough reflex, although they require careful monitoring and patient selection to optimize the outcomes. This review aims to examine the rationale for using neuromodulators in the management of cough in children.
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Affiliation(s)
- Simone Foti Randazzese
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 1, 98124 Messina, Italy; (S.F.R.); (F.T.); (M.L.R.); (G.A.); (L.C.)
| | - Fabio Toscano
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 1, 98124 Messina, Italy; (S.F.R.); (F.T.); (M.L.R.); (G.A.); (L.C.)
| | - Antonella Gambadauro
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 1, 98124 Messina, Italy; (S.F.R.); (F.T.); (M.L.R.); (G.A.); (L.C.)
| | - Mariarosaria La Rocca
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 1, 98124 Messina, Italy; (S.F.R.); (F.T.); (M.L.R.); (G.A.); (L.C.)
| | - Giulia Altavilla
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 1, 98124 Messina, Italy; (S.F.R.); (F.T.); (M.L.R.); (G.A.); (L.C.)
| | - Mariagrazia Carlino
- Pediatric Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Lucia Caminiti
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 1, 98124 Messina, Italy; (S.F.R.); (F.T.); (M.L.R.); (G.A.); (L.C.)
| | - Paolo Ruggeri
- Pulmonology Unit, Department of Biomedical, Dental, Morphological and Functional Imaging Sciences (BIOMORF), University of Messina, Via Consolare Valeria, 1, 98124 Messina, Italy;
| | - Sara Manti
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 1, 98124 Messina, Italy; (S.F.R.); (F.T.); (M.L.R.); (G.A.); (L.C.)
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Fujiki RB, Thibeault SL. Diagnostic utility of spirometry for children with induced laryngeal obstruction or chronic non-specific cough. Am J Otolaryngol 2024; 45:104316. [PMID: 38677150 PMCID: PMC11168868 DOI: 10.1016/j.amjoto.2024.104316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE To determine the diagnostic utility of spirometry in distinguishing children with Induced Laryngeal Obstruction (ILO) or chronic non-specific cough (a.k.a. tic cough) from those with mild or moderate to severe asthma. METHODS Retrospective cross sectional design. Children diagnosed with ILO (N = 70), chronic non-specific cough (N = 70), mild asthma (N = 60), or moderate to severe asthma (N = 60) were identified from the electronic medical record of a large children's hospital. Spirometry was completed before ILO, non-specific cough, or asthma diagnoses were made by pediatric laryngologists or pulmonologists. Spirometry was performed following American Thoracic Society guidelines and was interpreted by a pediatric pulmonologist. Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 Second (FEV1), FEV1/FVC Ratio (FEV1/FVC), Forced Mid-Expiratory Flow 25--75 % (FEF25-75%), pulmonologist interpretation of flow volume loops, and overall exam findings were extracted from the medical record. RESULTS Ninety seven percent of children with ILO or chronic non-specific cough presented with spirometry values within normative range. Patients with ILO, non-specific cough, and mild asthma presented with FVC, FEV1, FEV1/FVC, and FEF25-75% values in statistically similar range. Children with moderate to severe asthma presented with significantly reduced FVC (p < .001), FEV1 (p < .001), FEV1/FVC (p < .001), and FEF25-75% (p < .001) values when compared with patients in the other groups. Flow volume loops were predominantly normal for children with ILO and non-specific cough. CONCLUSIONS Findings indicate that ILO and chronic non-specific cough can neither be diagnosed nor differentiated from mild asthma using spirometry alone. Spirometry should therefore be used judiciously with this population, bearing in mind the limitations of the procedure. Future research should determine the most effective and efficient ways of delineating ILO and non-specific cough from other respiratory conditions in children.
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Affiliation(s)
- Robert Brinton Fujiki
- Department of Surgery, University of Wisconsin - Madison, Madison, WI, United States of America
| | - Susan L Thibeault
- Department of Surgery, University of Wisconsin - Madison, Madison, WI, United States of America.
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Azam NSA, Jalaludin J, Suhaimi NF. The association between indoor air quality and respiratory health symptoms among preschool children in Penang, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-14. [PMID: 38860645 DOI: 10.1080/09603123.2024.2365308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 06/03/2024] [Indexed: 06/12/2024]
Abstract
A cross-sectional study was conducted among 126 preschool children aged 4-6 years in traffic, industrial, and suburban areas of Penang, Malaysia, to determine their exposure to indoor air pollutants and their associations with respiratory symptoms. A standardised and validated questionnaire was used to collect data on respiratory health symptoms among respondents. An indoor air quality assessment was conducted in selected preschools that included temperature, relative humidity, air velocity, volatile organic compounds (VOCs), and particulate matter (PM2.5, and PM10). There were significant differences in median concentrations of PM2.5, PM10 and relative humidity among study groups. Statistical analysis showed significant associations between air pollutants in preschool with respiratory symptoms. Factors that influenced the increased likelihood of cough and phlegm were linked to the increase in PM2.5 exposure. This study suggests regular classroom cleaning and routine maintenance of air conditioners to be done inside the preschools.
