Coronavirus has caused a pandemic affecting both adults and children. Although mortality rates in adults are high, that in children has been low, with many children experiencing only mild disease. This article looks at the pathophysiologic mechanisms that may account for the differences observed in children, namely a strong immune response, a lower number of angiotensin-converting enzyme 2, and a lower inflammatory response. Though children in general have mild disease, there is a hyperinflammatory condition known as multisystem inflammatory syndrome, which is likely a postinfectious immunologic response, which is seen mainly in children and adolescents and not adults.
{"title":"Children are not little adults","authors":"A. Goh","doi":"10.4103/prcm.prcm_11_21","DOIUrl":"https://doi.org/10.4103/prcm.prcm_11_21","url":null,"abstract":"Coronavirus has caused a pandemic affecting both adults and children. Although mortality rates in adults are high, that in children has been low, with many children experiencing only mild disease. This article looks at the pathophysiologic mechanisms that may account for the differences observed in children, namely a strong immune response, a lower number of angiotensin-converting enzyme 2, and a lower inflammatory response. Though children in general have mild disease, there is a hyperinflammatory condition known as multisystem inflammatory syndrome, which is likely a postinfectious immunologic response, which is seen mainly in children and adolescents and not adults.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125073485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Overcoming COVID-19 in children","authors":"Yu-Tsun Su","doi":"10.4103/prcm.prcm_12_21","DOIUrl":"https://doi.org/10.4103/prcm.prcm_12_21","url":null,"abstract":"","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121640812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mucus production of the respiratory tract is our first defense against microbes and allergens. However, overproduction of the sputum and difficulty with airway clearance could lead to many respiratory tract diseases. Mucoactive agents are medications that either change the properties of the sputum or decrease its production. This article aims to provide an overview of common mucoactive agent.
{"title":"An overview of mucoactive agents","authors":"L. Hsu, Y. Huang, Y. Chiou, BaoRen Nong","doi":"10.4103/prcm.prcm_6_20","DOIUrl":"https://doi.org/10.4103/prcm.prcm_6_20","url":null,"abstract":"Mucus production of the respiratory tract is our first defense against microbes and allergens. However, overproduction of the sputum and difficulty with airway clearance could lead to many respiratory tract diseases. Mucoactive agents are medications that either change the properties of the sputum or decrease its production. This article aims to provide an overview of common mucoactive agent.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133201996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reduction of complications in interhospital transport of critically ill infants: Impact of a standardized neonatal referral workflow and specialized neonatal transport team at the Hong Kong children’s hospital","authors":"Y. Chee, Rosanna Wong, G. Chan","doi":"10.4103/prcm.prcm_17_20","DOIUrl":"https://doi.org/10.4103/prcm.prcm_17_20","url":null,"abstract":"","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"18 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133076881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Anuntaseree, Waroon Tangjitrapitak, Hansa Sriphongphankul, K. Ruangnapa, Kantara Saelim, Pharsai Prasertsan
Background: The tuberculin skin test (TST) is used in children who have been in contact with tuberculosis (TB). The test has limitations in terms of operator variability and the need for a second visit at 48–72 h for interpretation. Serum adenosine deaminase (ADA) was studied in adults and found to have a strong correlation with TST. Until now no data are available in the pediatric population. Objective: To examine the correlation between serum ADA and the TST in children who had been in contact with TB. Materials and Methods: A prospective study was conducted at Songklanagarind Hospital in southern Thailand among children aged 2–15 years with a history of contact TB between 2016 and 2018. Serum ADA was obtained before performing the TST. Children with active TB disease were excluded from the analysis. Results: Sixty-seven children were enrolled. The serum ADA ranged from 9.3–43 IU/L. The overall correlation between serum ADA and TST was poor (ρ = −0.03, P = 0.84). However, a subgroup analysis excluding 32 children with TST size 0 mm and a high variation of serum ADA (10–37.6 IU/L) found that in the remaining children, serum ADA and TST had a moderate correlation with statistical significance (ρ = 0.48, P = 0.004). Conclusions: The correlation between serum ADA and TST in contact TB pediatric patients was poor. The cause of low correlation was due to a high variability of serum ADA level in children who had no reaction to TST.
