Abstract:
:Inhaled corticosteroids are commonly used in cystic fibrosis (CF), but there are few studies evaluating their safety in young children. We, therefore, prospectively administered beclomethasone diproprionate (BDP) to 12 clinically stable young children with CF to examine the safety of this therapy with respect to adrenal suppression and airway infection. To determine potential mechanisms of corticosteroid action in CF, we also examined airway markers of inflammation before and after inhaled steroid treatment. BDP 210 microg twice a day was given via spacer for 2 months. Twelve-hour serum and urine cortisols and response to low-dose synthetic ACTH cortisol stimulation were assessed. Bronchoalveolar lavage fluid (BALF) was examined pre- and posttreatment with BDP by quantitative bacteriology and indices of airway inflammation, including levels of total neutrophils, neutrophil elastase-alpha-1 antiprotease complexes (NEAP), CA 19-9 mucin-associated antigen, interleukin-8 (IL-8), and macrophage IL-8 mRNA. Following 2 months of treatment, serum and urine cortisol levels were unchanged. Response to low-dose ACTH cortisol stimulation was not significantly decreased at 30 min. Posttreatment BALF bacterial density was not statistically different from pretreatment; however, one patient who was initially culture negative became culture-positive with Hemophilus influenzae. BALF total neutrophil counts, corrected for epithelial lining fluid dilution, were decreased to approximately one third of pretreatment values (P = 0.03). NEAP and CA 19-9 mucin-associated antigen demonstrated similar decreases. BALF IL-8 levels and macrophage IL-8 mRNA levels were not statistically changed. These findings suggest that treatment with BDP 420 microg per day for 2 months in young children with CF does not affect urine and blood cortisol, causes no decrease in adrenal reserve, and does not result in a clinically significant increase in airway infection. In addition, the fall in bronchoalveolar lavage fluid inflammatory markers following BDP suggests possible modulation of neutrophil influx into the CF airway and provides justification for further studies of inhaled corticosteroids in CF.
journal_name
Pediatr Pulmonoljournal_title
Pediatric pulmonologyauthors
Wojtczak HA,Kerby GS,Wagener JS,Copenhaver SC,Gotlin RW,Riches DW,Accurso FJdoi
10.1002/ppul.1122subject
Has Abstractpub_date
2001-10-01 00:00:00pages
293-302issue
4eissn
8755-6863issn
1099-0496pii
10.1002/ppul.1122journal_volume
32pub_type
杂志文章abstract:OBJECTIVE:Both healthy preterm infants and those with bronchopulmonary dysplasia (BPD) have poor lung function during childhood and adolescence, although there is no evidence whether prematurity alone explains the reduction in lung function found in BPD infants. Our study seeks to know if lung function, measured in inf...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.21609
更新日期:2012-07-01 00:00:00
abstract::A study was designed to determine the sensitivity and specificity of a cold air bronchial provocation test. A total of 18 children with asthma (mean age 12 years) and 18 normal children (mean age 14 years) were studied. The cold air challenge consisted of a 4 min period of isocapnic hyperventilation of subfreezing air...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950030410
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVE:Telomere length is associated with poorer lung health in older adults, possibly from cumulative risk factor exposure, but data are lacking in pediatric and population-based cohorts. We examined associations of telomere length with lung function in children and mid-life adults. METHODS:Data were drawn from a ...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24489
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Pneumonia is a leading killer of children under-5 years, with a high burden in Nigeria. We aimed to quantify the regional burden and risks of pediatric pneumonia in Nigeria, and specifically the states of Lagos and Jigawa. METHODS:We conducted a scoping literature search for studies of pneumonia morbidity a...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.24626
更新日期:2020-06-01 00:00:00
abstract::Our aim was to evaluate long-term effects of exogenous surfactant therapy on pulmonary functional outcome in children born very preterm. We examined 40 children aged 7-12 years who were born before 30 weeks of gestation with an immature surfactant system, and were randomized to one of three treatment groups: human sur...
journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/(sici)1099-0496(199803)25:3<182::aid-ppul8
更新日期:1998-03-01 00:00:00
abstract::Cystic fibrosis (CF) patients with advanced lung disease are at risk for developing pulmonary vascular disease and pulmonary hypertension, characterized by progressive exercise intolerance beyond the exercise-limiting effects of airways disease in CF. We report on a patient with severe CF lung disease who experienced ...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20393
更新日期:2006-04-01 00:00:00
abstract::Mucus plugging constitutes a nutrient-rich nidus for a bacterial infection that has long been recognized as a potent stimulus for neutrophilic airway inflammation driving progressive lung damage in people with cystic fibrosis (CF). However, mucus plugging and neutrophilic inflammation are already present in many infan...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.24462
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:The prevalence of obstructive sleep apnea (OSA) is higher in children with poorly controlled asthma. We aimed to determine the validity of the Pediatric Sleep Questionnaire (PSQ) to screen for OSA in children with asthma. METHODS:This retrospective review encompassed sleep studies and medical records of asth...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.23568
更新日期:2017-03-01 00:00:00
abstract::With better understanding of the role of type 2 inflammation in allergic asthma, there has been progress made in the development of new biologic therapies targeting these specific pathways. This review will consider diagnostic criteria for using biologic therapies for pediatric asthma with special emphasis on populati...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.24613
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:Induced sputum sampling holds promise as a method for obtaining samples representative of the lower airways in young children. Collection of induced sputum samples in young children differs from older children and adults' as pharyngeal suctioning is often required. Our aim was to determine the sensitivity ...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.23636
更新日期:2017-02-01 00:00:00
abstract:RATIONALE:Increasing evidence suggests the forced oscillation technique (FOT) has the capacity to provide non-invasive monitoring and diagnosis of respiratory disease in young children. However, which FOT outcomes provide the most pertinent clinical information is currently unknown. The aim of this study was to determi...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24286
更新日期:2019-06-01 00:00:00
abstract::Inadequate intake and suboptimal growth are common problems for patients with CF and a critical target for intervention. The purpose of this study was to compare the growth outcomes of children with CF who participated in a randomized clinical trial to improve energy intake and weight to children with CF receiving sta...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,随机对照试验
doi:10.1002/ppul.21322
更新日期:2011-01-01 00:00:00
abstract::A variety of postnatal therapies have been and will be evaluated for prevention or treatment of neonatal chronic lung disease (CLD). A simple method for early selection of the highest risk infants would optimize intervention trials. Our study compared a clinical scoring system for predicting neonatal CLD (defined at 3...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/(sici)1099-0496(199906)27:6<388::aid-ppul5
更新日期:1999-06-01 00:00:00
abstract::Childhood interstitial lung disease (chILD) comprises a wide heterogeneous group of rare parenchymal lung disorders associated with substantial morbidity and mortality. Pulmonary hypertension is a common comorbidity in adults with interstitial lung disease (ILD) and associated with poor survival. We aimed to systemati...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.23632
更新日期:2017-05-01 00:00:00
abstract::A thorough understanding of the early natural history of cystic fibrosis (CF) lung disease is critical for the development of effective interventions in the youngest patients. We assessed the evolution of pulmonary infection, inflammation, and clinical course among 40 infants over a 2-year period through annual bronch...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1144
更新日期:2001-11-01 00:00:00
abstract::The reliability and predictive value of salivary theophylline levels was investigated in 58 children who were treated with oral sustained-release theophylline preparations for bronchial asthma. Serum and saliva levels were assessed by fluorescence polarization immunoassay (FPIA), and Seralyzer (reagent strip reflectan...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950060407
更新日期:1989-01-01 00:00:00
abstract::A computerized method for the measurement of alveolar ventilation (VA) and the mean alveolar partial pressures of CO2 and O2 is described and tested in healthy, awake fullterm (FT) newborns and preterm (PT) infants (postnatal age 40 days). This study emphasizes the technical pitfalls generally encountered when dealing...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950050409