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Affiliation(s)
- Nur Syazura Akmal Azam
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Juliana Jalaludin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Occupational Health and Safety Department, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Nur Faseeha Suhaimi
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Mallet MC, Mozun R, Pedersen ESL, Ardura-Garcia C, Gaillard EA, Latzin P, Moelller A, Kuehni CE. Prevalence of childhood cough in epidemiological studies depends on the question used: findings from two population-based studies. Swiss Med Wkly 2023; 153:40044. [PMID: 36912371 DOI: 10.57187/smw.2023.40044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Epidemiological studies use different questions to assess recurrent cough in children. In two independent population-based studies, we assessed how prevalence estimates of cough vary depending on the questions parents are asked about their child's cough and how answers to the different questions overlap. METHODS We analysed cross-sectional data from two population-based studies on respiratory health: LuftiBus in the School (LUIS), conducted in 2013-2016 among 6- to 17-year-school children in the Canton of Zurich, Switzerland, and the 1998 Leicester Respiratory Cohort (LRC) study, UK where we used data from 6- to 8-year-old children from the 2003 follow-up survey. Both studies used parental questionnaires that included the same three questions on the child's cough, namely cough without a cold, dry cough at night and coughing more than others. We assessed how the prevalence of cough varied depending on the question and how answers to the different questions on cough overlapped. We also assessed how results were influenced by age, sex, presence of wheeze and parental education. RESULTS We included 3457 children aged 6-17 years from LUIS and 2100 children aged 6-8 years from LRC. All respiratory outcomes - cough, wheeze and physician-diagnosed asthma - were reported twice as often in the LRC as in LUIS. We found large differences in the prevalence of parent-reported cough between the three cough questions. In LUIS, 880 (25%) parents reported cough without a cold, 394 (11%) dry night cough, and 159 (5%) reported that their child coughed more than other children. In the LRC, these numbers were 1003 (48%), 527 (25%) and 227 (11%). There was only partial overlap of answers, with 89 (3%) answering yes to all questions in LUIS and 168 (8%) in LRC. Prevalence of all types of cough and overlap between the cough questions was higher in children with current wheeze. CONCLUSION In both population-based studies prevalence estimates of cough depended strongly on the question used to assess cough with only partial overlap of responses to different questions. Epidemiological studies on cough can only be compared if they used exactly the same questions for cough.
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Affiliation(s)
- Maria Christina Mallet
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Switzerland
| | - Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Department of Intensive Care and Neonatology, and Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Switzerland
| | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | | | - Erol A Gaillard
- Institute for Lung Health, Department of Respiratory Sciences, College of Life Sciences, Department of Paediatrics, NIHR Biomedical Research Centre: Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Alexander Moelller
- Department of Respiratory Medicine, University Children's Hospital Zurich and Children's Research Centre, University of Zurich, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Vogelberg C, Cuevas Schacht F, Watling CP, Upstone L, Seifert G. Therapeutic principles and unmet needs in the treatment of cough in pediatric patients: review and expert survey. BMC Pediatr 2023; 23:34. [PMID: 36670372 PMCID: PMC9860236 DOI: 10.1186/s12887-022-03814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/20/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There are evidence gaps in the management of pediatric cough, particularly for acute pediatric cough. This study had two aims: to identify therapeutic principles and unmet needs in the treatment of cough in pediatric patients (internationally), and to consider the evidence required to address these unmet needs. METHODS A MEDLINE/PubMed database search was performed to identify articles describing therapeutic principles in the treatment of pediatric cough. An online survey of international pediatric cough experts was conducted, with questions on the definitions, diagnosis, treatment, and unmet needs in pediatric cough management. RESULTS Cough guidelines have differing definitions of pediatric patients (≤12-18 years), acute pediatric cough (< 2-3 weeks), and chronic pediatric cough (> 4-8 weeks). Similarly, among 18 experts surveyed, definitions varied for pediatric patients (≤10-21 years), acute pediatric cough (< 3-5 days to < 6 weeks), and chronic pediatric cough (> 2-8 weeks). Guidelines generally do not recommend over-the-counter or prescription cough medicines in acute pediatric cough, due to lack of evidence. In the expert survey, participants had differing opinions on which medicines were most suitable for treating acute pediatric cough, and noted that effective treatments are lacking for cough-related pain and sleep disruption. Overall, guidelines and experts agreed that chronic pediatric cough requires diagnostic investigations to identify the underlying cough-causing disease and thereby to guide treatment. There are unmet needs for new effective and safe treatments for acute pediatric cough, and for randomized controlled trials of existing treatments. Safety is a particular concern in this vulnerable patient population. There is also a need for better understanding of the causes, phenotypes, and prevalence of pediatric cough, and how this relates to its diagnosis and treatment. CONCLUSIONS Whereas pediatric cough guidelines largely align with regard to the diagnosis and treatment of chronic cough, there is limited evidence-based guidance for the management of acute cough. There is a need for harmonization of pediatric cough management, and the development of standard guidelines suitable for all regions and patient circumstances.
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Affiliation(s)
- Christian Vogelberg
- grid.412282.f0000 0001 1091 2917Paediatric Department, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany
| | - Francisco Cuevas Schacht
- grid.419216.90000 0004 1773 4473Department of Pulmonology and Thoracic Surgery, National Institute of Paediatrics, Mexico City, Mexico
| | | | | | - Georg Seifert
- grid.6363.00000 0001 2218 4662Department of Paediatric Oncology/Haematology, Otto-Heubner Centre for Paediatric and Adolescent Medicine (OHC), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Mao H, Wei YH, Su HM, Jiang ZY, Li X. Pediatric Tui Na for cough in children: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2022; 71:102882. [PMID: 36031023 DOI: 10.1016/j.ctim.2022.102882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness and safety of pediatric Tui Na for the treatment of cough in children under seven years of age. DESIGN Systematic review and meta-analysis of randomized controlled trials. METHODS We searched seven major databases and two ongoing trial registers before November 2021 for randomized controlled trials (RCTs) on pediatric Tui Na for cough in children. Main outcome measures were cough related status (such as cough frequency, severity, and duration), use of western medicines, quality of life, medical costs, recurrence rate, adverse events and acceptance. Two reviewers independently selected studies and extracted data. Results were presented by RevMan 5.4 as risk ratios (RRs) and mean differences (MDs), both with 95 % confidence intervals (CIs). Risk of bias were assessed using ROB tools and quality of evidence by GRADE. RESULTS Sixteen RCTs involving 1502 participants were included in this review. Most trials were poor in quality for not reporting allocation concealment, blinding of outcomeassessment or outcome data completeness. The pooled results demonstrated that pediatric Tui Na alone (2 RCTs, 205 participants; MD -2.22, 95 %CI -3.71 to -0.73; P = 0.004; I 2 = 90 %; low certainty) or combined with conventional treatment (7 RCTs, 668 participants; MD -1.66, 95 %CI -2.89 to -0.44; P = 0.008; I 2 = 98 %; low certainty) shortened cough duration. The combined treatment also decreased the recurrence rate of cough (3 RCTs, 135 participants; RR 0.35, 95 %CI 0.21-0.58; P < 0.0001; I 2 = 0 %; moderate certainty). There were insufficient data on adverse events. CONCLUSIONS This review indicates that pediatric Tui Na may shorten the course and decrease the recurrence rate of cough in children, and appears to be relatively safe. However, large-sample, multi-center and high-quality RCTs are warranted to confirm these findings.
