scholarly journals Progressive ventilation inhomogeneity in infants with cystic fibrosis after pulmonary infection

2015 ◽  
Vol 46 (6) ◽  
pp. 1680-1690 ◽  
Author(s):  
Shannon J. Simpson ◽  
Sarath Ranganathan ◽  
Judy Park ◽  
Lidija Turkovic ◽  
Roy M. Robins-Browne ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Pulmonary Infection ◽  
Pulmonary Inflammation ◽  
First Year ◽  
Cross Sectional ◽  
Ventilation Inhomogeneity ◽  
Multiple Breath Washout ◽  
First Year Of Life ◽  
The Impact

Measures of ventilation distribution are promising for monitoring early lung disease in cystic fibrosis (CF). This study describes the cross-sectional and longitudinal impacts of pulmonary inflammation and infection on ventilation homogeneity in infants with CF.Infants diagnosed with CF underwent multiple breath washout (MBW) testing and bronchoalveolar lavage at three time points during the first 2 years of life.Measures were obtained for 108 infants on 156 occasions. Infants with a significant pulmonary infection at the time of MBW showed increases in lung clearance index (LCI) of 0.400 units (95% CI 0.150–0.648; p=0.002). The impact was long lasting, with previous pulmonary infection leading to increased ventilation inhomogeneity over time compared to those who remained free of infection (p<0.05). Infection with Haemophilus influenzae was particularly detrimental to the longitudinal lung function in young children with CF where LCI was increased by 1.069 units for each year of life (95% CI 0.484–1.612; p<0.001).Pulmonary infection during the first year of life is detrimental to later lung function. Therefore, strategies aimed at prevention, surveillance and eradication of pulmonary pathogens are paramount to preserve lung function in infants with CF.

Aspergillus and progression of lung disease in children with cystic fibrosis

Thorax ◽  
2018 ◽  
Vol 74 (2) ◽  
pp. 125-131 ◽  
Author(s):  
Sabariah Noor Harun ◽  
Claire E Wainwright ◽  
Keith Grimwood ◽  
Stefanie Hennig
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Bronchoalveolar Lavage ◽  
Lung Disease ◽  
Lung Function Decline ◽  
Air Trapping ◽  
Cross Sectional ◽  
Progression Model ◽  
Non Linear ◽  
The Impact

BackgroundThe impact of Aspergillus on lung disease in young children with cystic fibrosis is uncertain.AimsTo determine if positive respiratory cultures of Aspergillus species are associated with: (1) increased structural lung injury at age 5 years; (2) accelerated lung function decline between ages 5 years and 14 years and (3) to identify explanatory variables.MethodsA cross-sectional analysis of association between Aspergillus positive bronchoalveolar lavage (BAL) cultures and chest high-resolution CT (HRCT) scan findings at age 5 years in subjects from the Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) study was performed. A non-linear mixed-effects disease progression model was developed using FEV1% predicted measurements at age 5 years from the ACFBAL study and at ages 6–14 years for these subjects from the Australian Cystic Fibrosis Data Registry.ResultsPositive Aspergillus BAL cultures at age 5 years were significantly associated with increased HRCT scores for air trapping (OR 5.53, 95% CI 2.35 to 10.82). However, positive Aspergillus cultures were not associated with either FEV1% predicted at age 5 years or FEV1% predicted by age following adjustment for body mass index z-score and hospitalisation secondary to pulmonary exacerbations. Lung function demonstrated a non-linear decline in this population.ConclusionIn children with cystic fibrosis, positive Aspergillus BAL cultures at age 5 years were associated contemporaneously with air trapping but not bronchiectasis. However, no association was observed between positive Aspergillus BAL cultures on FEV1% predicted at age 5 years or with lung function decline between ages 5 years and 14 years.

scholarly journals Evolution of lung function during the first year of life in newborn screened cystic fibrosis infants

