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Buendía JA, Acuña-Cordero R, Rodriguez-Martinez CE. Exploratory analysis of the economically justifiable price of nirsevimab for healthy late-preterm and term infants in Colombia. Pediatr Pulmonol 2024; 59:1372-1379. [PMID: 38358037 DOI: 10.1002/ppul.26920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Respiratory syncytial virus infection is the leading cause of lower respiratory infection globally. Recently, nirsevimab has been approved to prevent respiratory syncytial virus (RSV) infection. This study explores the economically justifiable price of nirsevimab for preventing RSV infection in Colombia's children under 1 year of age. MATERIALS AND METHODS A static model was developed using the decision tree microsimulation to estimate the quality-adjusted costs and life years of two interventions: a single intramuscular dose of nirsevimab versus not applying nirsevimab. This analysis was made during a time horizon of 1 year and from a societal perspective. RESULTS The annual savings in Colombia associated with this cost per dose ranged from U$ 2.5 to 4.1 million. Based on thresholds of U$ 4828, U$ 5128, and U$ 19 992 per QALY evaluated in this study, we established economically justifiable drug acquisition prices of U$ 21.88, U$ 25.04, and U$ 44.02 per dose of nirsevimab. CONCLUSION the economically justifiable cost for nirsevimab in Colombia is between U$ 21 to U$ 44 per dose, depending on the willingness to pay used to decide its implementation. This result should encourage more studies in the region that optimize decision-making processes when incorporating this drug into the health plans of each country.
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Affiliation(s)
- Jefferson Antonio Buendía
- Departamento de Farmacología y Toxicología, Facultad de Medicina, Grupo de Investigación en Farmacología y Toxicología, Universidad de Antioquia, Medellín, Colombia
| | - Ranniery Acuña-Cordero
- Departamento de Neumología Pediátrica, Hospital Militar Central, Departamento de Pediatría, Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá, Colombia
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Ghezzi M, Longoni E, Munari A, Raso I, Biganzoli G, Zuccotti G, D'Auria E. Lung involvement in children with COVID-19 multisystem inflammatory syndrome. Pediatr Pulmonol 2023; 58:615-618. [PMID: 36345237 PMCID: PMC9877654 DOI: 10.1002/ppul.26224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/30/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022]
Abstract
Since the beginning of the COVID-19 pandemic, multisystem inflammatory syndrome in children (MIS-C) has been reported in increasing numbers, mostly focusing on cardiac dysfunction. Very few studies have evaluated lung involvement in terms of imaging findings, while data regarding pulmonary function in children with MIS-C are not available. The purpose of our study was to evaluate lung involvement in MIS-C by imaging and lung function by structured light plethysmography (SLP) at hospital admission and 6 months afterwards. Spirometry is the gold standard technique to evaluate lung function in children. However, SLP has the advantage of not requiring contact with the patient, offering an effective solution for the evaluation of lung function during the pandemic. To our knowledge this is the first study that aims to investigate pulmonary function by SLP in children with MIS-C.