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Affiliation(s)
- Hui Mao
- School of Humanities, Beijing University of Chinese Medicine, Beijing 100029, China.
| | - Yue-Hui Wei
- School of Humanities, Beijing University of Chinese Medicine, Beijing 100029, China.
| | - Hui-Ming Su
- Beijing Universality of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China.
| | - Zi-Yun Jiang
- School of Management, Beijing University of Chinese Medicine, Beijing 100029, China.
| | - Xun Li
- Centre for Evidence-Based Chinese Medicine, Beijing 100029, China.
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Divaret‐Chauveau A, Mauny F, Hose A, Depner M, Dalphin M, Kaulek V, Barnig C, Schaub B, Schmausser‐Hechfellner E, Renz H, Riedler J, Pekkanen J, Karvonen AM, Täubel M, Lauener R, Roduit C, Vuitton DA, von Mutius E, Demoulin‐Alexikova S, Kirjavainen P, Roponen M, Laurent L, Theodorou J, Böck A, Pechlivanis S, Ege M, Genuneit J, Illi S, Kabesch M, Pfefferle P, Frei R. Trajectories of cough without a cold in early childhood and associations with atopic diseases. Clin Exp Allergy 2022; 53:429-442. [PMID: 36453463 DOI: 10.1111/cea.14257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Although children can frequently experience a cough that affects their quality of life, few epidemiological studies have explored cough without a cold during childhood. OBJECTIVES The objective of the study was to describe the latent class trajectories of cough from one to 10 years old and analyse their association with wheezing, atopy and allergic diseases. METHODS Questions about cough, wheeze and allergic diseases were asked at 1, 1.5, 2, 3, 4, 5, 6 and 10 years of age in the European prospective cohort of Protection against Allergy: STUdy in Rural Environment (PASTURE). Specific IgE assays were performed at 10 years of age. Questions regarding a cough without a cold were used to build a latent class model of cough over time. RESULTS Among the 961 children included in the study, apart from the never/infrequent trajectory (59.9%), eight trajectories of cough without a cold were identified: five grouped acute transient classes (24.1%), moderate transient (6.8%), late persistent (4.8%) and early persistent (4.4%). Compared with the never/infrequent trajectory, the other trajectories were significantly associated with wheezing, asthma and allergic rhinitis. For asthma, the strongest association was with the early persistent trajectory (ORa = 31.00 [14.03-68.51]), which was inversely associated with farm environment (ORa = 0.39 [0.19-0.77]) and had a high prevalence of cough triggers and unremitting wheeze. Late and early persistent trajectories were also associated with food allergy. Atopic sensitization was only associated with the late persistent trajectory. CONCLUSION Late and early persistent coughs without a cold are positively associated with atopic respiratory diseases and food allergy. Children having recurrent cough without a cold with night cough and triggers would benefit from an asthma and allergy assessment. Growing up on a farm is associated with reduced early persistent cough.
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Affiliation(s)
- Amandine Divaret‐Chauveau
- Paediatric Allergy Department University Hospital of Nancy Vandoeuvre‐les‐Nancy France
- EA3450 Développement Adaptation et Handicap (DevAH) University of Lorraine Nancy France
- UMR 6249 Chrono‐environment, CNRS and University of Franche‐Comté Besançon France
| | - Frederic Mauny
- UMR 6249 Chrono‐environment, CNRS and University of Franche‐Comté Besançon France
- Unité de Méthodologie en Recherche Clinique, Épidémiologie et Santé Publique CIC Inserm 143, University Hospital of Besançon Besançon France
| | - Alexander Hose
- Department of Paediatric Allergology, Dr von Hauner Children's Hospital Ludwig Maximilian University of Munich Munich Germany
| | - Martin Depner
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg Germany
| | | | - Vincent Kaulek
- Respiratory Diseases Department University Hospital of Besançon Besançon France
| | - Cindy Barnig
- Respiratory Diseases Department University Hospital of Besançon Besançon France
- INSERM, EFS BFC, LabEx LipSTIC, UMR1098, Interactions Hôte‐Greffon‐Tumeur, Ingénierie Cellulaire et Génique Bourgogne Franche‐Comté University Besançon France
| | - Bianca Schaub
- Department of Paediatric Allergology, Dr von Hauner Children's Hospital Ludwig Maximilian University of Munich Munich Germany
- Comprehensive Pneumology Center Munich (CPC‐M), Member of the German Centre for Lung Research Neuherberg Germany
| | - Elisabeth Schmausser‐Hechfellner
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg Germany
| | - Harald Renz
- Institute for Medicine Laboratory, Pathobiochemistry and Molecular Diagnostics Philipps‐University Marburg Marburg Germany
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergology Sechenov University Moscow Russia
| | | | - Juha Pekkanen
- Department of Health Security Finnish Institute for Health and Welfare Kuopio Finland
- Department of Public Health University of Helsinki Helsinki Finland
| | - Anne M. Karvonen
- Department of Health Security Finnish Institute for Health and Welfare Kuopio Finland
| | - Martin Täubel
- Department of Health Security Finnish Institute for Health and Welfare Kuopio Finland
| | - Roger Lauener
- Christine Kühne Centre for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Children's Hospital of Eastern Switzerland St Gallen Switzerland
| | - Caroline Roduit
- Christine Kühne Centre for Allergy Research and Education (CK‐CARE) Davos Switzerland
- University Children's Hospital Zurich Zurich Switzerland
| | | | - Erika von Mutius
- Department of Paediatric Allergology, Dr von Hauner Children's Hospital Ludwig Maximilian University of Munich Munich Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg Germany
- Comprehensive Pneumology Center Munich (CPC‐M), Member of the German Centre for Lung Research Neuherberg Germany
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Masson V, Kier C, Chandran L. Cough Conundrums: A Guide to Chronic Cough in the Pediatric Patient. Pediatr Rev 2022; 43:691-703. [PMID: 36450640 DOI: 10.1542/pir.2021-005398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Vicki Masson
- Division of Pediatric Pulmonology and Sleep Medicine
| | - Catherine Kier
- Division of Pediatric Pulmonology, Stony Brook University, Stony Brook, NY
| | - Latha Chandran
- Department of Medical Education and Pediatrics, University of Miami, Miller School of Medicine, Miami, FL
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9
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Mashat GD, Hazique M, Khan KI, Ramesh P, Kanagalingam S, Ul Haq Z, Victory Srinivasan N, Khan AI, Khan S. Comparing the Effectiveness of Honey Consumption With Anti-Cough Medication in Pediatric Patients: A Systematic Review. Cureus 2022; 14:e29346. [PMID: 36284810 PMCID: PMC9583571 DOI: 10.7759/cureus.29346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Coughing is one of the most prevalent symptoms in children presenting at outpatient departments. This systematic review aimed to review previous literature in order to compare the use of honey and antitussive medications for treating coughs in children. Literature was screened across five databases using Medical Subject Heading (MeSH) strategy, keywords, and inclusion and exclusion criteria. The remaining literature was evaluated using a quality appraisal tool checklist. This review includes systematic reviews, meta-analyses, randomized controlled trials (RCTs), observational studies, cross-sectional studies, and articles without a defined methodology section. This review suggests that honey is effective in treating children above 12 months of age, while cold and cough medications (CCMs) are safe if administered at therapeutic doses. Since fatalities can occur in children under two years of age, further RCT studies on CCMs are required to establish safety across all age groups.
