DOCSLIB.ORG

Pediatric Pulmonology, on Pediatric Pulmonology, International Congress Th 15 ISSN 8755-6863 PEDIATRIC

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pediatric Pulmonology, on Pediatric Pulmonology, International Congress Th 15 ISSN 8755-6863 PEDIATRIC PEDIATRIC PULMONOLOGY PEDIATRIC VOLUME 51 • SUPPLEMENT 43 • JUNE 2016 PEDIATRIC PULMONOLOGY Volume 51 • Supplement 43 • June 2016 Proceedings S1 Foreword S2 Postgraduate Course on LFT S6 Keynote Speaker S8 I. Plenary Sessions S21 II. Topic Sessions S57 III. Young Investigator Oral Communications S60 IV. Posters PEDIATRIC PULMONOLOGY S90 Index Volume 51 Volume • Supplement 43 15th International Congress on Pediatric Pulmonology, Naples, Italy, June 23–26, 2016 • June 2016 June Pages S1–S92 Pages ISSN 8755-6863 ONLINEhttp://mc.manuscriptcentral.com/ppul SUBMISSION AND PEER REVIEW PEDIATRIC PULMONOLOGY Editor-in-Chief: THOMAS MURPHY, Watertown, MA USA Deputy Editor: TERRY NOAH, Chapel Hill, NC USA Associate Editors: ANNE CHANG, Brisbane, Queensland, Australia STEPHANIE DAVIS, Indianapolis, IN USA ALEXANDER MOELLER, Zurich, Switzerland KUNLING SHEN, Beijing, China PAUL STEWART, Chapel Hill, NC USA STEVEN TURNER, Aberdeen, Scotland, United Kingdom Topic Editors: JUDITH VOYNOW, Richmond, VA USA © 2016 Wiley Periodicals, Inc. All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means without the prior permission in writing from the copyright holder. Authorization to copy items for internal and personal use is granted by the HEATHER ZAR, Cape Town, South Africa copyright holder for libraries and other users registered with their local Reproduction Rights Organization (RRO), e.g. Copyright Clearance Center (CCC), 222 Rosewood Drive, Danvers, MA 01923, USA (www.copyright.com), provided the appropriate fee is paid directly to the RRO. This consent Managing Editor: CARLENE RUMMERY, Winnipeg, MB Canada does not extend to other kinds of copying such as copying for general distribution, for advertising or promotional purposes, for creating new collective works or for resale. Special requests should be addressed to: [email protected] Pediatric Pulmonology (Print ISSN 8755-6863; Online ISSN 1099-0496 at Wiley transit and where reserve stock permits. Send claims in care of John Wiley & Sons, Inc., Online Library, wileyonlinelibrary.com) is published monthly by Wiley Periodicals, lnc., Attn: Journals Admin Dept UK, 111 River Street, Hoboken, NJ 07030. Cancellations: Editorial Board through Wiley Subscription Services, Inc., a Wiley Company, 111 River St., Hoboken, Subscription cancellations will not be accepted after the fi rst issue has been mailed. Delivery Richard Auten Brigitte Fauroux Min Lu NJ 07030-5774. Periodical Postage Paid at Hoboken, NJ and additional offi ces. Terms and Legal Title: Where the subscription price includes print issues and delivery is Jürgen Schwarze Postmaster: Send all address changes to Pediatric Pulmonology, Journal Customer to the recipient’s address, delivery terms are Delivered Duty Unpaid (DDU); the recipient is Durham, NC USA Paris, France Shanghai, China Edinburgh, Scotland Services, John Wiley & Sons, Inc., 350 Main St., Malden, MA 02148-5020. Send responsible for paying any import duty or taxes. Title to all issues transfers FOB our ship- subscription inquiries in care of: John Wiley & Sons, Inc., Attn: Journals Admin, Dept ping point, freight prepaid. We will endeavour to fulfi ll claims for missing or damaged copies Michael Fayon George B. Mallory, Jr. Avi Avital Hiran Selvadurai UK, 111 River Street, Hoboken, NJ 07030. Advertising inquiries should be addressed to within six months of publication, within our reasonable discretion and subject to availability. Jerusalem, Israel Bordeaux, France Houston, TX USA M.J. Mrvica and