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Affiliation(s)
- Michele Ghezzi
- Allergology and Pneumology Unit, V. Buzzi Children's Hospital, Milan, Italy
| | - Emma Longoni
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy
| | - Alice Munari
- Department of Radiology, V. Buzzi Children's Hospital, Milano, Italy
| | - Irene Raso
- Pediatric Cardiology Unit, "Vittore Buzzi" Children's Hospital, Milano, Italy
| | - Giacomo Biganzoli
- Medical Statistics Unit, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy.,Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Milan, Italy
| | - Enza D'Auria
- Allergology and Pneumology Unit, V. Buzzi Children's Hospital, Milan, Italy
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Illan Montero J, Berger A, Levy J, Busson L, Hainaut M, Goetghebuer T. Retrospective comparison of respiratory syncytial virus and metapneumovirus clinical presentation in hospitalized children. Pediatr Pulmonol 2023; 58:222-229. [PMID: 36202614 DOI: 10.1002/ppul.26188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 01/11/2023]
Abstract
Respiratory syncytial virus (RSV) and Human metapneumovirus (hMPV), members of Pneumoviridae family are common causes of acute respiratory tract infections (ARTI) among children. Study material includes routine nasopharyngeal samples obtained during 8-year period for hMPV and one single season for RSV in children hospitalized for ARTI between 0 and 15 years at the Center Hospitalier Universitaire (CHU) Saint Pierre in Brussels. Positive samples for RSV or hMPV identified by viral culture, lateral flow chromatography test for RSV or direct fluorescent assay for hMPV were selected retrospectively. Characteristics of children hospitalized for RSV or hMPV infections were compared. Children hospitalized for RSV infection were significantly younger and requiring more respiratory support, longer hospital stay and transfers in Pediatric intensive Care Units than those hospitalized for hMPV infection. Pneumonia diagnostic and antibiotics therapies were more significantly associated with hMPV infections. In conclusion, despite their genetic similarities, RSV, and hMPV present epidemiological and clinical differences in pediatric infections. Our results should be confirmed prospectively.
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Affiliation(s)
- Jonathan Illan Montero
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium
| | - Alice Berger
- Division of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Jack Levy
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium
| | - Laurent Busson
- Laboratoire des Hôpitaux Universitaires Bruxellois, Department of Microbiology, Brussels, Belgium
| | - Marc Hainaut
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium
| | - Tessa Goetghebuer
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium
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Hazan G, Orscheln RC, Kertz L, Rivera-Spoljaric K. A child with chronic cough and eosinophilia secondary to Strongyloides stercoralis infection. Pediatr Pulmonol 2022; 57:2562-2564. [PMID: 35778783 DOI: 10.1002/ppul.26048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/16/2022] [Accepted: 06/26/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Guy Hazan
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Rachel C Orscheln
- Division of Pediatric Infectious Diseases, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lila Kertz
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Katherine Rivera-Spoljaric
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
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Korppi M. No need to take chest radiographs in pediatric community-acquired pneumonia if complications are not suspected. Pediatr Pulmonol 2022; 57:315-316. [PMID: 34583426 DOI: 10.1002/ppul.25696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/02/2021] [Accepted: 09/21/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Matti Korppi
- Center for Child Health Research, University of Tampere and University Hospital, Tampere, Finland
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Cabral CZ, Guaragna JBDA, Amantéa FC, Lopes PGM, Pasqualotto AC, Rhoden CR, Amantéa SL. Distribution of airborne respiratory pathogens in pediatric emergency department waiting room. Pediatr Pulmonol 2021; 56:2724-2728. [PMID: 34185972 DOI: 10.1002/ppul.25469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine the presence of genetic material from potentially infectious airborne respiratory virus pathogens in a pediatric emergency department (PED) waiting room. METHODS A cross-sectional study in the waiting room area of PED at Santo Antonio Children's Hospital, Porto Alegre, in southern Brazil. The room air samples were collected with a portable cyclone sampler (Coriolis®), twice a day (8 a.m. and 8 p.m.), during 5 consecutive weekdays, during two seasons, fall and spring (20 samples), in 2016. Reverse transcription polymerase chain reaction was used to detect influenza A, influenza B, parainfluenza 2, parainfluenza 3, human metapneumovirus, respiratory syncytial virus, human adenovirus, human bocavirus, and Bordetella pertussis. The PED provides care to an average of 6000 patients per month and the age of patients ranges from 1 month to 17 years old. It is waiting area has 645 ft square. RESULTS Genetic material from pathogens was detected in 12 out of 20 samples (60%). In 5 samples, more than one pathogen of respiratory virus was identified. Human adenovirus was the most frequent pathogen (n = 9/52%), followed by Bordetella pertussis (n = 4/24%), respiratory syncytial virus (n = 2/12%) and human bocavirus (n = 2/12%). Season and number of people in the waiting room were not associated with the presence of genetic material from pathogens. CONCLUSIONS Genetic material from pathogens potentially associated with severe respiratory diseases was found in the room air of a pediatric ED waiting room.