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Affiliation(s)
- Ghadi D Mashat
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohammad Hazique
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Kokab Irfan Khan
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Prasana Ramesh
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Suthasenthuran Kanagalingam
- Internal Medicine/Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Zargham Ul Haq
- Medicine and Surgery, California Institute of Behavioral Neurosciences & Psychology, Farifield, USA
| | | | - Aujala Irfan Khan
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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10
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Garaiova I, Paduchová Z, Nagyová Z, Wang D, Michael DR, Plummer SF, Marchesi JR, Ďuračková Z, Muchová J. Probiotics with vitamin C for the prevention of upper respiratory tract symptoms in children aged 3-10 years: randomised controlled trial. Benef Microbes 2021; 12:431-440. [PMID: 34511049 DOI: 10.3920/bm2020.0185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In a double-blind, randomised, parallel-group, placebo-controlled study, healthy school children aged 3-10 years received a probiotic based supplement daily for 6 months to assess the impact on the incidence and duration of upper respiratory tract infection (URTI) symptoms. The intervention comprised Lab4 probiotic (Lactobacillus acidophilus CUL21 and CUL60, Bifidobacterium bifidum CUL20 and Bifidobacterium animalis subsp. lactis CUL34) at 12.5 billion cfu/day plus 50 mg vitamin C or a matching placebo. 171 children were included in the analysis (85 in placebo and 86 in active group). Incidence of coughing was 16% (P=0.0300) significantly lower in the children receiving the active intervention compared to the placebo. No significant differences in the incidence rate of other URTI symptoms were observed. There was significantly lower risk of experiencing five different URTI related symptoms in one day favouring the active group (Risk ratio: 0.31, 95% confidence interval: 0.12, 0.81, P=0.0163). Absenteeism from school and the use of antibiotics was also significantly reduced for those in the active group (-16%, P=0.0060 and -27%, P=0.0203, respectively). Our findings indicate that six months daily supplementation with the Lab4 probiotic and vitamin C combination reduces the incidence of coughing, absenteeism and antibiotic usage in 3 to 10 year old children.
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Affiliation(s)
- I Garaiova
- Research and Development Department, Cultech Ltd, Unit 2 Christchurch Road, Port Talbot, SA12 7BZ, United Kingdom
| | - Z Paduchová
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
| | - Z Nagyová
- JuvenaliaA Paediatric Centre, Veľkoblahovská 44/A, 929 01 Dunajská Streda, Slovakia
| | - D Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - D R Michael
- Research and Development Department, Cultech Ltd, Unit 2 Christchurch Road, Port Talbot, SA12 7BZ, United Kingdom
| | - S F Plummer
- Research and Development Department, Cultech Ltd, Unit 2 Christchurch Road, Port Talbot, SA12 7BZ, United Kingdom
| | - J R Marchesi
- School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom.,Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, W2 1NY, United Kingdom
| | - Z Ďuračková
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
| | - J Muchová
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
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11
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McGarvey L, Rubin BK, Ebihara S, Hegland K, Rivet A, Irwin RS, Bolser DC, Chang AB, Gibson PG, Mazzone SB. Global Physiology and Pathophysiology of Cough: Part 2. Demographic and Clinical Considerations: CHEST Expert Panel Report. Chest 2021; 160:1413-1423. [PMID: 33905678 PMCID: PMC8692102 DOI: 10.1016/j.chest.2021.04.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/15/2021] [Accepted: 04/18/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Cough characteristics vary between patients, and this can impact clinical diagnosis and care. The purpose of part two of this state-of-the-art review is to update the American College of Chest Physicians (CHEST) 2006 guideline on global physiology and pathophysiology of cough. STUDY DESIGN AND METHODS A review of the literature was conducted using PubMed and MEDLINE databases from 1951 to 2019 using prespecified search terms. RESULTS We describe the demographics of typical patients with cough in the clinical setting, including how cough characteristics change across age. We summarize the effect of common clinical conditions impacting cough mechanics and the physical properties of mucus on airway clearance. INTERPRETATION This is the second of a two-part update to the 2006 CHEST cough guideline; it complements part one on basic phenomenology of cough by providing an extended clinical picture of cough along with the factors that alter cough mechanics and efficiency in patients. A greater understanding of the physiology and pathophysiology of cough will improve clinical management.