背景:结核菌素皮肤试验(TST)用于与结核病有过接触的儿童。该测试在操作人员的可变性方面存在局限性，并且需要在48-72小时内进行第二次访问以进行解释。研究成人血清腺苷脱氨酶(ADA)与TST有很强的相关性。到目前为止，还没有关于儿科人群的数据。目的:探讨接触结核儿童血清ADA与TST的相关性。材料与方法:在泰国南部的Songklanagarind医院对2016年至2018年间有接触性结核病史的2-15岁儿童进行了一项前瞻性研究。在TST前测定血清ADA。患有活动性结核病的儿童被排除在分析之外。结果:67名儿童入组。血清ADA范围9.3 ~ 43 IU/L。血清ADA与TST总体相关性较差(ρ = - 0.03, P = 0.84)。然而，对32例TST大小为0 mm且血清ADA变化较大(10-37.6 IU/L)的患儿进行亚组分析发现，在其余患儿中，血清ADA与TST有中度相关性，差异有统计学意义(ρ = 0.48, P = 0.004)。结论:儿童接触性结核患者血清ADA与TST相关性较差。低相关性的原因是由于对TST无反应的儿童血清ADA水平的高变异性。
{"title":"Serum adenosine deaminase and tuberculin skin test in children with tuberculosis contact","authors":"W. Anuntaseree, Waroon Tangjitrapitak, Hansa Sriphongphankul, K. Ruangnapa, Kantara Saelim, Pharsai Prasertsan","doi":"10.4103/PRCM.PRCM_12_20","DOIUrl":"https://doi.org/10.4103/PRCM.PRCM_12_20","url":null,"abstract":"Background: The tuberculin skin test (TST) is used in children who have been in contact with tuberculosis (TB). The test has limitations in terms of operator variability and the need for a second visit at 48–72 h for interpretation. Serum adenosine deaminase (ADA) was studied in adults and found to have a strong correlation with TST. Until now no data are available in the pediatric population. Objective: To examine the correlation between serum ADA and the TST in children who had been in contact with TB. Materials and Methods: A prospective study was conducted at Songklanagarind Hospital in southern Thailand among children aged 2–15 years with a history of contact TB between 2016 and 2018. Serum ADA was obtained before performing the TST. Children with active TB disease were excluded from the analysis. Results: Sixty-seven children were enrolled. The serum ADA ranged from 9.3–43 IU/L. The overall correlation between serum ADA and TST was poor (ρ = −0.03, P = 0.84). However, a subgroup analysis excluding 32 children with TST size 0 mm and a high variation of serum ADA (10–37.6 IU/L) found that in the remaining children, serum ADA and TST had a moderate correlation with statistical significance (ρ = 0.48, P = 0.004). Conclusions: The correlation between serum ADA and TST in contact TB pediatric patients was poor. The cause of low correlation was due to a high variability of serum ADA level in children who had no reaction to TST.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116798858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since December 2019, coronavirus disease 2019 (COVID-19) cases have been reported. The clinical features of COVID-19 in children are different from those in adults including morbidity and mortality. Even in infants and children, the clinical features are different according to ages in some cases. The children are commonly coinfected to diverse respiratory viruses, and therefore physicians, who take care of infants and children infected with COVID-19, have to consider diverse clinical aspects in their patients infected with COVID-19. In this review, we have summarized the clinical features of COVID-19 in children.