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Affiliation(s)
- Catiane Zanin Cabral
- Department of Postgraduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Fernanda Chaves Amantéa
- Department of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo Guilherme Markus Lopes
- Department of Pollution and Oxidative Stress Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Alessandro Cumaru Pasqualotto
- Department of Postgraduate, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Claudia Ramos Rhoden
- Department of Postgraduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Pollution and Oxidative Stress Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Postgraduate, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sérgio Luís Amantéa
- Department of Postgraduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Pediatric Emergency, Santo Antônio Children's Hospital, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Pollution and Oxidative Stress Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Hizal M, Aykac K, Yayla BCC, Yilmaz A, Altun D, Akkaya HE, Bayhan GI, Kurt ANC, Karakaya J, Ozsurekci Y, Ceyhan M. Diagnostic value of lung ultrasonography in children with COVID-19. Pediatr Pulmonol 2021; 56:1018-1025. [PMID: 33085218 DOI: 10.1002/ppul.25127] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/10/2020] [Accepted: 10/09/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Lung ultrasound (LUS) has been successfully used in the diagnosis of different pulmonary diseases. Present study design to determine the diagnostic value of LUS in the evaluation of children with novel coronavirus disease 2019 (COVID-19). METHODS AND OBJECTIVES Prospective multicenter study, 40 children with confirmed COVID-19 were included. LUS was performed to all patients at admission. The chest X-ray and computed tomography (CT) were performed according to the decision of the primary physicians. LUS results were compared with chest X-ray and CT findings and diagnostic performance was determined. RESULTS Of the 40 children median (range) was 10.5 (0.4-17.8) years. Chest X-ray and LUS were performed on all and chest CT was performed on 28 (70%) patients at the time of diagnosis. Sixteen (40%) patients had no apparent chest CT abnormalities suggestive of COVID-19, whereas 12 (30%) had abnormalities. LUS confirmed the diagnosis of pulmonary involvement in 10 of 12 patients with positive CT findings. LUS demonstrated normal lung patterns among 15 of 16 patients who had normal CT features. The sensitivity and the area under the receiver operating characteristics (ROC) curve (area under the ROC curve) identified by the chest X-ray and LUS tests were compared and statistically significantly different (McNemar's test: p = .016 and p = .001 respectively) detected. Chest X-ray displayed false-negative results for pulmonary involvement in 75% whereas for LUS it was 16.7%. CONCLUSIONS LUS might be a useful tool in the diagnostic steps of children with COVID-19. A reduction in chest CT assessments may be possible when LUS is used in the initial diagnostic steps for these children.
