scholarly journals Tidal flow variability measured by impedance pneumography relates to childhood asthma risk

2016 ◽  
Vol 47 (6) ◽  
pp. 1687-1696 ◽  
Author(s):  
Ville-Pekka Seppä ◽  
Anna S. Pelkonen ◽  
Anne Kotaniemi-Syrjänen ◽  
Jari Viik ◽  
Mika J. Mäkelä ◽  
...  
Keyword(s):  
Lung Function ◽  
Young Children ◽  
Inhaled Corticosteroids ◽  
Risk Groups ◽  
Lower Airway ◽  
Flow Profile ◽  
Predictive Index ◽  
Flow Variability ◽  
Impedance Pneumography ◽  
At Home

Lung function variability is a fundamental feature of asthma but has been difficult to quantify in children due to methodological limitations. We assessed the feasibility and clinical implications of overnight flow variability measurement at home using impedance pneumography in young children.44 children aged 3–7 years with recurrent or persistent lower airway symptoms were recruited. Patients were divided into high- or lower-risk groups (HR and LR groups) based on their risk of asthma (modified Asthma Predictive Index), and a third group was formed of children who had a history of wheeze and who were treated with inhaled corticosteroids (ICS group). Tidal volume and the derived flow were recorded through skin electrodes using impedance pneumography at home during sleep. Quantities describing overnight change in expiratory flow–volume minimum curve shape correlation (CSRmin) and respiratory chaoticity (minimum noise limit (NLmin)) were derived.Recordings were successful in 34 children. CSRmin differed between the HR and LR groups (p=0.002) and between the HR and ICS groups (p=0.003), indicating a stronger change in flow profile shape in the HR group. NLmin differed between the HR and LR groups (p=0.014), indicating momentarily lowered chaoticity in the HR group.Impedance pneumography was found feasible for quantifying nocturnal lung function variability and the measured variability was associated with risk of asthma in young children.

The infant and toddler with wheezing

2019 ◽  
Vol 40 (6) ◽  
pp. 393-395
Author(s):  
Nurcicek Padem ◽  
Rachel Glick Robison
Keyword(s):  
Young Children ◽  
Inhaled Corticosteroids ◽  
Immunoglobulin E ◽  
Bacterial Colonization ◽  
High Dose ◽  
Predictive Index ◽  
Double Blind ◽  
Recurrent Wheezing ◽  
Young Infants ◽  
Tract Infections

Recurrent wheezing is common in young infants and toddlers, with 50% of all children having at least one wheezing episode in the first 6 years of life. Initial wheezing episodes in young children often are linked to respiratory infections due to viral pathogens, such as respiratory syncytial virus, human rhinovirus, human metapneumovirus, and influenza virus. Bacterial colonization of the neonatal airway also may be significant in the late development of recurrent wheeze and asthma. Wheezing in young children can be classified into specific phenotypes based on the onset and persistence of wheezing. Although some children will only wheeze transiently in early childhood, persistent wheezing is often classified as immunoglobulin E (IgE) associated and/or atopic or nonatopic. By using a modified asthma predictive index, future development of asthma can be interpreted, especially in high-risk populations. It is recommended to follow National Asthma Education and Prevention Program (NAEPP) guidelines for initiation of treatment; however, asthma management of young children often requires tailored regimens. Inhaled corticosteroids used as a daily controller medication have been shown to aid symptoms and exacerbation control; however, these do not change the natural course of the disease or progression to asthma. Although randomized double-blind studies in preschoolers investigated a role of macrolide antibiotics in early infection as well as high-dose inhaled corticosteroids during severe lower respiratory tract infections, more research is needed in this field to understand mechanisms of asthma development and optimal treatment in this young age group.

scholarly journals Defective monocyte-derived macrophage phagocytosis is associated with exacerbation frequency in COPD

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
R. Singh ◽  
◽  
K. B. R. Belchamber ◽  
P. S. Fenwick ◽  
K. Chana ◽  
...  
Keyword(s):  
Lung Function ◽  
Inhaled Corticosteroids ◽  
Stable State ◽  
Smoking History ◽  
Lower Airway ◽  
Lung Function Decline ◽  
Bacterial Colonisation ◽  
Exacerbation Frequency ◽  
Macrophage Phagocytosis ◽  
Copd Patients