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Affiliation(s)
- Lorcan McGarvey
- Wellcome-Wolfson Institute of Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland.
| | - Bruce K Rubin
- Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
| | - Satoru Ebihara
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Karen Hegland
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, FL
| | - Alycia Rivet
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, FL
| | - Richard S Irwin
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester, MA
| | - Donald C Bolser
- Department of Physiological Sciences, University of Florida, Gainesville, FL
| | - Anne B Chang
- Division of Child Health, Menzies School of Health Research, Darwin, NT, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Queensland's University of Technology, Brisbane, QLD, Australia
| | - Peter G Gibson
- Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Stuart B Mazzone
- Department of Anatomy and Neuroscience, The University of Melbourne, Melbourne, VIC, Australia
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12
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Bergmann M, Haasenritter J, Beidatsch D, Schwarm S, Hörner K, Bösner S, Grevenrath P, Schmidt L, Viniol A, Donner-Banzhoff N, Becker A. Coughing children in family practice and primary care: a systematic review of prevalence, aetiology and prognosis. BMC Pediatr 2021; 21:260. [PMID: 34088294 PMCID: PMC8176681 DOI: 10.1186/s12887-021-02739-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND For evidence-based decision making, primary care physicians need to have specific and reliable information on the pre-test probabilities of underlying diseases and a symptom's course. We performed a systematic review of symptom-evaluating studies in primary care, following three research questions: (1) What is the prevalence of the symptom cough in children consulting primary care physicians? (2) What are the underlying aetiologies of cough and the respective frequencies? (3) What is the prognosis of children with cough? METHODS Following a pre-defined algorithm and independent double reviewer ratings we searched MEDLINE and EMBASE. All quantitative original research articles in English, French or German were included if they focused on unselected study populations of children consulting a primary care physician for cough. We used the random effects model for meta-analysis in subgroups, if justifiable in terms of heterogeneity. RESULTS We identified 14 eligible studies on prevalence, five on aetiology and one on prognosis. Prevalence estimates varied between 4.7 and 23.3% of all reasons for an encounter, or up to estimates of 60% when related to patients or consultations. Cough in children is more frequent than in adults, with lowest prevalences in adolescents and in summer. Acute cough is mostly caused by upper respiratory tract infections (62.4%) and bronchitis (33.3%); subacute or chronic cough by recurrent respiratory tract infection (27.7%), asthma (up to 50.4% in cough persisting more than 3 weeks), and pertussis (37.2%). Potentially serious diseases like croup, pneumonia or tuberculosis are scarce. In children with subacute and chronic cough the total duration of cough ranged from 24 to 192 days. About 62.3% of children suffering from prolonged cough are still coughing two months after the beginning of symptoms. CONCLUSION Cough is one of the most frequent reasons for an encounter in primary care. Our findings fit in with current guideline recommendations supporting a thoughtful wait-and-see approach in acute cough and a special awareness in chronic cough of the possibility of asthma and pertussis. Further evidence of aetiological pre-test probabilities is needed to assess the diagnostic gain based on patient history and clinical signs for differential diagnoses of cough in children.
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Affiliation(s)
- Milena Bergmann
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Jörg Haasenritter
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Dominik Beidatsch
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Sonja Schwarm
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Kaja Hörner
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Stefan Bösner
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Paula Grevenrath
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Laura Schmidt
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Annika Viniol
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Norbert Donner-Banzhoff
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany
| | - Annette Becker
- Department of General Practice/Family Medicine, University of Marburg, Karl-von-Frisch-Str. 4, 35043, Marburg, Germany.
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13
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Gaillard EA, Kuehni CE, Turner S, Goutaki M, Holden KA, de Jong CCM, Lex C, Lo DKH, Lucas JS, Midulla F, Mozun R, Piacentini G, Rigau D, Rottier B, Thomas M, Tonia T, Usemann J, Yilmaz O, Zacharasiewicz A, Moeller A. European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5-16 years. Eur Respir J 2021; 58:13993003.04173-2020. [PMID: 33863747 DOI: 10.1183/13993003.04173-2020] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/15/2021] [Indexed: 11/05/2022]
Abstract
Diagnosing asthma in children represents an important clinical challenge. There is no single gold standard test to confirm the diagnosis. Consequently, both over-, and under-diagnosis of asthma are frequent in children.A Task Force (TF) supported by the European Respiratory Society has developed these evidence-based clinical practice guidelines for the diagnosis of asthma in children aged 5-16 years using nine PICO (Population, Intervention, Comparator and Outcome) questions. The TF conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full text articles. All TF members approved the final decision for inclusion of research papers. The TF assessed the quality of the evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach.The TF then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The TF formulated recommendations using the GRADE Evidence to Decision framework.Based on the critical appraisal of the evidence and the Evidence to Decision Framework the TF recommends spirometry, bronchodilator reversibility testing and FeNO as first line diagnostic tests in children under investigation for asthma. The TF recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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Affiliation(s)
- Erol A Gaillard
- Department of Respiratory Sciences, Leicester NIHR Biomedical Research Centre (Respiratory theme), University of Leicester, Leicester, UK .,Department of Paediatric Respiratory Medicine, Leicester Children's Hospital, University Hospitals Leicester, Leicester, UK
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Children's Hospital, University of Bern, Bern, Switzerland