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Affiliation(s)
- Mina Hizal
- Department of Pediatric Pulmonology, Ankara Training and Research Hospital, University of Health Science, Ankara, Turkey
| | | | - Burcu C C Yayla
- Department of Pediatric Infectious Disease, Ankara Training and Research Hospital, University of Health Science, Ankara, Turkey
| | - Arzu Yilmaz
- Department of Pediatric, Ankara Training and Research Hospital, University of Health Science, Ankara, Turkey
| | - Demet Altun
- Department of Pediatrics, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Habip E Akkaya
- Department of Radiology, Ankara Training and Research Hospital, University of Health Science, Ankara, Turkey
| | - Gulsum I Bayhan
- Department of Pediatric Infectious Disease, Yenimahalle Training and Educational Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Aysegul N C Kurt
- Department of Pediatrics, Yenimahalle Training and Educational Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | - Yasemin Ozsurekci
- Department of Pediatric Infectious Disease, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Ceyhan
- Department of Pediatric Infectious Disease, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Manti S, Esper F, Alejandro-Rodriguez M, Leonardi S, Betta P, Cuppari C, Lanzafame A, Worley S, Salpietro C, Perez MK, Rezaee F, Piedimonte G. Respiratory syncytial virus seropositivity at birth is associated with adverse neonatal respiratory outcomes. Pediatr Pulmonol 2020; 55:3074-3079. [PMID: 32741145 PMCID: PMC7808412 DOI: 10.1002/ppul.25001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND More than 60 years since the discovery of the respiratory syncytial virus (RSV), the effects of prenatal exposure to this virus remain largely unknown. In this investigation, we sought to find evidence of RSV seroconversion in cord blood and explore its clinical implications for the newborn. METHODS Offspring from 22 pregnant women with a history of viral respiratory infection during the third trimester of pregnancy (respiratory viral illness [RVI] group) and 40 controls were enrolled in this study between 1 September 2016 and 31 March 2019. Cord blood sera were tested for anti-RSV antibodies by indirect fluorescent antibody assay. RSV seropositivity was defined as the presence of anti-RSV immunoglobulin M (IgM) or immunoglobulin A (IgA), in addition to IgG in cord blood serum at ≥1:20 dilution. RESULTS Anti-RSV IgG was present in all cord blood serum samples from infants born to RVI mothers (95% confidence interval [CI] = 82%-100%), with 16 samples also having elevated titers for either anti-RSV IgA or IgM (73%; 95% CI = 52%-87%). No controls had evidence of anti-RSV antibodies. Eight (50%) seropositive newborns developed at least one respiratory tract finding, including respiratory distress syndrome (N = 8), respiratory failure (N = 3), and pneumonia (N = 1). RSV seropositive newborns also required more days on oxygen, had leukocytosis and elevated C-reactive protein (P = .025, P = .047, and P < .001, respectively). CONCLUSION This study provides evidence of acute seropositivity against RSV in cord blood of newborns delivered from mothers with a history of upper respiratory tract illness in the third trimester. Cord blood seropositivity for anti-RSV IgA or IgM was associated with adverse clinical and laboratory outcomes in newborns.
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Affiliation(s)
- Sara Manti
- Cleveland Clinic Center for Pediatric Research, Lerner Research Institute, Cleveland, Ohio, United States
- Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy
| | - Frank Esper
- Cleveland Clinic Center for Pediatric Research, Lerner Research Institute, Cleveland, Ohio, United States
- Center for Pediatric Infectious Diseases, Cleveland Clinic Children’s, Cleveland, Ohio, United States
| | | | - Salvatore Leonardi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Pasqua Betta
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Caterina Cuppari
- Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy
| | - Angela Lanzafame
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sarah Worley
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, United States
| | - Carmelo Salpietro
- Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy
| | - Miriam K. Perez
- Cleveland Clinic Center for Pediatric Research, Lerner Research Institute, Cleveland, Ohio, United States
| | - Fariba Rezaee
- Cleveland Clinic Center for Pediatric Research, Lerner Research Institute, Cleveland, Ohio, United States