Thorax ◽  
2013 ◽  
Vol 69 (10) ◽  
pp. 910-917 ◽  
Author(s):  
The Thanh-Diem Nguyen ◽  
Lena P Thia ◽  
Ah-Fong Hoo ◽  
Andrew Bush ◽  
Paul Aurora ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
First Year ◽  
First Year Of Life

Cross-sectional analysis of universal vitamin D supplementation in former East Germany during the first year of life

2017 ◽  
Vol 30 (4) ◽  
Author(s):  
Aris Siafarikas ◽  
Alfons Deichl ◽  
Gerhard Jahreis ◽  
Angela Pieplow ◽  
Hartmut Vogel ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D3 ◽  
East Germany ◽  
Vitamin D Supplementation ◽  
First Year ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
First Year Of Life ◽  
Sectional Analysis ◽  
The Impact

AbstractBackground:Universal vitamin D supplementation is controversial. Preventative examinations and public health initiatives in former East Germany that included vitamin D prophylaxis for children were regulated by official recommendations and guidelines. The aim of this study is to analyse the impact of a standardised nationwide guideline for universal supplementation with 400 International Units (IU) vitamin D3/day during the first year of life on clinical and biochemical parameters and the influence of surrounding factors.Methods:This is a cross-sectional analysis looking at data from a field study of 3481 term-born children during their first year of life that was conducted in 1989.Results:There were no significant clinical signs of rickets. 25 hydroxyvitamin D (25(OH)D) (mean and SEM, total analyses n=572) after birth (n=28) was 36(7) nmol/L, at 1 month 64(4) nmol/L (n=70, p<0.0001), 91(5) nmol/L at 3 months (n=95, p<0.0001), 65(8) nmol/L at 8 months (n=21, p=0.005) and ranged between 33 and 109 nmol/L until 12 months. Less than 0.2% of analyses revealed pathological levels for calcium or phosphate. Alkaline phosphatase (ALP) levels (n=690) were >1500 U/L (95th percentile) in 3.6%. Participants were on breastmilk or vitamin D-free formula, with solids added from 6 months of age. There were seasonal variations in 25(OH)D levels with a rise during spring and autumn. Thus this analysis is unique as sun exposure and supplementation can be considered as the only vitamin D sources.Conclusions:We conclude that universal supplementation with 400 IU of vitamin D3 during the first year of life is safe and provides sufficient 25(OH)D levels in Germany.

Social inequality in parent–infant relations: Epidemiological study of community nurse records

2021 ◽  
pp. 140349482098313
Author(s):  
Bjørn E. Holstein ◽  
Sofie Weber Pant ◽  
Janni Ammitzbøll ◽  
Trine Pagh Pedersen
Keyword(s):  
Community Sample ◽  
Occupational Status ◽  
Home Visits ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Immigrant Parents ◽  
First Year ◽  
Cross Sectional ◽  
Parents And Children ◽  
First Year Of Life

Background: Some studies suggest that favourable socioeconomic circumstances are associated with better parent–child relations but the documentation of such an association is limited and inconsistent. Few studies focused on infancy, few studies relied on objective measurement of parent–infant relations, and few studies included more than one measurement of parent–infant relations in the first year of life. Aims: To report the prevalence of objectively measured problems in parent–infant relations during the first year of life and to examine the association between socioeconomic circumstances and parent–infant relations in an unselected community sample of infants. Methods: Cross-sectional study of a community sample of children from birth to 10 months in 15 municipalities in Denmark, n = 11,765. The exposure variables were population register data about socioeconomic circumstances: (a) parents’ education, (b) family composition, (c) parents’ origin, and (d) parents’ occupational status. The outcome variable was the health visitor’s concerns about the parent–infant relation assessed at four home visits from birth to 10 months after delivery. Results: The proportion of children with concerns about the parent–infant relation was 10.5%, 7.8% at one home visit and 2.8% at two or more home visits. Logistic regression analyses showed that all four indicators of socioeconomic circumstances were associated with concerns about the parent–infant relation in the first year of life. Conclusions: The risk of problematic parent–infant relations were significantly elevated among, children of immigrant parents, and children of parents with shorter education and not in education or work.