| | - Steve Turner
- Child Health, University of Aberdeen, Aberdeen, UK
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Children's Hospital, University of Bern, Bern, Switzerland
| | - Karl A Holden
- Department of Respiratory Sciences, Leicester NIHR Biomedical Research Centre (Respiratory theme), University of Leicester, Leicester, UK
| | - Carmen C M de Jong
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Christiane Lex
- Department of Paediatric Cardiology, Intensive Care Medicine and Neonatology with Paediatric Pulmonology, University Medical Center Goettingen, Goettingen, Germany
| | - David K H Lo
- Department of Respiratory Sciences, Leicester NIHR Biomedical Research Centre (Respiratory theme), University of Leicester, Leicester, UK.,Department of Paediatric Respiratory Medicine, Leicester Children's Hospital, University Hospitals Leicester, Leicester, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,University of Southampton Faculty of Medicine, School of Clinical and Experimental Medicine, Southampton, UK
| | - Fabio Midulla
- Maternal-Science Department, Sapienza University of Rome, Rome, Italy
| | - Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - David Rigau
- Iberoamerican Cochrane Centre, Barcelona, Spain
| | - Bart Rottier
- Department of Paediatric Pulmonology and Paediatric Allergology, University Medical Centre Groningen, Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands.,University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD, (GRIAC), Groningen, The Netherlands
| | - Mike Thomas
- Primary Care, Population Sciences and Medical Education (PPM), Faculty of Medicine, University of Southampton, Southampton, UK
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- University Children's Hospital Basel (UKBB), Basel, Switzerland.,Division of Respiratory Medicine, University Children's Hospital Zuerich and Childhood Research Center, Zuerich, Switzerland
| | - Ozge Yilmaz
- Department of Pediatric Allergy and Pulmonology, Celal Bayar University, Manisa, Turkey
| | - Angela Zacharasiewicz
- Department of Pediatrics and Adolescent Medicine, Wilhelminenspital, Teaching Hospital of the University of Vienna, Vienna, Austria
| | - Alexander Moeller
- Division of Respiratory Medicine, University Children's Hospital Zuerich and Childhood Research Center, Zuerich, Switzerland
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14
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Bhopal SS, Absoud M. Vaccinating children to prevent long covid? More caution is needed in interpreting current epidemiological data. BMJ 2021; 372:n520. [PMID: 33627337 DOI: 10.1136/bmj.n520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Sunil S Bhopal
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Michael Absoud
- Evelina London Children's Hospital and Department of Women and Children's Health, King's College London, London, UK
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15
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Johansson H, Emtner M, Janson C, Nordang L, Malinovschi A. The course of specific self-reported exercise-induced airway symptoms in adolescents with and without asthma. ERJ Open Res 2020; 6:00349-2020. [PMID: 33263020 PMCID: PMC7680906 DOI: 10.1183/23120541.00349-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/14/2020] [Indexed: 11/27/2022] Open
Abstract
Airway symptoms in conjunction with exercise can take on many forms and can have several contributory factors such as exercise-induced bronchoconstriction (EIB), exercise-induced laryngeal obstruction or hyperventilation [1]. Previous longitudinal studies on self-reported exercise-induced airway symptoms among adolescents have primarily studied single symptoms, focusing on dyspnoea or wheeze, often as a way to investigate the prevalence of asthma [2, 3]. To the best of our knowledge, there are, as yet, no population-based studies investigating the difference between adolescents with and without current asthma regarding the development of different specific exercise-induced airway symptoms. Therefore, we studied the natural course of self-reported exercise-induced dyspnoea, throat tightness, wheeze, chest tightness, cough, stridor and hoarseness over a 5-year period among adolescents with and without current asthma. In a general population, the prevalence of exercise-induced cough, dyspnoea, throat and chest tightness, wheeze, and stridor increases from adolescence to young adulthood among individuals without asthma in contrast to individuals with asthmahttps://bit.ly/3hR57OX
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Affiliation(s)
- Henrik Johansson
- Dept of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.,Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.,Dept of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden
| | - Margareta Emtner
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Leif Nordang
- Dept of Surgical Sciences, Otorhinolaryngology, and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Dept of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
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16
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Malaeb D, Hallit S, Sacre H, Hallit R, Salameh P. Factors associated with wheezing among Lebanese children: Results of a cross-sectional study. Allergol Immunopathol (Madr) 2020; 48:523-529. [PMID: 32402625 DOI: 10.1016/j.aller.2020.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND In Lebanon, asthma is underdiagnosed due to low access to healthcare, particularly in rural areas, although asthma diagnosis in children is based mainly on clinical symptoms. Thus, wheezing might be more suggestive of undiagnosed respiratory diseases including asthma in Lebanese children. This study aimed to determine the factors associated with wheezing in Lebanese children without asthma diagnosis. METHODS This cross-sectional study was conducted between December 2015 and April 2016, enrolling a total of 1203 schoolchildren. RESULTS Out of 1500 prepared questionnaires, 1380 questionnaires were distributed in schools, and 1203 (87.17%) were collected back from the parents of children aged between 4-17 years old. The sample included 42 (3.5%) [95% CI 0.025-0.045] children with reported chronic wheezing. A multivariable analysis was performed taking the presence versus absence of wheezing in children as the dependent variable. The results showed that spraying pesticides at home (aOR=1.91), presence of humidity at home (aOR=2.21) and child reflux (aOR=2.60) were significantly associated with the presence of wheezing in children. CONCLUSION The findings of the study suggest that certain environmental factors, such as pesticides, humidity at home and reflux disease, might be associated with wheezing episodes in children. Those factors can be prevented through raising awareness by health care professionals.