Associates, Inc., 2 West Taunton Avenue, Berlin, NJ 08009, (856) 768-9360. Submission Instructions, Subscription, and All Other Information: www.wileyonlineli- Sydney, Australia Fax: (856) 753-0064. E-mail: [email protected]. Information for subscribers: Pediat- brary.com/access Shona Fielding Franc¸ois Marchal ric Pulmonology is published in 12 issues per year. Institutional subscription prices for 2016 Ian Balfour-Lynn Wiley’s Corporate Citizenship initiative seeks to address the environmental, social, economic, are: Print and online: US$3976 (US), €2775 (Europe), £2195 (UK). Prices are exclusive of Aberdeen, Scotland Nancy, France Renato Stein and ethical challenges faced in our business and which are important to our diverse stake- London, UK tax. Asia-Pacifi c GST, Canadian GST/HST and European VAT will be applied at the appropri- holder groups. Since launching the initiative, we have focused on sharing our content with Porto Alegre, Brazil ate rates. For more information on current tax rates, please go to www.wileyonlinelibrary.com/ Monika Gappa Susanna McColley those in need, enhancing community philanthropy, reducing our carbon impact, creating Eugenio Baraldi tax-vat. The price includes online access to the current and all online back fi les to January 1st global guidelines and best practices for paper use, establishing a vendor code of ethics, and Wesel, Germany Chicago, IL USA Mary Sunday 2011, where available. For other pricing options, including access information and terms and Padova, Italy engaging our colleagues and other stakeholders in our efforts. Follow our progress at www. conditions, please visit www.wileyonlinelibrary.com/access. Ben Gaston Mark Montgomery Durham, NC USA wiley.com/go/citizenship Lea Bentur Pediatric Pulmonology accepts articles for Open Access publication. Please visit http://olabout. Cleveland, OH USA Calgary, AB Canada Access to this journal is available free online within institutions in the developing Masat wiley.com/WileyCDA/Section/id-406241.html for further information about OnlineOpen. Haifa, Israel o Takase world through the HINARI initiative with the WHO. For information, visit www. Robert P. Gie Thomas Nicolai Tokyo, Japan Please direct production questions to [email protected] healthinternetwork.org David Birnkrant Tygerberg, South Africa Munich, Germany Journal Customer Services: For ordering information, claims, and any enquiry Disclaimer: The Publisher and Editors cannot be held responsible for errors or any Cleveland, OH USA Asher Tal concerning your journal subscription please go to www.wileycustomerhelp.com/ask or consequences arising from the use of information contained in this journal; the views and David Gozal Cathy Owens Beer-Sheva, Israel contact your nearest offi ce. opinions expressed do not necessarily reflect those of the Publisher and Editors, neither does Hans Bisgaard Chicago, IL, USA London, UK Americas: Email: [email protected]; Tel:+ 1 781 388 8598 or + 1 800 835 6770 the publication of advertisements constitute any endorsement by the Publisher and Editors Copenhagen, Denmark (toll free in the USA & Canada). of the products advertised. Anne Greenough Stacey Peterson-Carmichael Alejandro Teper Europe, Middle East and Africa: Email: [email protected]; Tel: +44 (0) 1865 778315. The Journal is indexed by: CAB Abstracts® (CABI), CINAHL: Cumulative Index to Nursing Asia Pacifi c: Email: [email protected]: Tel: +65 6511 8000. Frank J. Cerny London, UK Indianapolis, IN USA Buenos Aires, Argentina & Allied Health Literature (EBSCO), Current Contents®/Clinical Medicine (Thomson ISI), Japan: For Japanese speaking support, Email: [email protected]; Tel: +65 6511 8010 or EMBASE/Excerpta Medica (Elsevier), Index Medicus/MEDLINE/PubMed (NLM), Journal Buffalo, NY USA Tel (toll-free): 005 316 50 480. Matthias Griese Thomas A.E. Platts-Mills Dick Tibboel Citation Reports/Science Edition (Thomson ISI), PASCAL Database (INIST/ CNRS), Visit our Online Customer Help available in 7 languages at www.wileycustomerhelp. Munich, Germany Charlottesville, VA USA Pulmonary Reviews (Jobson Medical Group), Reference Update (Thomson ISI), Respiratory Ira Cheifetz Rotterdam, The Netherlands com/ask. Reviews (Clinicians Group), Science Citation Index ExpandedTM (Thomson ISI), Durham, NC USA Zoltan Hantos Jean-Paul Praud Production Editor: Jacqueline Beggins (email: [email protected]). Back issues: Single Science Citation Index® (Thomson ISI), SCOPUS (Elsevier), SIIC Databases (Sociedad Harm Tiddens Szeged, Hungary Sherbrooke, QC Canada issues from current and prior year volumes are available at the current single issue price from Iberoamericana de Informacion Cientifi ca), VINITI (All-Russian Institute of Science & Andrew A. Colin Rotterdam, The Netherlands [email protected]. Earlier issues may be obtained from Periodicals Service Company, Technological Information), Web of Science® (Thomson ISI). 11 Main Street, Germantown, NY 12526, USA. Tel: +1 518 537 4700, Fax: +1 518 537 5899, Miami, FL USA Adam Jaffe Sarath Ranganathan View this journal online at wileyonlinelibrary.com/journal/PPUL Sydney, Australia Melbourne, Australia Goran Wennergren Email: [email protected]. Cori Daines Goteborg, Sweden Reprints (50–500 copies): Order online at http://www.sheridanreprints.com/orderForm. Tucson, AZ USA Benny Joyner Felix Ratjen html. Email: [email protected] ISSN 8755-6863 (Print) Chapel Hill, NC USA Toronto, ON Canada Yong Hong Yang Change of address: Please forward to the Subscriptions address listed above prior to move: ISSN 1099-0496 (Online) Shyamala Dakshinamurti enclose present mailing label with change of address. Claims for missing issues: Claims Athanasios Kaditis Gregory J. Redding Beijing, China Winnipeg, MB Canada for undelivered copies will be accepted only after the following issue has been received. Cover image design by Gustavo Rymberg. Athens, Greece Seattle, WA USA Please enclose a copy of the mailing label or cite your subscriber reference number
Load more

Recommended publications
  • 1 British Thoracic Society Guidelines Recommendations for The
    Thorax Online First, published on September 28, 2007 as 10.1136/thx.2007.077370 Thorax: first published as 10.1136/thx.2007.077370 on 28 September 2007. Downloaded from British Thoracic Society Guidelines Recommendations for the assessment and management of cough in children MD Shields, A Bush, ML Everard, S McKenzie and R Primhak on behalf of the British Thoracic Society Cough Guideline Group Michael D Shields Dept. of Child Health, Queen’s University of Belfast, Clinical Institute, Grosvenor Road, Belfast, BT12 6BJ Email: [email protected] Andrew Bush Royal Brompton Hospital, Sydney Street, London, SW3 6NP Email: [email protected] Mark L Everard Dept of Paediatrics, Sheffield Children’s Hospital, Western Bank, Sheffield, S. Yorkshire, S10 2TH. Email: [email protected] Sheila McKenzie Queen Elizabeth Children’s Services, http://thorax.bmj.com/ The Royal London Hospital, Whitechapel, London, E1 1BB Email: [email protected] Robert Primhak Dept. of Paediatrics, Sheffield Children’s Hospital, on September 29, 2021 by guest. Protected copyright. Western Bank, Sheffield, S. Yorkshire, S10 2TH. Email: [email protected] “the Corresponding Author (Michael D Shields) has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd and its Licensees to permit this article (if accepted) to be published in [THORAX] editions and any other BMJPG Ltd products to exploit all subsidiary rights, as set out in our licence 1 Copyright Article author (or their employer) 2007.