| | - Giovanni Piedimonte
- Departments of Pediatrics, Biochemistry and Molecular Biology, Tulane University School of Medicine, New Orleans, Louisiana, United States
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Graham H, Bakare AA, Ayede AI, Oyewole OB, Gray A, Neal E, Qazi SA, Duke T, Falade AG. Diagnosis of pneumonia and malaria in Nigerian hospitals: A prospective cohort study. Pediatr Pulmonol 2020; 55 Suppl 1:S37-S50. [PMID: 32074408 PMCID: PMC7318580 DOI: 10.1002/ppul.24691] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/30/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pneumonia and malaria are the leading causes of global childhood mortality. We describe the clinical presentation of children diagnosed with pneumonia and/or malaria, and identify possible missed cases and diagnostic predictors. METHODS Prospective cohort study involving children (aged 28 days to 15 years) admitted to 12 secondary-level hospitals in south-west Nigeria, from November 2015 to October 2017. We described children diagnosed with malaria and/or pneumonia on admission and identified potential missed cases using WHO criteria. We used logistic regression models to identify associations between clinical features and severe pneumonia and malaria diagnoses. RESULTS Of 16 432 admitted children, 16 184 (98.5%) had adequate data for analysis. Two-thirds (10 561, 65.4%) of children were diagnosed with malaria and/or pneumonia by the admitting doctor; 31.5% (567/1799) of those with pneumonia were also diagnosed with malaria. Of 1345 (8.3%) children who met WHO severe pneumonia criteria, 557 (41.4%) lacked a pneumonia diagnosis. Compared with "potential missed" diagnoses of severe pneumonia, children with "detected" severe pneumonia were more likely to receive antibiotics (odds ratio [OR], 4.03; 2.63-6.16, P < .001), and less likely to die (OR, 0.72; 0.51-1.02, P = .067). Of 2299 (14.2%) children who met WHO severe malaria criteria, 365 (15.9%) lacked a malaria diagnosis. Compared with "potential missed" diagnoses of severe malaria, children with "detected" severe malaria were less likely to die (OR, 0.59; 0.38-0.91, P = 0.017), with no observed difference in antimalarial administration (OR, 0.29; 0.87-1.93, P = .374). We identified predictors of severe pneumonia and malaria diagnosis. CONCLUSION Pneumonia should be considered in all severely unwell children with respiratory signs, regardless of treatment for malaria or other conditions.
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Affiliation(s)
- Hamish Graham
- Centre for International Child Health, MCRI, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Ayobami A Bakare
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Adejumoke I Ayede
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria.,Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Oladapo B Oyewole
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria
| | - Amy Gray
- Centre for International Child Health, MCRI, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Eleanor Neal
- Centre for International Child Health, MCRI, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.,Infection & Immunity, MCRI, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Shamim A Qazi
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Trevor Duke
- Centre for International Child Health, MCRI, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Adegoke G Falade
- Department of Paediatrics, University College Hospital, Ibadan, Nigeria.,Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
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Affiliation(s)
- Kim Mulholland
- Infection and Immunity, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Loughlin CE, Muston HN, Pena MA, Ren CL, Yilmaz O, Noah TL. Pediatric Pulmonology year in review 2018: Asthma, physiology/pulmonary function testing, and respiratory infections. Pediatr Pulmonol 2019; 54:1508-1515. [PMID: 31237426 DOI: 10.1002/ppul.24420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 11/06/2022]
Abstract
Pediatric Pulmonology publishes original research, reviews, and case reports related to a wide range of children's respiratory disorders. In our "Year in Review" series, we summarize publications in our major topic areas from 2018, in the context of selected literature in these areas from other journals relevant to our discipline. This review covers selected articles on asthma, physiology/lung function testing, and respiratory infections.