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17
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Bisballe-Müller N, Chang AB, Plumb EJ, Oguoma VM, Halken S, McCallum GB. Can Acute Cough Characteristics From Sound Recordings Differentiate Common Respiratory Illnesses in Children?: A Comparative Prospective Study. Chest 2020; 159:259-269. [PMID: 32653569 DOI: 10.1016/j.chest.2020.06.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/21/2020] [Accepted: 06/24/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Acute respiratory illnesses cause substantial morbidity worldwide. Cough is a common symptom in these childhood respiratory illnesses, but no large cohort data are available on whether various cough characteristics can differentiate between these etiologies. RESEARCH QUESTION Can various clinically based cough characteristics (frequency [daytime/ nighttime], the sound itself, or type [wet/dry]) be used to differentiate common etiologies (asthma, bronchiolitis, pneumonia, other acute respiratory infections) of acute cough in children? STUDY DESIGN AND METHODS Between 2017 and 2019, children aged 2 weeks to ≤16 years, hospitalized with asthma, bronchiolitis, pneumonia, other acute respiratory infections, or control subjects were enrolled. Spontaneous coughs were digitally recorded over 24 hours except for the control subjects, who provided three voluntary coughs. Coughs were extracted and frequency defined (coughs/hour). Cough sounds and type were assessed independently by two observers blinded to the clinical data. Cough scored by a respiratory specialist was compared with discharge diagnosis using agreement (Cohen's kappa coefficient [қ]), sensitivity, and specificity. Caregiver-reported cough scores were related with objective cough frequency using Spearman coefficient (rs). RESULTS A cohort of 148 children (n = 118 with respiratory illnesses, n = 30 control subjects), median age = 2.0 years (interquartile range, 0.7-3.9), 58% males, and 50% First Nations children were enrolled. In those with respiratory illnesses, caregiver-reported cough scores and wet cough (range, 42%-63%) was similar. Overall agreement in diagnosis between the respiratory specialist and discharge diagnosis was slight (қ = 0.13; 95% CI, 0.03 to 0.22). Among diagnoses, specificity (8%-74%) and sensitivity (53%-100%) varied. Interrater agreement in cough type (wet/dry) between blinded observers was almost perfect (қ = 0.89; 95% CI, 0.81 to 0.97). Objective cough frequency was significantly correlated with reported cough scores using visual analog scale (rs = 0.43; bias-corrected 95% CI, 0.25 to 0.56) and verbal categorical description daytime score (rs = 0.39; bias-corrected 95% CI, 0.22 to 0.54). INTERPRETATION Cough characteristics alone are not distinct enough to accurately differentiate between common acute respiratory illnesses in children.
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Affiliation(s)
- Nina Bisballe-Müller
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Department for Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Erin J Plumb
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Victor M Oguoma
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
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18
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Increased prevalence of exercise-induced airway symptoms - A five-year follow-up from adolescence to young adulthood. Respir Med 2019; 154:76-81. [PMID: 31226623 DOI: 10.1016/j.rmed.2019.06.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/11/2019] [Accepted: 06/10/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Exercise-induced airway symptoms are common in adolescents. Little is known about the development of symptoms from adolescence to early adulthood. Therefore, we studied the prevalence, incidence, and remission of exercise-induced airway symptoms (including wheeze, cough, chest and throat tightness, hoarseness, and stridor) in adolescents, over a five-year period. METHODS In 2011, all adolescents aged 12-13 years in Uppsala (n = 3 838) were invited to answer a questionnaire on exercise-induced airway symptoms. All responding adolescents (n = 2 309) were invited to answer the same questionnaire again after five years. In total, 1 002 adolescents responded (43.4%). RESULTS The prevalence of exercise-induced airway symptoms increased from 25% at baseline to 49% at follow-up (p < 0.001). More females than males reported symptoms at both time points. The incidence of airway symptoms was 42.2%, with no sex differences. More males than females reported symptom remission (20.2 vs. 10.7%, p < 0.001). Females reported a higher asthma prevalence at follow-up than at baseline (7.6 vs. 15.2%), while males did not (10.9 vs. 8.0%), leading to a sex difference in prevalence at follow-up (p < 0.001). Smoking and baseline respiratory symptoms were associated with an increased risk of reporting symptoms at follow-up. CONCLUSIONS A twofold increase in the prevalence of exercise-induced airway symptoms over a five-year period was found in this cohort. Females were more likely to report symptoms at both time points. Knowledge of these age-related changes in symptoms and their association to female gender is useful for future studies and healthcare providers.
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Abstract
Cough is a forced expulsive manoeuvre, usually against a closed glottis and is associated with a characteristic sound that is easily recognised. It is a protective reflex against aspiration and to clear airway secretions. In children cough is extremely common and when prolonged it is often a cause for concern for parents, resulting in a high proportion of attendances to primary and secondary care. There are many causes of cough which may be divided into productive or non-productive in character. As there are many guidelines for the management of productive or 'wet' cough the focus of this paper will be to discuss some of the main causes, investigations and management options for 'dry' cough. Dry coughing suggests airway irritation and or inflammation (without excessive extra secretion formation) and is predominantly the result of an acute viral respiratory infection that may last up to 3-4 weeks.
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Affiliation(s)
- Niamh C Galway
- Royal Belfast Hospital for Sick Children, United Kingdom
| | - Michael D Shields
- Royal Belfast Hospital for Sick Children, United Kingdom; Centre for Experimental Medicine, Queen's University Belfast, United Kingdom.
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20
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Ptak K, Cichocka-Jarosz E, Kwinta P. [Chronic cough in children]. DEVELOPMENTAL PERIOD MEDICINE 2019; 22. [PMID: 30636230 PMCID: PMC8522820 DOI: 10.34763/devperiodmed.20182204.329340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Coughing is one of the most common patient complaints at physicians' office. The majority of children experience 5 to 8 episodes of cough lasting about a week throughout the year. Episodes of cough which last longer than 4 weeks, defined as a chronic cough, result in serious parental concern, impaired quality of life, increased number of medical consultations and the adverse effects of inappropriately used medications. Overall, a chronic cough is not only a serious health problem, but also a social one. The article presented below summarizes our current knowledge on the pathophysiology of chronic cough, the latest diagnostics and most recent measurement and monitoring methods as well as recommendations for therapeutic proceedings. In order to emphasize the distinct pathophysiology of chronic cough we use a new term: cough hypersensitivity syndrome. We point out the necessity of the concurrent implementation of more than one cough monitoring method for its more adequate evaluation. This article in addition presents the diagnostic and therapeutic algorithms in the treatment of a chronic cough which shorten the time to make a proper diagnosis, enable the introduction of adequate treatment, and ultimately improve the patients' quality of life. We present new therapeutic strategies, which are based on regulating the activity of vagal afferent nerves and modifying the neurotransmiters' transmission in the brainstem and midbrain.