Breast-feeding promotion in hospitals and prospective breast-feeding rates during the first year of life in two national surveys 1997–1998 and 2017–2019 in Germany

2021 ◽  
pp. 1-13
Author(s):  
Nele Hockamp ◽  
Constanze Burak ◽  
Erika Sievers ◽  
Silvia Rudloff ◽  
Anja Burmann ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Infant Nutrition ◽  
Feeding Habits ◽  
First Year ◽  
Feeding Rates ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Phone Calls ◽  
First Year Of Life

Abstract Objectives: The present study aimed to assess the current state of breast-feeding promotion in hospitals and the prevalence of breast-feeding during the first year of life in Germany and to compare the results with a study 20 years earlier. Design: In the studies on ‘breast-feeding and infant nutrition in Germany’ named ‘SuSe’, a cross-sectional survey in hospitals was combined with a subsequent prospective survey of breast-feeding and infant nutrition during the first year of life (0·5, 2, 4, 6 and 12 months after birth) in mother–infant pairs who were recruited in the hospitals. Written questionnaires and phone calls were used in SuSe I and web-based questionnaires in SuSe II. Breast-feeding promotion and prevalence were evaluated using recommendations from the WHO and the UNICEF. Setting: Two nationwide surveys SuSe I (1997–1998) and SuSe II (2017–2019). Participants: In SuSe I, 177 hospitals and 1717 mother–infant pairs and in SuSe II 109 hospitals and 962 mother–infant pairs were included. Results: In SuSe II, hospitals implemented seven of the WHO ‘Ten Steps to Successful Breastfeeding’ to a greater extent than the hospitals in SuSe I. More mothers exclusively breastfed for 4 months (57 % v. 33 %) and continued breast-feeding until 6 (78 % v. 48 %) and 12 months (41 % v. 13 %). In both studies, exclusive breast-feeding decreased between 4 and 6 months of age due to the introduction of complementary feeding. Conclusions: In Germany, breast-feeding habits have come closer to the recommendations over the last 20 years.

scholarly journals Breastfeeding, maternal asthma and wheezing in the first year of life: a longitudinal birth cohort study

2017 ◽  
Vol 49 (5) ◽  
pp. 1602019 ◽  
Author(s):  
Meghan B. Azad ◽  
Lorena Vehling ◽  
Zihang Lu ◽  
David Dai ◽  
Padmaja Subbarao ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Respiratory Health ◽  
Birth Cohort Study ◽  
P Value ◽  
First Year ◽  
Dependent Manner ◽  
Complementary Foods ◽  
Adjusted Rate ◽  
First Year Of Life ◽  
The Impact

The impact of breastfeeding on respiratory health is uncertain, particularly when the mother has asthma. We examined the association of breastfeeding and wheezing in the first year of life.We studied 2773 infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Caregivers reported on infant feeding and wheezing episodes at 3, 6 and 12 months. Breastfeeding was classified as exclusive, partial (supplemented with formula or complementary foods) or none.Overall, 21% of mothers had asthma, 46% breastfed for at least 12 months and 21% of infants experienced wheezing. Among mothers with asthma, breastfeeding was inversely associated with infant wheezing, independent of maternal smoking, education and other risk factors (adjusted rate ratio (aRR) 0.52; 95% CI 0.35–0.77 for ≥12 versus <6 months breastfeeding). Compared with no breastfeeding at 6 months, wheezing was reduced by 62% with exclusive breastfeeding (aRR 0.38; 95% CI 0.20–0.71) and by 37% with partial breastfeeding supplemented with complementary foods (aRR 0.63; 95% CI 0.43–0.93); however, breastfeeding was not significantly protective when supplemented with formula (aRR 0.89; 95% CI 0.61–1.30). Associations were not significant in the absence of maternal asthma (p-value for interaction <0.01).Breastfeeding appears to confer protection against wheezing in a dose-dependent manner among infants born to mothers with asthma.

scholarly journals The development of the cortisol response to dyadic stressors in Black and White infants