    [Show full text]
  • Complications of Different Ventilation Strategies in Endoscopic Laryngeal
    Anesthesiology 2006; 104:52–9 © 2005 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. Complications of Different Ventilation Strategies in Endoscopic Laryngeal Surgery A 10-year Review Yves Jaquet, M.D.,* Philippe Monnier, M.D.,† Guy Van Melle, M.D., Ph.D.,‡ Patrick Ravussin, M.D.,§ Donat R. Spahn, M.D., F.R.C.A.,࿣ Madeleine Chollet-Rivier, M.D.# Background: Spontaneous ventilation, mechanical controlled tracheal tube offers adequate airway protection and ventilation, apneic intermittent ventilation, and jet ventilation gas exchange, but the endotracheal tube prevents are commonly used during interventional suspension micro- optimal vision and access to the larynx. Furthermore, laryngoscopy. The aim of this study was to investigate specific 1–4 complications of each technique, with special emphasis on endotracheal fire may still be encountered with transtracheal and transglottal jet ventilation. the use of carbon dioxide laser despite the develop- Methods: The authors performed a retrospective single-insti- ment of nonflammable endotracheal tubes.5–7 tution analysis of a case series of 1,093 microlaryngoscopies 2. Spontaneous ventilation offers a free access to the performed in 661 patients between January 1994 and January larynx, but with a moving surgical field and a risk of 2004. Data were collected from two separate prospective data- bases. Feasibility and complications encountered with each inhalation of anesthetic gases and laser fumes by the technique of ventilation were analyzed as main outcome mea- patient
    [Show full text]
  • Diagnosis and Therapy for Airway Obstruction in Children with Down Syndrome
    ORIGINAL ARTICLE Diagnosis and Therapy for Airway Obstruction in Children With Down Syndrome Ron B. Mitchell, MD; Ellen Call, MS, CFNP; James Kelly, PhD Objectives: To document the causes of upper airway children had subglottic stenosis. Laryngomalacia was the obstruction in a population of children with Down syn- primary diagnosis in 10 children (43%), 8 of whom were drome and to highlight the role of associated comorbidi- younger than 1 month. Obstructive sleep apnea was the ties. primary diagnosis in 11 children (48%), 8 of whom were older than 2 years. All children with obstructive sleep ap- Design and Setting: Review of 23 cases involving chil- nea and 4 children with laryngomalacia had a second- dren with Down syndrome who were referred for upper ary ear, nose, and throat disorder. Gastroesophageal re- airway obstruction over a 21⁄2-year period to the Pediat- flux was a comorbidity in 14 children (61%). ric Otolaryngology Service of the University of New Mexico, Albuquerque. Conclusions: The causes, severity, and presentation of upper airway obstruction in children with Down syn- Methods: Data on the following variables were ob- drome are related to the age of the child and to associ- tained: reason for referral, demographics, diagnosis, sur- ated comorbidities. The treatment of comorbidities and gical procedures, complications, and comorbidities. secondary ear, nose, and throat disorders is an integral component of the surgical management of upper airway Results: The children ranged in age from 1 day to 10.2 obstruction in such cases. years (mean age, 1.8 years; median age, 6 months). Thir- teen children were male and 10 were female.
    [Show full text]
  • A Study on Hierarchical Clustering for Identifying Asthma Endotypes (J4R/ Volume 03 / Issue 05 / 004)
    Journal for Research | Volume 03| Issue 05 | July 2017 ISSN: 2395-7549 A Study on Hierarchical Clustering for Identifying Asthma Endotypes S. Poorani Dr. P. Balasubramanie Assistant Professor Professor Department of Computer Technology Department of Computer Technology Kongu Engineering College, Perundurai, India Kongu Engineering College, Perundurai, India N. Sasipriyaa Assistant Professor Department of Computer Science and Engineering Kongu Engineering College, Perundurai, India Abstract Large multitudes of medical data are attained due to advancement in recent technology. These large volumes comprise valuable information which helps for diagnosing diseases. Data mining techniques can be used to extract useful patterns from these mass data. It provides a user- oriented approach to the novel and hidden patterns in the data. One of the major challenges in medical domain is the extraction of comprehensible knowledge from medical diagnosis data. Healthcare system needs an automated tool that identifies and disseminates relevant healthcare information. Asthma is one of the dominant disease all over the world. Identifying subtypes of the disease will help in the treatment and prevention approaches. In this paper a clustering model is proposed based on observable symptoms of asthma. The hierarchical clustering technique is used to group the samples based on important characteristics of asthma. Keywords: Data Mining, Hierarchical Clustering, Asthma, Health Care _______________________________________________________________________________________________________ I. INTRODUCTION There are 300 million asthmatics worldwide with 1/10th of those living in India. A recent review about epidemiological studies showed that the asthma prevalence among children was 7.24%[1]. Recently the Global Initiative for Asthma (GINA) defines asthma as a heterogeneous disease usually characterized by chronic airway inflammation.