Abstract Background Lower airway bacterial colonisation (LABC) in COPD patients is associated with increased exacerbation frequency and faster lung function decline. Defective macrophage phagocytosis in COPD drives inflammation, but how defective macrophage function contributes to exacerbations is not clear. This study investigated the association between macrophage phagocytosis and exacerbation frequency, LABC and clinical parameters. Methods Monocyte-derived macrophages (MDM) were generated from 92 stable COPD patients, and at the onset of exacerbation in 39 patients. Macrophages were exposed to fluorescently labelled Haemophilus influenzae or Streptococcus pneumoniae for 4 h, then phagocytosis measured by fluorimetry and cytokine release by ELISA. Sputum bacterial colonisation was measured by PCR. Results Phagocytosis of H. influenzae was negatively correlated with exacerbation frequency (r = 0.440, p < 0.01), and was significantly reduced in frequent vs. infrequent exacerbators (1.9 × 103 RFU vs. 2.5 × 103 RFU, p < 0.01). There was no correlation for S. pneumoniae. There was no association between phagocytosis of either bacteria with age, lung function, smoking history or treatment with inhaled corticosteroids, or long-acting bronchodilators. Phagocytosis was not altered during an exacerbation, or in the 2 weeks post-exacerbation. In response to phagocytosis, MDM from exacerbating patients showed increased release of CXCL-8 (p < 0.001) and TNFα (p < 0.01) compared to stable state. Conclusion Impaired COPD macrophage phagocytosis of H. influenzae, but not S. pneumoniae is associated with exacerbation frequency, resulting in pro-inflammatory macrophages that may contribute to disease progression. Targeting these frequent exacerbators with drugs that improve macrophage phagocytosis may prove beneficial.

scholarly journals Inhaled corticosteroids and lower lung function decline in young children with cystic fibrosis

2010 ◽  
Vol 37 (5) ◽  
pp. 1091-1095 ◽  
Author(s):  
K. De Boeck ◽  
F. Vermeulen ◽  
S. Wanyama ◽  
M. Thomas ◽  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Young Children ◽  
Inhaled Corticosteroids ◽  
Lung Function Decline ◽  
Lower Lung

scholarly journals Tidal breathing flow volume profiles during sleep in wheezing infants measured by impedance pneumography

2019 ◽  
Vol 126 (5) ◽  
pp. 1409-1418 ◽  
Author(s):  
Javier Gracia-Tabuenca ◽  
Ville-Pekka Seppä ◽  
Milla Jauhiainen ◽  
Anne Kotaniemi-Syrjänen ◽  
Kristiina Malmström ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Eye Movement ◽  
Rapid Eye Movement ◽  
Flow Volume ◽  
Tidal Breathing ◽  
Sleep Phase ◽  
Asthma Risk ◽  
Impedance Pneumography ◽  
At Home

Overnight analysis of tidal breathing flow volume (TBFV) loops, recorded by impedance pneumography (IP), has been successfully applied in the home monitoring of children with wheezing disorders. However, little is known on how sleep physiology modifies the relationship between TBFV profiles and wheeze. We studied such interactions in wheezing infants. Forty-three infants recruited because of recurrent lower airway symptoms were divided into three groups based on their risk of asthma: high (HR), intermediate (IR), or low (LR). Sedated patients underwent infant lung function testing including assessment of airway responsiveness to methacholine at the hospital and a full-night recording of TBFV profiles at home with IP during natural sleep. Overnight TBFV indexes were estimated from periods of higher and lower respiration variability, presumably belonging to active [rapid eye movement (REM)] and quiet [non-REM (NREM)] sleep, respectively. From 35 valid recordings, absolute time indexes showed intrasubject sleep phase differences. Peak flow relative to time and volume was lower in HR compared with LR only during REM, suggesting altered expiratory control. Indexes estimating the concavity/convexity of flow decrease during exhalation suggested limited flow during passive exhale in HR compared with IR and LR, similarly during NREM and REM. Moreover, during REM convexity was negatively correlated with maximal flow at functional residual capacity and methacholine responsiveness. We conclude that TBFV profiles determined from overnight IP recordings vary because of sleep phase and asthma risk. Physiological changes during REM, most likely decrease in respiratory muscle tone, accentuate the changes in TBFV profiles caused by airway obstruction. NEW & NOTEWORTHY Impedance pneumography was used to investigate overnight tidal breathing flow volume (TBFV) indexes and their interactions with sleep phase [rapid eye movement (REM) vs. non-REM] at home in wheezing infants. The study shows that TBFV indexes vary significantly because of sleep phase and asthma risk of the infant and that during REM the changes in TBFV indexes caused by airway obstruction are accentuated and better associated with lung function of the infant.

scholarly journals Impulse oscillometry and free-running tests for diagnosing asthma and monitoring lung function in young children

2021 ◽  
Author(s):  
Janne Burman ◽  
L. Pekka Malmberg ◽  
Sami Remes ◽  
Tuomas Jartti ◽  
Anna S. Pelkonen ◽  
...  
Keyword(s):  
Lung Function ◽  
Young Children ◽  
Impulse Oscillometry ◽  
Free Running

scholarly journals Young Children with Orthopedic Handicaps: Self-Knowledge about Their Disability