2018 ◽  
Vol 30 (5) ◽  
pp. 1995-2008 ◽  
Author(s):  
Andrew Dismukes ◽  
Elizabeth Shirtcliff ◽  
Christopher W. Jones ◽  
Charles Zeanah ◽  
Katherine Theall ◽  
...  
Keyword(s):  
Urban Life ◽  
First Year ◽  
Strange Situation ◽  
Cortisol Reactivity ◽  
Hypothalamic Pituitary Adrenal ◽  
Black And White ◽  
First Year Of Life ◽  
The Impact ◽  
Still Face Paradigm ◽  
Strange Situation Procedure

AbstractAcute reactivity of the stress hormone cortisol is reflective of early adversity and stress exposure, with some studies finding that the impact of adversity on the stress response differs by race. The objectives of the current study were to characterize cortisol reactivity to two dyadically based stress paradigms across the first year of life, to examine cortisol reactivity within Black and White infants, and to assess the impact of correlates of racial inequity including socioeconomic status, experiences of discrimination, and urban life stressors, as well as the buffering by racial socialization on cortisol patterns. Salivary cortisol reactivity was assessed at 4 months of age during the Still Face paradigm (N = 207) and at 12 months of age across the Strange Situation procedure (N = 129). Infants demonstrated the steepest recovery after the Still Face paradigm and steepest reactivity to the Strange Situation procedure. Race differences in cortisol were not present at 4 months but emerged at 12 months of age, with Black infants having higher cortisol. Experiences of discrimination contributed to cortisol differences within Black infants, suggesting that racial discrimination is already “under the skin” by 1 year of age. These findings suggest that race-related differences in hypothalamic–pituitary–adrenal reactivity are present in infancy, and that the first year of life is a crucial time period during which interventions and prevention efforts for maternal–infant dyads are most likely able to shape hypothalamic–pituitary–adrenal reactivity thereby mitigating health disparities early across the life course.

scholarly journals Body mass index status and peripheral airway obstruction in school-age children: a population-based cohort study

Thorax ◽  
2018 ◽  
Vol 73 (6) ◽  
pp. 538-545 ◽  
Author(s):  
Sandra Ekström ◽  
Jenny Hallberg ◽  
Inger Kull ◽  
Jennifer L P Protudjer ◽  
Per Thunqvist ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Lung Function ◽  
Airway Obstruction ◽  
Body Mass ◽  
Overweight And Obesity ◽  
School Age Children ◽  
Childhood And Adolescence ◽  
Small Airways ◽  
Cross Sectional ◽  
The Impact

BackgroundFew large prospective studies have investigated the impact of body mass index (BMI) on lung function during childhood.MethodsUsing data collected between 2002 and 2013, we analysed associations between BMI status and lung function (assessed by spirometry) from 8 to 16 years, as well as cross-sectional associations with small airway function (impulse oscillometry) at 16 years in the BAMSE cohort (n=2889). At 16 years, cross-sectional associations with local and systemic inflammation were investigated by analysing FENO, blood eosinophils and neutrophils.ResultsOverweight and obesity at 8 years were associated with higher FVC, but lower FEV1/FVC ratio at 8 and 16 years. In boys, but not girls, obesity at 8 years was associated with a further reduction in FEV1/FVC between 8 and 16 years. In cross-sectional analyses, overweight and obesity were associated with higher frequency dependence of resistance (R5–20) and larger area under the reactance curve (AX0.5) at 16 years. Increased blood neutrophil counts were seen in overweight and obese girls, but not in boys. No association was found between BMI status and FENO. Persistent, but not transient, overweight/obesity between 8 and 16 years was associated with higher R5–20 and AX0.5 and lower FEV1/FVC (−2.8% (95% CI −4.1 to −1.2) in girls and −2.7% (95% CI −4.4 to −1.1) in boys) at 16 years, compared with persistent normal weight.ConclusionIn childhood and adolescence, overweight and obesity, particularly persistent overweight, were associated with evidence of airway obstruction, including the small airways.

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