bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical characteristics of respiratory syncytial virus infections in healthy versus previously compromised host
Authors: Meert Kathleen , Heidemann Sabrina , Lieh‐Lai Mary , Sarnaik Ashok P. 
Published: March 2007

AbstractIn an effort to delineate the clinical characteristics of respiratory syncytial virus (RSV) infection in the compromised host, we compared children with bronchopulmonary dysplasia (BPD), congenital heart disease (CHD), premature birth, failure to thrive, and gastro‐esophageal reflux to previously healthy children. During a four‐year period, 262 patients were admitted to the hospital with RSV infection diagnosed by a rapid RSV antigen detection test. Children with BPD or CHD had more hospital days and supplemental oxygen days than the previously healthy group (P < 0.05). Patients with BPD also had more ICU days, ventilator days, and NPO days, as well as a higher physiologic stability index and therapeutic intervention score than the previously healthy group (P < 0.05). Premature infants were more likely to present with apnea from RSV (P < 0.001). Patients with underlying illness tended to be older, although significant difference was demonstrated only for the BPD group (7.0±5.3 vs. 3.5±3.3, P < 0.05). Patients with BPD and CHD had more nosocomial infections than the previously healthy group (P < 0.0001) and death occurred only in patients with underlying illness. We conclude that previously compromised patients are at risk for more severe and prolonged RSV disease. Earlier diagnosis and therapeutic intervention may be necessary in such patients to improve outcome.Pediatr Pulmonol. 1989; 7:167‐170.
Treatment of Pseudomonas lung infection in cystic fibrosis with piperacillin plus tobramycin versus ceftazidime monotherapy: Preliminary communication
Authors: de Boeck K. , Smet M. , Eggermont E. 
Published: March 2007

AbstractTwenty‐one patients with cystic fibrosis and chronic Pseudomonas lung infection were treated at random with ceftazidime, 150 mg/kg/day, or with piperacillin, 300 mg/kg/day, and tobramycin, 10 and more mg/kg/day for 14 days. On admission and at discharge, body weight, erythrocyte sedimentation rate, white blood cell count, and differential were determined. Pulmonary function analysis and chest X‐rays were also obtained on both occasions as was sputum bacteriology. After hospitalization, the patients were followed in the outpatient department for 14–26 months. Both treatments were associated with significant improvement in most of the parameters that were studied, but neither treatment was superior. Pediatr Pilmonol. 1989; 7:171–173.
Determining optimum inspiratory time during intermittent positive pressure ventilation in surfactant‐depleted cats
Authors: Mammel Mark C. , Boros Stephen J. , Bing Dennis R. , Holloman Keith K. , Connett John R. 
Published: March 2007

AbstractThis study compares two methods of selecting inspiratory time (Ti) during mechanical ventilation. One selects a standard Ti producing a brief inspiratory pressure plateau (P). The other uses simultaneous pressure, flow and tidal volume (VT) waveforms, generated by a computer‐assisted lung mechanics analyzer, to reduce Ti to the point where Vt ceases to accumulate and flow returns to zero. This method does not produce a pressure plateau (NP). Following saline lung washout, ten intubated, paralyzed surfactant‐depleted cats were ventilated with pressure‐preset infant ventilators at constant measured VT and rates. Five animals were initially ventilated with P (Ti = 0.98±0.02 s) and five with NP (Ti = 0.77±0.10 s). Ti was then varied to produce P or NP by using a four‐period crossover design. All other ventilator variables remained constant. Intravascular pressures, thermodilution cardiac outputs, arterial and mixed venous blood gases and oxygen saturations, airway pressures, Ti, VT, and gas flows were measured; respiratory system mechanics, alveolar‐arterial oxygen gradients, and intrapulmonary shunts were determined for each study period. When P and NP states were compared, only mean airway pressures differed (10.1 vs. 8.9 cmH2O; P<0.001). Blood gas values, intravascular pressures, cardiac output, and respiratory system mechanics were all similar. Under the conditions of this study, there was no advantage to prolonging Ti beyond the point where VT ceased to accumulate. Pediatr Pulmonol 1989; 7:223–229.
Safety of aerosol tobramycin administration for 3 months to patients with cystic fibrosis
Authors: Smith Arnold L. , Ramsey Bonnie W. , Hedges Donna L. , Hack Barbara , Williams‐Warren Judy , Weber Allan , Gore Edmond J. , Redding Gregory J. 
Published: March 2007