    [Show full text]
  • Supraglottoplasty Home Care Instructions Hospital Stay Most Children Stay Overnight in the Hospital for at Least One Night
    10914 Hefner Pointe Drive, Suite 200 Oklahoma City, OK 73120 Phone: 405.608.8833 Fax: 405.608.8818 Supraglottoplasty Home Care Instructions Hospital Stay Most children stay overnight in the hospital for at least one night. Bleeding There is typically very little to no bleeding associated with this procedure. Though very unlikely to happen, if your child were to spit or cough up blood you should contact your physician immediately. Diet After surgery your child will be able to eat the foods or formula that they usually do. It is important after surgery to encourage your child to drink fluids and remain hydrated. Daily fluid needs are listed below: • Age 0-2 years: 16 ounces per day • Age 2-4 years: 24 ounces per day • Age 4 and older: 32 ounces per day It is our experience that most children experience a significant improvement in eating after this procedure. However, we have found about that approximately 4% of otherwise healthy infants may experience a transient onset of coughing or choking with feeding after surgery. In our experience these symptoms resolve over 1-2 months after surgery. We have also found that infants who have other illnesses (such as syndromes, prematurity, heart trouble, or other congenital abnormalities) have a greater risk of experiencing swallowing difficulties after a supraglottoplasty (this number can be as high as 20%). In time the child usually will return to normal swallowing but there is a small risk of feeding difficulties. You will be given a prescription before you leave the hospital for an acid reducing (anti-reflux) medication that must be filled before you are discharged.
    [Show full text]
  • Stridor in the Newborn
    Stridor in the Newborn Andrew E. Bluher, MD, David H. Darrow, MD, DDS* KEYWORDS Stridor Newborn Neonate Neonatal Laryngomalacia Larynx Trachea KEY POINTS Stridor originates from laryngeal subsites (supraglottis, glottis, subglottis) or the trachea; a snoring sound originating from the pharynx is more appropriately considered stertor. Stridor is characterized by its volume, pitch, presence on inspiration or expiration, and severity with change in state (awake vs asleep) and position (prone vs supine). Laryngomalacia is the most common cause of neonatal stridor, and most cases can be managed conservatively provided the diagnosis is made with certainty. Premature babies, especially those with a history of intubation, are at risk for subglottic pathologic condition, Changes in voice associated with stridor suggest glottic pathologic condition and a need for otolaryngology referral. INTRODUCTION Families and practitioners alike may understandably be alarmed by stridor occurring in a newborn. An understanding of the presentation and differential diagnosis of neonatal stridor is vital in determining whether to manage the child with further observation in the primary care setting, specialist referral, or urgent inpatient care. In most cases, the management of neonatal stridor is outside the purview of the pediatric primary care provider. The goal of this review is not, therefore, to present an exhaustive review of causes of neonatal stridor, but rather to provide an approach to the stridulous newborn that can be used effectively in the assessment and triage of such patients. Definitions The neonatal period is defined by the World Health Organization as the first 28 days of age. For the purposes of this discussion, the newborn period includes the first 3 months of age.
    [Show full text]
  • Laryngomalacia: Disease Presentation, Spectrum, and Management
    Hindawi Publishing Corporation International Journal of Pediatrics Volume 2012, Article ID 753526, 6 pages doi:10.1155/2012/753526 Review Article Laryngomalacia: Disease Presentation, Spectrum, and Management April M. Landry1 and Dana M. Thompson2 1 Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, AZ 85054, USA 2 Division of Pediatric Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Mayo Clinic Children’s Center and Mayo Eugenio Litta Children’s Hospital, Mayo Clinic Rochester, 200 First Street SW, Gonda 12, Rochester, MN 55905, USA Correspondence should be addressed to Dana M. Thompson, [email protected] Received 10 August 2011; Accepted 23 November 2011 Academic Editor: Jeffrey A. Koempel Copyright © 2012 A. M. Landry and D. M. Thompson. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Laryngomalacia is the most common cause of stridor in newborns, affecting 45–75% of all infants with congenital stridor. The spectrum of disease presentation, progression, and outcomes is varied. Identifying symptoms and patient factors that influence disease severity helps predict outcomes. Findings. Infants with stridor who do not have significant feeding-related symptoms can be managed expectantly without intervention. Infants with stridor and feeding-related symptoms benefit from acid suppression treatment. Those with additional symptoms of aspiration, failure to thrive, and consequences of airway obstruction and hypoxia require surgical intervention. The presence of an additional level of airway obstruction worsens symptoms and has a 4.5x risk of requiring surgical intervention, usually supraglottoplasty.