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVES:A pilot study to compare pulmonary mechanics in a neonatal intensive care unit (NICU) cohort, specifically, comparing lung elastance between male and female infants in the NICU. HYPOTHESIS:Anecdotally, male infants are harder to ventilate than females. We hypothesize that males have higher model-based elast...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24538
更新日期:2020-01-01 00:00:00
abstract::The purpose of this study was to compare the pathogens obtained by oropharyngeal suction (OPS) and bronchoalveolar lavage (BAL) in children with chronic pulmonary infections. Forty-four children (mean age of 6.1 years; range 4 months to 15 years) were included in the study (27 children with recurrent localized lung in...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950200108
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Child exposure to cigarette smoke is harmful. It should be reduced through parental smoking cessation interventions. The aim of our study was to determine the impact of simple advice provided by the pediatrician on the smoking habits of parents of children with cystic fibrosis (CF), diabetes mellitus (DM) an...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.25277
更新日期:2021-01-22 00:00:00
abstract:OBJECTIVE:To examine cystic fibrosis (CF) physician adherence to the 2007 CF Foundation (CFF) Pulmonary Guidelines for Chronic Medications. Specifically adherence and barriers to prescribing level A medication recommendations (i.e., inhaled tobramycin and dornase alfa) and level B medication recommendations (i.e., macr...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.21573
更新日期:2012-05-01 00:00:00
abstract::It has been suggested that children with asthma recover more quickly from exercise-induced bronchoconstriction than adults. On the basis of clinical observation we hypothesized that recovery rate from exercise-induced asthma (EIA) in childhood also decreases with age. In 14 children (aged 7-12 years) with a history of...
journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/ppul.1950200309
更新日期:1995-09-01 00:00:00
abstract::In adults, the term specific pulmonary renal syndrome describes disorders with pulmonary and glomerular manifestations and includes Wegener's granulomatosis, Goodpasture disease, and systemic lupus erythematosus. Nonspecific pulmonary renal syndrome refers to either pulmonary disease complicating glomerular disease, o...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/(sici)1099-0496(200005)29:5<382::aid-ppul7
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Percutaneous lymphatic intervention (PCL) is a promising new therapy for plastic bronchitis (PB). We characterized bronchoalveolar lavage (BAL) and cast morphology in surgically repaired congenital heart disease (CHD) patients with PB during PCL. We quantified respiratory and bronchoscopic characteristics an...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24161
更新日期:2018-11-01 00:00:00
abstract::Cystic fibrosis (CF) is an illness associated with high healthcare utilization and healthcare costs, even when compared to other chronic illnesses. In a variety of medical populations, depression has been found to be associated with lower adherence and poorer medical outcomes. The current study is a retrospective char...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.22990
更新日期:2014-12-01 00:00:00
abstract::The jet nebulizer is a common device used for administering aerosol medication in young children. However, compared to a metered dose inhaler-spacer (MDI-spacer), it takes more time and personnel. This study aimed to compare the efficacy of salbutamol aerosol therapy given via these two devices in young wheezing child...
journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/ppul.20204
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Several studies have shown that exposure to air pollutants affects lung growth and development and can result in poor respiratory health in early life. METHODS:We included a subsample of 772 Mexican preschoolers whose mothers participated in a Prenatal Omega-3 fatty acid Supplements, GRowth, And Development...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24889
更新日期:2020-08-01 00:00:00
abstract::Background The prevalence of respiratory-technology dependent children is increasing although for most children the goal is liberation from technology. Liberation from home mechanical ventilation (HMV) and decannulation strategies vary due to the lack of clinical practice standards. The primary objective of this study...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24164
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:To develop reference equations of maximal voluntary ventilation (MVV) in children and adolescents, and to test the validity and reproducibility of MVV. STUDY DESIGN:Cross-sectional study. PATIENT-SUBJECT SELECTION:A total of 348 healthy volunteers (6-17 years)-248 for the development of reference equations...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24576
更新日期:2020-02-01 00:00:00
abstract::Most pneumatoceles disappear spontaneously and do not cause severe symptoms. Treatment alternatives include various conventional or surgical methods. However, an enlarging, complicated pneumatocele with cardiorespiratory instability requires imaging-guided catheter drainage or surgery. Here, we report the case of a ne...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.23311
更新日期:2016-02-01 00:00:00