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Affiliation(s)
- Ceila E Loughlin
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Heather N Muston
- Department of Pediatrics, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael A Pena
- Department of Pediatrics, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana
| | - Clement L Ren
- Department of Pediatrics, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana
| | - Ozge Yilmaz
- Department of Pediatrics, Pediatric Allergy and Pulmonology, Celal Bayar University, Manisa, Turkey
| | - Terry L Noah
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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12
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Musolino AM, Tomà P, Supino MC, Scialanga B, Mesturino A, Scateni S, Battaglia M, Pirozzi N, Bock C, Buonsenso D. Lung ultrasound features of children with complicated and noncomplicated community acquired pneumonia: A prospective study. Pediatr Pulmonol 2019; 54:1479-1486. [PMID: 31264383 DOI: 10.1002/ppul.24426] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 06/06/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The purpose of this study was to describe lung ultrasound (LUS) findings at baseline and 48 hours after the beginning of treatment and evaluate how they correlate with outcome DESIGN: We prospectively analyzed patients from 1 month to 17 years of age with community acquired pneumonia (CAP) evaluated at a tertiary level pediatric hospital. At baseline and 48 hours after the beginning of treatment, history, clinical examination, laboratory testing, chest X-ray, and LUS were performed. RESULTS One hundred one children were enrolled in the study (13 with complicated CAP). At baseline those who developed complications presented a larger size of the subpleural pulmonary parenchymal lesions (P = .001) often associated with a complex pleural effusion (63.6%, P = .013). Those with an uncomplicated CAP presented an air, arboriform, superficial and dynamic bronchogram, as opposed to complicated CAP which had an air and liquid bronchogram, deep, fixed (P = .001). At the 48-hour control in the noncomplicated CAP group, bronchogram was more frequently superficial and dynamic (P = .050). Pleural effusion disappeared in half cases (P = .050). In all patients, neutrophilic leucocytosis with increased C-reactive protein was detected and decreased at control (P = .001). The linear regression analyses showed the switch from a deep to a superficial bronchogram as the only explanatory variable (r = 0.97, R2 = 0.94, P = .001, t = 10.73). CONCLUSIONS Our study describe early LUS features of CAP that might be able to predict the development of complicated CAP.
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Affiliation(s)
- Anna Maria Musolino
- Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paolo Tomà
- Department of Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Chiara Supino
- Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Barbara Scialanga
- Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessia Mesturino
- Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Simona Scateni
- Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Massimo Battaglia
- Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Nicola Pirozzi
- Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Caterina Bock
- Department of Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Pediatric Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
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13
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Grayson SA, Griffiths PS, Perez MK, Piedimonte G. Detection of airborne respiratory syncytial virus in a pediatric acute care clinic. Pediatr Pulmonol 2017; 52:684-688. [PMID: 27740722 DOI: 10.1002/ppul.23630] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/14/2016] [Accepted: 10/01/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Respiratory syncytial virus (RSV) is the most common cause of respiratory illness in infants and young children, but this virus is also capable of re-infecting adults throughout life. Universal precautions to prevent its transmission consist of gown and glove use, but masks and goggles are not routinely required because it is believed that RSV is unlikely to be transmitted by the airborne route. Our hypothesis was that RSV is present in respirable-size particles aerosolized by patients seen in a pediatric acute care setting. STUDY DESIGN RSV-laden particles were captured using stationary 2-stage bioaerosol cyclone samplers. Aerosol particles were separated into three size fractions (<1, 1-4.1, and ≥4.1 μm) and were tested for the presence of RSV RNA by real-time PCR. Samplers were set 152 cm ("upper") and 102 cm ("lower") above the floor in each of two examination rooms. RESULTS Of the total, 554 samples collected over 48 days, only 13 (or 2.3%) were positive for RSV. More than 90% of the RSV-laden aerosol particles were in the ≥4.1 μm size range, which typically settle to the ground within minutes, whereas only one sample (or 8%) was positive for particles in the 1-4.1 μm respirable size range. CONCLUSIONS Our data indicate that airborne RSV-laden particles can be detected in pediatric outpatient clinics during the epidemic peak. However, RSV airborne transmission is highly inefficient. Thus, the logistical and financial implications of mandating the use of masks and goggles to prevent RSV spread seem unwarranted in this setting. Pediatr Pulmonol. 2017;52:684-688. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Stephanie A Grayson