    [Show full text]
  • Series of Laryngomalacia, Tracheomalacia, and Bronchomalacia Disorders and Their Associations with Other Conditions in Children
    Pediatric Pulmonology 34:189-195 (2002) Series of Laryngomalacia, Tracheomalacia, and Bronchomalacia Disorders and Their Associations With Other Conditions in Children I.B. Masters, MBBS, FRACP,1* A.B. Chang, PhD, FRACP,2 L. Patterson, MBBS, FANZCAC,1 С Wainwright, MD, FRACP,1 H. Buntain, MBBS,1 B.W. Dean, MSC,1 and P.W. Francis, MD, FRACP1 Summary. Laryngomalacia, bronchomalacia, and tracheomalacia are commonly seen in pediatric respiratory medicine, yet their patterns and associations with other conditions are not well-understood. We prospectively video-recorded bronchoscopic data and clinical information from referred patients over a 10-year period and defined aspects of interrelationships and associations. Two hundred and ninety-nine cases of malacia disorders (34%) were observed in 885 bronchoscopic procedures. Cough, wheeze, stridor, and radiological changes were the most common symptoms and signs. The lesions were most often found in males (2:1) and on the left side (1.6:1). Concomitant malacia lesions ranged from 24%forlaryngotracheobronchomalaciato 47% for tracheobronchomalacia. The lesions were found in association with other disorders such as congenital heart disorders (13.7%), tracheo-esophageal fistula (9.6%), and various syndromes (8%). Even though the understanding of these disorders is in its infancy, pediatricians should maintain a level of awareness for malacia lesions and consider the possibility of multiple lesions being present, even when one symptom predominates or occurs alone. Pediatr Pulmonol Pediatr Pulmonol. 2002; 34:189-195. © 2002 wiiey-Liss. inc. Key words: laryngomalacia; tracheomalacia; bronchomalacia; malacia disorders; syndromes. INTRODUCTION The aim of this report is to describe an extensive experience of various forms of laryngomalacia, tracheo­ Tracheomalacia, bronchomalacia, and laryngomalacia malacia, and bronchomalacia and explore some of the disorders are commonly seen in tertiary pediatric respira­ interrelationships that exist between these conditions with tory practice.
    [Show full text]
  • ATS Technical Standards: Flexible Airway Endoscopy in Children
    AMERICAN THORACIC SOCIETY DOCUMENTS Official American Thoracic Society Technical Standards: Flexible Airway Endoscopy in Children Albert Faro, Robert E. Wood, Michael S. Schechter, Albin B. Leong, Eric Wittkugel, Kathy Abode, James F. Chmiel, Cori Daines, Stephanie Davis, Ernst Eber, Charles Huddleston, Todd Kilbaugh, Geoffrey Kurland, Fabio Midulla, David Molter, Gregory S. Montgomery, George Retsch-Bogart, Michael J. Rutter, Gary Visner, Stephen A. Walczak, Thomas W. Ferkol, and Peter H. Michelson; on behalf of the American Thoracic Society Ad Hoc Committee on Flexible Airway Endoscopy in Children THESE OFFICIAL TECHNICAL STANDARDS OF THE AMERICAN THORACIC SOCIETY (ATS) WERE APPROVED BY THE ATS BOARD OF DIRECTORS,JANUARY 2015 Background: Flexible airway endoscopy (FAE) is an accepted and Results: There is a paucity of randomized controlled trials in frequently performed procedure in the evaluation of children with pediatric FAE. The committee developed recommendations based known or suspected airway and lung parenchymal disorders. predominantly on the collective clinical experience of our committee However, published technical standards on how to perform FAE in members highlighting the importance of FAE-specific airway children are lacking. management techniques and anesthesia, establishing suggested competencies for the bronchoscopist in training, and defining areas Methods: The American Thoracic Society (ATS) approved the deserving further investigation. formation of a multidisciplinary committee to delineate technical standards for
    [Show full text]
  • Respiratory Concerns in Children with Down Syndrome