{"title":"Clinical spectrum of pediatric coronavirus disease 2019 infection","authors":"Eun Lee, S. Hong","doi":"10.4103/PRCM.PRCM_14_20","DOIUrl":"https://doi.org/10.4103/PRCM.PRCM_14_20","url":null,"abstract":"Since December 2019, coronavirus disease 2019 (COVID-19) cases have been reported. The clinical features of COVID-19 in children are different from those in adults including morbidity and mortality. Even in infants and children, the clinical features are different according to ages in some cases. The children are commonly coinfected to diverse respiratory viruses, and therefore physicians, who take care of infants and children infected with COVID-19, have to consider diverse clinical aspects in their patients infected with COVID-19. In this review, we have summarized the clinical features of COVID-19 in children.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128856280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu-Jen Wei, Y. Ju, Ming-Lin Hsieh, Ming-Ho Wu, Jing‐Ming Wu, Jieh-Neng Wang
Objectives: Although children with complicated parapneumonic effusions (CPEs) clinically improve within weeks after being discharged from the hospital, it remains unclear whether the injury and subsequent repair of the damaged lung allow a full return to premorbid lung function. We investigated the pulmonary function status in children whose CPE had been treated with different modalities. Patients and Methods: We therefore enrolled forty patients with a history of CPE: (1) patients treated with systemic antibiotics and conventional chest tube therapy only (control Group 1, n = 11); (2) patients treated with systemic antibiotics, conventional chest tube therapy, and intrapleural fibrinolytic therapy (Group 2, n = 20); and (3) patients treated with surgical intervention in addition to prior medical treatment (Group 3, the surgical rescue group, n = 9). Pulmonary function tests were done when patients had been discharged at least for 1 year. We used a spirometry test for pediatric pulmonary functions. Results: The basic demographic data of the three groups were not significantly different. The forced volume vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were significantly higher in Group 2 patients (percentage of the predicted value in FVC: 87.6% ± 8.5% versus 79.2% ± 13.4% (Group 1) vs. 77.6% ± 9.0% (Group 3)). Significantly, fewer Group 2 patients had abnormal pulmonary function (P
{"title":"A follow-up study for pulmonary function evaluation in children with complicated parapneumonic pleural effusion","authors":"Yu-Jen Wei, Y. Ju, Ming-Lin Hsieh, Ming-Ho Wu, Jing‐Ming Wu, Jieh-Neng Wang","doi":"10.4103/PRCM.PRCM_15_20","DOIUrl":"https://doi.org/10.4103/PRCM.PRCM_15_20","url":null,"abstract":"Objectives: Although children with complicated parapneumonic effusions (CPEs) clinically improve within weeks after being discharged from the hospital, it remains unclear whether the injury and subsequent repair of the damaged lung allow a full return to premorbid lung function. We investigated the pulmonary function status in children whose CPE had been treated with different modalities. Patients and Methods: We therefore enrolled forty patients with a history of CPE: (1) patients treated with systemic antibiotics and conventional chest tube therapy only (control Group 1, n = 11); (2) patients treated with systemic antibiotics, conventional chest tube therapy, and intrapleural fibrinolytic therapy (Group 2, n = 20); and (3) patients treated with surgical intervention in addition to prior medical treatment (Group 3, the surgical rescue group, n = 9). Pulmonary function tests were done when patients had been discharged at least for 1 year. We used a spirometry test for pediatric pulmonary functions. Results: The basic demographic data of the three groups were not significantly different. The forced volume vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were significantly higher in Group 2 patients (percentage of the predicted value in FVC: 87.6% ± 8.5% versus 79.2% ± 13.4% (Group 1) vs. 77.6% ± 9.0% (Group 3)). Significantly, fewer Group 2 patients had abnormal pulmonary function (P","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121885084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/2543-0343.315581
D. K. Ng
{"title":"COVID – Resuming A New Norm","authors":"D. K. Ng","doi":"10.4103/2543-0343.315581","DOIUrl":"https://doi.org/10.4103/2543-0343.315581","url":null,"abstract":"","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116093594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Bhat, N. Choh, Shihab Zahoor, B. Charoo, Z. Tramboo
Background: Foreign body aspiration (FBA) in children is considered one of the most important diagnostic and therapeutic challenges for physicians. Often there is no history of aspiration of foreign body in this population and these children present with a wide range of nonspecific signs and symptoms. The objective of the study was to study the diagnostic utility of chest computed tomography (CT) scan in children with suspected FBA in comparison to flexible bronchoscopy (FB) and the role of later as a therapeutic tool in the removal of airway foreign bodies. Methods: This was a prospective observational study conducted from January 2015 to August 2019. Children admitted for persistent respiratory symptoms underwent CT chest and FB for confirmation of the diagnosis and retrieval of the foreign body if present. Results: A total of 101 patients of both genders were enrolled in the study. Fifty-three participants were boys and 48 were girls. FBA was diagnosed in 53 patients on chest CT. On FB, FBA was confirmed in 55 patients. The sensitivity and specificity of chest CT in our study were 85% and 87% respectively. In 25 of these patients, removal was successfully done by the FB. Conclusion: We conclude that a Chest CT scan is inferior to FB in the diagnosis of suspected trachea-bronchial foreign bodies in children. FB as a therapeutic tool has an excellent safety record in the retrieval of airway foreign bodies in this population.