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Affiliation(s)
- Katarzyna Ptak
- Klinika Chorób Dzieci, Uniwersytecki Szpital Dziecięcy wKrakowie, Polska
| | - Ewa Cichocka-Jarosz
- Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński Collegium Medicum, KrakowiePolska, Ewa Cichocka Jarosz Klinika Chorób Dzieci Katedry Pediatrii UJ CM ul. Wielicka 265, 30-663 Kraków tel. (+48 12) 658-20-11 wewn. 1655
| | - Przemko Kwinta
- Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński Collegium Medicum, KrakowiePolska
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21
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Pedersen ESL, de Jong CCM, Ardura-Garcia C, Barben J, Casaulta C, Frey U, Jochmann A, Latzin P, Moeller A, Regamey N, Singer F, Spycher B, Sutter O, Goutaki M, Kuehni CE. The Swiss Paediatric Airway Cohort (SPAC). ERJ Open Res 2018; 4:00050-2018. [PMID: 30474037 PMCID: PMC6243078 DOI: 10.1183/23120541.00050-2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/27/2018] [Indexed: 11/20/2022] Open
Abstract
Chronic respiratory symptoms, such as cough, wheeze and dyspnoea, are common in children; however, most research has, with the exception of a few large-scale clinical cohort studies, been performed in the general population or in small, highly-selected samples. The Swiss Paediatric Airway Cohort (SPAC) is a national, prospective clinical cohort of children and adolescents who visit physicians for recurrent conditions, such as wheeze and cough, and exercise-related respiratory problems. The SPAC is an observational study and baseline assessment includes standardised questionnaires for families and data extracted from hospital records, including results of clinically indicated investigations, diagnoses and treatments. Outcomes are assessed through annual questionnaires, monthly symptom reporting via mobile phone and follow-up visits. The SPAC will address important questions about clinical phenotypes, diagnosis, treatment, and the short- and long-term prognosis of common respiratory problems in children. The cohort currently consists of 347 patients from four major hospitals (Bern, Zurich, Basel and Lucerne), with 70–80 additional patients joining each month. More centres will join and the target sample size is a minimum of 3000 patients. The SPAC will provide real-life data on children visiting the Swiss healthcare system for common respiratory problems and will provide a research platform for health services research and nested clinical and translational studies. The Swiss Paediatric Airway Cohort (SPAC) is a unique research platform for common respiratory problems in childrenhttp://ow.ly/Y1v030lDnji
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Affiliation(s)
- Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,These authors contributed equally
| | - Carmen C M de Jong
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,These authors contributed equally
| | | | - Juerg Barben
- Division of Paediatric Pulmonology, Children's Hospital, St Gallen, Switzerland
| | - Carmen Casaulta
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Urs Frey
- Dept of Paediatrics, University Children's Hospital, University of Basel, Basel, Switzerland
| | - Anja Jochmann
- Dept of Paediatrics, University Children's Hospital, University of Basel, Basel, Switzerland
| | - Philipp Latzin
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Alexander Moeller
- Division of Paediatric Pulmonology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nicolas Regamey
- Division of Paediatric Pulmonology, Children's Hospital, Lucerne, Switzerland
| | - Florian Singer
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland.,Division of Paediatric Pulmonology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ben Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
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22
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Olutola BG, Claassen N, Wichmann J, Voyi K. Factors associated with parent-reported wheeze and cough in children living in an industrial area of Gauteng, South Africa. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:33455-33463. [PMID: 30264349 DOI: 10.1007/s11356-018-3304-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/20/2018] [Indexed: 06/08/2023]
Abstract
We examined the factors associated with mother-reported wheeze and dry cough in children living in Tembisa, a residential and industrial community in South Africa. A cross-sectional sample of parents reported wheezing and dry cough in children (aged 1 to 26 months) by completing the standardised International Study of Asthma and Allergies in Childhood questionnaire with additional questions concerning tobacco use, income, living conditions, and mothers' educational level. Data were analysed using chi-square, univariate, and multivariable logistic regressions. Of the 493 children who participated, 81 (16.4%) had wheeze ever and 186 (37.7%) had dry cough ever. We observed that children had a higher probability of wheezing if mothers had lived in the area for longer periods (aOR 1.05; 95% CI 1.01-1.08). Children who had trucks passing on their streets frequently were more likely to have had dry cough ever compared to those with no trucks passing on their streets (aOR 3.88; 95% CI 2.29-6.57). In Tembisa, dry cough in a child was associated with the frequency of trucks passing in front of the child's home. Children were also more likely have wheeze if their mothers had been living in the community for longer times.
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Affiliation(s)
- Bukola G Olutola
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
| | - Nico Claassen
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Kuku Voyi
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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23
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Sun C, Huang C, Liu W, Zou Z, Hu Y, Shen L. Home dampness-related exposures increase the risk of common colds among preschool children in Shanghai, China: Modified by household ventilation. BUILDING AND ENVIRONMENT 2017; 124:31-41. [PMID: 32287973 PMCID: PMC7115772 DOI: 10.1016/j.buildenv.2017.07.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 07/23/2017] [Accepted: 07/24/2017] [Indexed: 06/10/2023]
Abstract
Few studies have estimated the effects of dampness-related exposures and its interaction effects with poor household ventilation on common colds of preschool children. During April 2011-April 2012, we conducted a cross-sectional survey on home environment and childhood health and collected 13,335 parents-reported questionnaires of 4-6 year-old children in Shanghai, China. In this paper, we investigated associations between the incidence and duration of common colds among these children during the past 12 months before the survey and frequency of opening windows, as well as household dampness-related exposures (indicated by six dampness indicators). Significantly higher incidence (≥3 times) and longer duration (≥2 weeks) of common cold were found among children with than without these dampness exposures (p-value <0.01 for mold spots and p-value <0.001 for all other indicators). The number of dampness-related indicators had a positive and strong dose-response relationship with common colds (p-trend <0.01). Low frequency of ventilation was also a risk factor for children common colds. After adjusted for the potential confounders in the multiple logistic regression analyses, all dampness-related indicators were significantly associated with the increased odds of common colds and the highest odds ratios was 1.21 (95% CI: 1.16-1.27). We also found that dampness-related exposures and household ventilation habits (p-value for interaction <0.001) had a strong interaction effect on the incidence and duration of common cold. The stratified analysis of ventilation condition displays that the influence of dampness-related exposures has been modified by ventilation. Therefore, good household ventilation habits may have an effect of modification for dampness-related exposures.
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Affiliation(s)
- Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Wei Liu
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhijun Zou
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, China
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