1988 ◽  
Vol 55 (3) ◽  
pp. 249-252 ◽  
Author(s):  
Nancy Lee Dunn ◽  
Kathleen W. McCartan ◽  
Robert W. Fuqua
Keyword(s):  
Young Children ◽  
Teacher Interviews ◽  
Self Knowledge ◽  
Home And School ◽  
At Home

Thirty children, age 36 to 83 months, were interviewed to ascertain the extent of their awareness of their orthopedic disability. Parent and teacher interviews were conducted to determine types and frequencies of discussions about the child's disability. Results supported previous findings that age of the child was significantly correlated with a child's awareness of differences and disability. However, additional findings indicated that occurrence of discussions on disabilities at home, but not at school, was significantly correlated with awareness. Implications of the findings for home and school discussions are discussed.

Inhaled Corticosteroid Therapy for Asthma in Preschool Children: Growth Issues

PEDIATRICS ◽  
2002 ◽  
Vol 109 (Supplement_E1) ◽  
pp. 373-380
Author(s):  
David B. Allen
Keyword(s):  
Young Children ◽  
Inhaled Corticosteroids ◽  
Persistent Asthma ◽  
Preventive Treatment ◽  
Growth Suppression ◽  
Mineral Density ◽  
Childhood Growth ◽  
Gh Secretion ◽  
Final Adult Height ◽  
Very Young Children

Although inhaled corticosteroids (ICS) have emerged as the preventive treatment of choice for persistent asthma, few studies have been conducted in infants and very young children that assess the benefits and risks of ICS therapy, particularly with regard to growth. Oral glucocorticoids inhibit growth at multiple levels by blunting pulsatile growth hormone (GH) secretion, decreasing insulin-like growth factor-1 bioactivity, and directly inhibiting new collagen synthesis. Normal childhood growth can be divided conceptually into 3 phases according to primary growth-supporting factors: nutrition-dependent growth of infancy, GH-dependent childhood growth, and sex steroid/GH stimulation of pubertal growth. Susceptibility to glucocorticoid-induced growth suppression appears to increase during periods of transition from one phase to another, particularly in the immediate prepubertal years. Studies using ICS at varying dosages demonstrate the possibility of short-term growth suppression, but long-term studies suggest a negligible effect, if any, on final adult height or bone mineral density. Although certain speculations regarding the safety of ICS use in infants and very young children can be made based on these data, age-specific studies are needed to account for effects of differences in oral versus airway deposition and growth axis resiliency, which may occur in these patients.

Mother's Perspective About Using the Gadget Safeness for Children

2020 ◽  
Vol 14 (2) ◽  
pp. 313-320
Author(s):  
Colti Sistiarani ◽  
Bambang Hariyadi ◽  
Saudin Yuniarno ◽  
Endo Dardjito
Keyword(s):  
Early Childhood ◽  
Young Children ◽  
Digital Technology ◽  
Media Use ◽  
Parental Mediation ◽  
Early Years ◽  
Special Issue ◽  
Children's Media ◽  
At Home

The rapid development of technology makes it easier for mothers to provide stimulation related to growth and development using gadgets. However, parental knowledge is needed about the safe limits of using a gadget in early childhood. This study aims to determine the perspective and behavior of mothers about the use of gadgets in toddlers. The method used is quantitative research with a cross-sectional approach. The participants of this study were thirty-one mothers who have early childhood and who are empowering family welfare. The inclusion criteria were mothers who agreed to be respondents, the exclusion criteria for mothers who did not have gadgets. This study uses a questionnaire measurement instrument for data collection. Data analysis was performed univariate and bivariate using the chi-square test. The results of the study concluded that the mother's knowledge regarding the safety of using a gadget was still lacking, with a value of around 54.8%, while the mother's behavior related to the same thing was better, which was around 58.1%. The relationship test shows that there is a strong enough relationship between maternal knowledge and maternal behavior in introducing or using gadgets in toddlers.  Keywords: Early Childhood, Mother Perspective, Gadget Safeness  References Appel, M. (2012). Are heavy users of computer games and social media more computer literate? Computers and Education, 59(4), 1339–1349. https://doi.org/10.1016/j.compedu.2012.06.004 Bandura, A. (1977). Social learning theory. Prentice-Hall. Cingel, D. P., & Krcmar, M. (2013). Predicting Media Use in Very Young Children: The Role of Demographics and Parent Attitudes. Communication Studies, 64(4), 374–394. https://doi.org/10.1080/10510974.2013.770408 Connell, S. L., Lauricella, A. R., & Wartella, E. (2015). 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