{"title":"Comparative analysis of computed tomography scan and flexible bronchoscopy in the evaluation of suspected foreign body aspiration in children and the role of later in its removal","authors":"J. Bhat, N. Choh, Shihab Zahoor, B. Charoo, Z. Tramboo","doi":"10.4103/prcm.prcm_4_20","DOIUrl":"https://doi.org/10.4103/prcm.prcm_4_20","url":null,"abstract":"Background: Foreign body aspiration (FBA) in children is considered one of the most important diagnostic and therapeutic challenges for physicians. Often there is no history of aspiration of foreign body in this population and these children present with a wide range of nonspecific signs and symptoms. The objective of the study was to study the diagnostic utility of chest computed tomography (CT) scan in children with suspected FBA in comparison to flexible bronchoscopy (FB) and the role of later as a therapeutic tool in the removal of airway foreign bodies. Methods: This was a prospective observational study conducted from January 2015 to August 2019. Children admitted for persistent respiratory symptoms underwent CT chest and FB for confirmation of the diagnosis and retrieval of the foreign body if present. Results: A total of 101 patients of both genders were enrolled in the study. Fifty-three participants were boys and 48 were girls. FBA was diagnosed in 53 patients on chest CT. On FB, FBA was confirmed in 55 patients. The sensitivity and specificity of chest CT in our study were 85% and 87% respectively. In 25 of these patients, removal was successfully done by the FB. Conclusion: We conclude that a Chest CT scan is inferior to FB in the diagnosis of suspected trachea-bronchial foreign bodies in children. FB as a therapeutic tool has an excellent safety record in the retrieval of airway foreign bodies in this population.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132464084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
SARS-CoV-2 has immensely changed the landscape in how vaccines are researched and developed. The timeline truncated for the propose of meeting the grave demand. Children stand to benefit from herd immunity for multiple reasons. Protection from SARS-CoV-2 would not only protect children from COVID but also a unique entity called Multisystem Inflammatory Syndrome in Children (MISC). Thus, it is vital that general pediatricians and practitioners who care for children to have foundational knowledge regarding the ever-expanding array of soon to be available COVID19 vaccines along with the potential pitfalls of their rushed development and implementation. This article seeks to provide a brief review of the most prominent COVID19 vaccines under development with intention for Pediatric use as well as recall historical knowledge regarding rushed development of respiratory viral vaccines that resulted in unintended consequences.
{"title":"SARS-CoV-2 vaccines: A brief review","authors":"Brandon Chatani, D. Ng","doi":"10.4103/prcm.prcm_4_21","DOIUrl":"https://doi.org/10.4103/prcm.prcm_4_21","url":null,"abstract":"SARS-CoV-2 has immensely changed the landscape in how vaccines are researched and developed. The timeline truncated for the propose of meeting the grave demand. Children stand to benefit from herd immunity for multiple reasons. Protection from SARS-CoV-2 would not only protect children from COVID but also a unique entity called Multisystem Inflammatory Syndrome in Children (MISC). Thus, it is vital that general pediatricians and practitioners who care for children to have foundational knowledge regarding the ever-expanding array of soon to be available COVID19 vaccines along with the potential pitfalls of their rushed development and implementation. This article seeks to provide a brief review of the most prominent COVID19 vaccines under development with intention for Pediatric use as well as recall historical knowledge regarding rushed development of respiratory viral vaccines that resulted in unintended consequences.","PeriodicalId":273845,"journal":{"name":"Pediatric Respirology and Critical Care Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129256392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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