AbstractTo determine the potential toxicity of prolonged aerosol tobramycin administration, 22 patients with cystic fibrosis were monitored while receiving inhaled tobramycin three times a day for 12 weeks. Prior to, four times during administration and approximately 6 weeks after discontinuation of treatment, we assessed pulmonary function, weight, height, body temperature, eighth cranial nerve function, serum creatinine, blood urea nitrogen, urinary creatinine clearance, plasma iothalamate clearance, urinary β‐2 microglobulin concentration, and Pseudomonas aeruginosa density in sputum. There was no detectable laboratory evidence of nephrotoxicity. Neither a decrease in auditory acuity (range 250–20,000 Hz) nor vestibular dysfunction was detected. Pulmonary function tests significantly improved during the first month in all subjects (P < 0.05) but returned to enrollment values by the end of the 12th week of administration of tobramycin aerosol. Sputum P. aeruginosa density initially decreased from a mean of 107 cfu/gm to a mean of 104 cfu/gm after 2 weeks of aerosol tobramycin administration and remained significantly below the enrollment value throughout. Coincident with the reduced bacterial density, a reduction in cough frequency and sputum production, as well as a weight gain was observed. Seventy‐three percent of the patients with sputum P. aeruginosa isolates susceptible to tobramycin on enrollment yielded resistant organisms during aerosol administration. However, 1 year later all sputum P. aeruginosa isolates obtained from patients were susceptible to tobramycin. We conclude that thrice daily aerosol tobramycin administration for 3 months is not associated with detectable eighth cranial nerve or renal toxicity. Transient emergence of tobramycin resistant P. aeruginosa may occur. Pediatr Pulmonol 1989; 7:265–271.
Changes in airflow obstruction and oxygen saturation in response to exercise and bronchodilators in cystic fibrosis
Authors: Macfarlane Peter I. , Heaf David 
Published: March 2007

AbstractThe airway response to exercise and inhaled terbutaline was assessed in 25 patients with cystic fibrosis (CF), seeking evidence for the possible deleterious effects of bronchial muscle relaxation. We postulated that “early” and “late” flows, taken from the full maximum expiratory flow volume curve, might move paradoxically in patients with unstable airways. Oxygen saturation was measured continuously; desaturation occurred early in exercise with partial recovery thereafter. This was unrelated to changes in expiratory airflow measurements. Both during and after exercise, and after inhaled bronchodilator, changes in expiratory airflow measurements were strikingly variable. Changes in individual measurements should be interpreted in relationship to the within‐subject variability of the test in patients with CF. During exercise, there was a significant increase in mean FEV1; this was most marked in patients with worst lung function. Two patients (both with severe lung disease) showed paradoxical changes in early and late flows. After exercise, only two patients showed the asthmatic pattern of postexercise bronchoconstriction. After inhaled bronchodilator, the group as a whole showed small but statistically significant increases in expiratory airflow measurements. Those with highest baseline FEV1 had the greatest bronchodilator response; this is the opposite of the pattern observed in asthma. Paradox did not occur after bronchodilators and only one patient showed a significant fall in late expiratory airflow.This pattern of expiratory airflow changes is compatible with the concept of airway instability in which any beneficial effects of bronchial tone reduction are canceled out by the effects of compression of damaged airways rendered more compliant by loss of bronchial wall tone. We did not observe any clinically important deleterious effects from this mechanism. Pediatr Pulmonol 1990; 8:4‐11.
Correlation of IgE antibody titer to Aspergillus fumigatus with decreased lung function in cystic fibrosis
Authors: Nicolai Thomas , Arleth Sissi , Spaeth Anne , Bertele‐Harms Rose‐Marie , Harms H. Karsten 
Published: March 2007