    Respiratory Concerns in Children with Down Syndrome Paul E. Moore, M.D. Associate Professor of Pediatrics and Pharmacology Director, Pediatric Allergy, Immunology, and Pulmonary Medicine Vanderbilt University School of Medicine Respiratory Concerns in Children with Down Syndrome • Overview • Respiratory infections • Airway issues • Sleep issues • Pulmonary vascular issues Respiratory Concerns in Children with Down Syndrome: Overview • Most common reason for children to be admitted to the hospital. • Respiratory infections can be more severe, and hospitalization often results in admission to the intensive care unit. Anatomical features in DS that contribute to respiratory concerns • Craniofacial features – Narrowed nasopharynx – Flattened mid-face – Macroglossia • Adenotonsillar hypertrophy • Airway size Other features of DS that contribute to respiratory concerns • Low tone (hypotonia) – Upper airway muscles: dysphagia – Airway: malacia • Gastroesophageal reflux – Contribution to adenotonsillar hypertrophy – Contribution to airway inflammation • Cardiac disease • Obesity Pearl #1: Anatomical features and physiologic contributors specific to Down Syndrome result in malacia • Definition: softening or loss of consistency in any of the organs or tissues • Origin: Greek malakía softness, tenderness, weakness • Laryngomalacia, tracheomalacia, bronchomalacia, airway malacia Respiratory Concerns in Children with DS: Respiratory Infections • Respiratory infection is a significant burden. – Bronchiolitis – URI/LRTI: upper respiratory infection and lower respiratory tract infection – Pneumonia Respiratory Concerns in Children with DS: Respiratory Infections • The specific defect in the immune system is not clear, although a number of studies suggest developmental delay. • Chronic aspiration is a significant contributor. Pearl #2: Developmental delay in Down Syndrome can refer to more than the nervous system. • Coordination of swallow • Immune development Pearl #3: Water (reflux) damage can be significant in children with DS.
    [Show full text]
  • Towards Using AI to Augment Human Support in Digital Mental Healthcare
    Towards Using AI to Augment Human Support in Digital Mental Healthcare Prerna Chikersal Abstract School of Computer Science To address the need for more access to, and increase Carnegie Mellon University, US the effectiveness of, mental health treatment, internet- [email protected] delivered psychotherapy programs such as iCBT are shown to achieve clinical outcomes comparable to face- Gavin Doherty to-face therapy. While offering ubiquitous access to School of Computer Science & Statistics healthcare, a key concern of digital therapy programs is Trinity College Dublin, IRL to sustain users’ engagement with the treatment to [email protected] attain desired benefits. Research has demonstrated that including a trained ‘human supporter’ to the digital Anja Thieme mental health ecosystem can provide useful guidance Healthcare Intelligence and motivation to its users, and lead to more effective Microsoft Research Cambridge, UK outcomes than unsupported interventions. Within this [email protected] context, we describe early research that makes use of machine learning (ML) approaches to better understand how the behaviors of these human supporters may benefit the mental health outcomes of clients; and how such effects could be maximized. We discuss new opportunities for augmenting human support through personalization, and the related ethical challenges. Author Keywords Mental health; digital behavioral intervention; ethics; responsible AI; machine learning; NLP; data mining. CSS Concepts •Human-centered computing → Human computer Submission
    [Show full text]
  • Laryngomalacia
    Laryngomalacia Laryngomalacia (LAYR inn go mah LAY shah) is also called laryngeal stridor. It results from a weakness of parts of the voice box (larynx) that is present at birth. This condition can cause a high-pitched sound called stridor (STRI der). You may hear this sound when your child breathes in. Cause of Laryngomalacia Laryngomalacia means “soft larynx.” It is caused by floppiness of the tissue above the vocal cords (called the supraglottic larynx). When a person breathes in (inspiration), these tissues fall in towards the airway and cause the airway to be partly blocked. This blockage at the area of the voice box creates noisy breathing (called stridor). Picture 1 What laryngomalacia looks like in the body. Laryngomalacia is the most common cause of noisy breathing in infants. More than half of infants have noisy breathing during the first week of life. Most other babies have it within 2 to 4 weeks of birth. It is rare, but laryngomalacia can happen in older children or adults, usually those with other medical problems. HH-I-332 Revised 3/15 Copyright 2011, Nationwide Children’s Hospital Laryngomalacia Page 2 of 2 Signs and Symptoms The main symptom of laryngomalacia is noisy breathing when your child breathes in. This is called inspiratory stridor. Stridor may: . Change with activity. It may be louder when your child is upset, crying, or is excited. Be louder when your child has a cold. Usually it will be louder when your child is lying on his or her back, and quieter when he is lying on his stomach.
    [Show full text]