- Department of Pediatrics, West Virginia University, Morgantown, West Virginia
| | - Pamela S Griffiths
- Department of Pediatrics, West Virginia University, Morgantown, West Virginia
| | - Miriam K Perez
- Department of Community Pediatrics, The Cleveland Clinic, Cleveland, Ohio
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14
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Burgener EB, Waggoner J, Pinsky BA, Chen SF. Clinical characteristics and outcomes of pediatric patients with CMV DNA detection in bronchoalveolar lavage fluid. Pediatr Pulmonol 2017; 52:112-118. [PMID: 27280337 DOI: 10.1002/ppul.23494] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 04/01/2016] [Accepted: 05/06/2016] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Cytomegalovirus (CMV) infection can cause severe pulmonary disease in immunocompromised patients. There are no standard diagnostic criteria for CMV pulmonary disease beyond histopathology findings on lung tissue, which is challenging to obtain in pediatric patients. Bronchoalveolar lavage (BAL) fluid is easier to obtain. Since CMV remains latent after primary infection and can potentially reactivate due to any inflammatory response, CMV detection in BAL specimen may not indicate acute CMV pulmonary disease. Thus, we describe the clinical manifestations and outcomes of pediatric patients with CMV detection in BAL fluid. METHODS We reviewed the clinical, radiologic, and laboratory data of patients <19 years old with a BAL specimen positive for CMV during a 5-year period. RESULTS Thirty-four encounters in 29 patients were found with CMV detected in their BAL specimen. Half (17/34) of the encounters were in immunocompromised patients. CMV, polymerase chain reaction (PCR) was the most common positive test. Forty-seven percent of the patients had other infections detected in BAL specimens. The majority of patients were never treated for CMV and resolved their acute respiratory illness. Only one patient had probable CMV pulmonary disease. DISCUSSION CMV is frequently recovered from BAL specimens but does not usually indicate acute CMV pulmonary disease. We would suggest that other diagnoses be considered first, even if CMV is recovered. Pediatr Pulmonol. 2017;52:112-118. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Elizabeth B Burgener
- Department of Pediatrics, Pulmonary Medicine, Stanford University School of Medicine, Palo Alto, 94304, California
| | - Jesse Waggoner
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Benjamin A Pinsky
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, California.,Department of Pathology, Stanford University School of Medicine, Palo Alto, California
| | - Sharon F Chen
- Department of Pediatrics, Infectious Disease, Stanford University School of Medicine, Palo Alto, California
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15
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Lee JM, Graciano AL, Dabrowski L, Kuzmic B, Tablizo MA. Coccidioidomycosis in infants: A retrospective case series. Pediatr Pulmonol 2016; 51:858-62. [PMID: 26829719 DOI: 10.1002/ppul.23387] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 11/30/2015] [Accepted: 01/04/2016] [Indexed: 11/06/2022]
Abstract
INTRODUCTION In contrast to adults, coccidioidomycosis is a rare disease in infants and the mechanisms of disease acquisition are not well described in infants. The purpose of this study was to describe the clinical presentation, treatment, and outcome of pulmonary coccidioidomycosis in infants in an endemic area. METHODS We performed a retrospective observational study of all patients less than 12 months of age admitted to a tertiary free standing children's hospital from 2003-2012 diagnosed with coccidioidomycosis. RESULTS Thirteen infants were hospitalized during the study period. The majority of the patients presented with upper and/or lower respiratory tract infection. The most common presenting symptoms included fever (77%), cough (61%), and respiratory distress (38%). Disseminated disease, included pericardial effusion, neck abscess, and lesions in the cerebellum, basal ganglia and left temporoparietal skull. Fluconazole was the initial, antifungal agent used. Amphotericin B was reserved for significant lung disease and disseminated cases. Failed response to fluconazole and amphotericin B were treated with a combination of voriconazole and caspofungin. Average length of treatment was 4 years. All patients survived to hospital discharge. The majority of the patients had resolution of chest radiograph and coccidiodal complement fixing antibody titers. DISCUSSION Infant coccidioidomycosis has a non-specific presentation and can mimic common infant respiratory illnesses. In endemic areas, coccidioidomycosis should be considered in the differential diagnosis of infants with pulmonary symptoms unresponsive to conventional treatment. Pediatr Pulmonol. 2016;51:858-862. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jessica M Lee
- University of California at San Francisco, Fresno, California.,Valley Children's Hospital, Madera, California
| | - Ana Lia Graciano
- University of California at San Francisco, Fresno, California.,Department of Anesthesia and Critical Care, Valley Children's Hospital, Madera, California
| | - Lukasz Dabrowski
- University of California at San Francisco, Fresno, California.,Southern Illinois Healthcare, Carbondale, Illinois
| | - Brenik Kuzmic
- Department of Pharmacy, Valley Children's Hospital, Madera, California
| | - Mary Anne Tablizo
- University of California at San Francisco, Fresno, California.,Department of Pulmonology, Valley Children's Hospital, Madera, California
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16
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Auten R, Schwarze J, Ren C, Davis S, Noah TL. Pediatric Pulmonology year in review 2015: Part 1. Pediatr Pulmonol 2016; 51:733-9. [PMID: 27124279 DOI: 10.1002/ppul.23423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/03/2016] [Accepted: 03/12/2016] [Indexed: 02/04/2023]
Abstract
Our journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection. Pediatr Pulmonol. 2016;51:733-739. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Jurgen Schwarze
- Department of Child Life and Health, The University of Edinburgh, Edinburgh, United Kingdom
| | - Clement Ren
- Department of Pediatrics, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana
| | - Stephanie Davis
- Department of Pediatrics, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana
| | - Terry L Noah
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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17
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Maduekwe ET, Buczynski BW, Yee M, Rangasamy T, Stevens TP, Lawrence BP, O'Reilly MA. Cumulative neonatal oxygen exposure predicts response of adult mice infected with influenza A virus. Pediatr Pulmonol 2015; 50:222-230. [PMID: 24850805 PMCID: PMC4334747 DOI: 10.1002/ppul.23063] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 03/31/2014] [Indexed: 11/05/2022]
Abstract
An acceptable level of oxygen exposure in preterm infants that maximizes efficacy and minimizes harm has yet to be determined. Quantifying oxygen exposure as an area-under-the curve (OAUC ) has been predictive of later respiratory symptoms among former low birth weight infants. Here, we test the hypothesis that quantifying OAUC in newborn mice can predict their risk for altered lung development and respiratory viral infections as adults. Newborn mice were exposed to room air or a FiO2 of 100% oxygen for 4 days, 60% oxygen for 8 days, or 40% oxygen for 16 days (same cumulative dose of excess oxygen). At 8 weeks of age, mice were infected intranasally with a non-lethal dose of influenza A virus. Adult mice exposed to 100% oxygen for 4 days or 60% oxygen for 8 days exhibited alveolar simplification and altered elastin deposition compared to siblings birthed into room air, as well as increased inflammation and fibrotic lung disease following viral infection. These changes were not observed in mice exposed to 40% oxygen for 16 days. Our findings in mice support the concept that quantifying OAUC over a currently unspecified threshold can predict human risk for respiratory morbidity later in life. Pediatr Pulmonol. 2015; 50:222-230. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Echezona T. Maduekwe
- Department of Pediatrics, School of Medicine and Dentistry, The University of Rochester, Rochester NY 14642
| | - Bradley W. Buczynski
- Department of Environmental Medicine, School of Medicine and Dentistry, The University of Rochester, Rochester NY 14642
| | - Min Yee
- Department of Pediatrics, School of Medicine and Dentistry, The University of Rochester, Rochester NY 14642
| | - Tiruamalai Rangasamy
- Department of Medicine, School of Medicine and Dentistry, The University of Rochester, Rochester NY 14642
| | - Timothy P. Stevens
- Department of Pediatrics, School of Medicine and Dentistry, The University of Rochester, Rochester NY 14642
| | - B. Paige Lawrence
- Department of Environmental Medicine, School of Medicine and Dentistry, The University of Rochester, Rochester NY 14642
| | - Michael A. O'Reilly
- Department of Pediatrics, School of Medicine and Dentistry, The University of Rochester, Rochester NY 14642
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