AbstractObstructive pulmonary disease is a typical feature of cystic fibrosis (CF) and is often associated with bronchial hyperreactivity. Positive skin‐test reactions to Aspergillus fumigatus antigens are frequently seen even in nonatopic patients with CF. Full‐fledged allergic bronchopulmonary aspergillosis (ABPA) has been estimated to occur in 10% of patients with CF. The relationship between lung function and presence of IgE antibodies to Aspergillus antigens in patients without ABPA is not clear.In 148 outpatients with CF (aged 6–34 years) specific immunoglobulin E (IgE) to Aspergillus fumigatus antigens, basic lung‐function parameters, and bronchial response to salbutamol were measured. Multiple regression was performed for age, weight as percentile for actual height (indicating general condition), and Aspergillus RAST. Aspergillus IgE was present in 46% of patients; 19% had RAST class 3 or 4.Independent negative correlations of Aspergillus RAST with FEV1, FEF50%, FEF25%, RV, Chrispin Norman score, and sRaw (P<0.05) were found. Bronchodilator sensitivity did not correlate significantly with age and weight percentile. However, Aspergillus RAST did correlate significantly with bronchodilator response measured by sRaw (P <0.05). High titers of Aspergillus RAST might serve as a selective criterion for patients to be included in future studies evaluating broncholytic or antiphlogistic therapies. Pediatr Pulmonol 1990; 8:12‐15.
Brush cells in the human fetal trachea
Authors: DiMaio Mary F. , Kattan Meyer , Ciurea Doina , Gil Joan , Dische Renate 
Published: March 2007

AbstractWe performed a morphologic examination of human fetal lung tissue, using scanning and transmission electron microscopy, in order to establish the presence of brush cells in extrapulmonary and intrapulmonary airways, and developing acinar epithelium. Brush cells, characterized by a border of regular straight microvilli containing a filamentous core, were observed within the tracheal epithelium of a 19–20 week gestational age fetus. These cells constituted 0.5% of the total epithelial cell population. Brush cells were not seen within the bronchial, bronchiolar or developing acinar epithelium. Our study shows that brush cells occur infrequently but normally in the developing tracheal epithelium of the second trimester fetus. Pediatr Pulmonol 1990; 8:40‐44.
Differential rates of lung growth as measured longitudinally by pulmonary function in children and adolescents
Authors: Sherrill Duane , Holberg C. J. , Lebowitz M. D. 
Published: March 2007

AbstractA sample population of 67 males and 71 females with longitudinal lung function and other anthropometric measurements from all non‐Hispanic white children in the Tucson Epidemiological Study of Airway Obstructive Diseases (AOD) was studied to evaluate biological determinants of the rate of lung growth. Groups within gender were defined by the following factors: 1) maximum height, 2) age at maximum forced expiratory volume at 1 second (FEV1), 3) % predicted initial FEV1or FEV1/FVC ratio. Only groups defined by low initial function (FEV1or FEV1/FVC ≤ 85% predicted versus >85% predicted) showed statistically significant differences from those with more “normal” function by comparing their maximum % of predicted FEV1s and FEV1/FVC ratios. The longitudinal FEV1data by age for the latter groups were characterized by a mathematical model (polynomial smoothing spline) yielding optimal fitted curves and an estimate of each group's growth velocity curve. The statistical comparisons between these fitted curves indicate that subjects with low initial pulmonary function continued to have significantly lower FEV1values for males older than 13.12 years and for females between 8.23 and 15.3 years. At post‐hoc analysis persistent wheezing was more likely in the initially more impaired group. Disease at the end of follow‐up was not related to initial functional status. Pediatr Pulmonol 1990; 8:145‐154.
Clinical observations of children with pleuropneumonia due to Mycoplasma pneumoniae
Authors: Nagayama Yoko , Sakurai Nobukiyo , Yamamoto Koshi 
Published: March 2007

AbstractA comparative study on the clinical presentation of Mycoplasma pneumoniae infection was performed in 56 patients with pleuropneumonia and those who had pneumonia without pleural effusion. The latter consisted of 773 cases; their age distribution reached a peak at 3–5 years of age in males and at 4–6 years in females. The 56 cases with pleuropneumonia were distributed among children of all ages. Pneumococcal infection was demonstrated by blood culture in one of 56 cases. Serological tests revealed a higher prevalence of mixed viral infections among children with pleuropneumonia (18/44) than with pneumonia but no effusion (69/419). There was a tendency toward a severe and prolonged course of illness with strong indications of infection among pleuropneumonia cases. Complications such as exanthema or liver dysfunction were observed more frequently among pleuropneumonia cases than among simple pneumonia cases. These results suggest that other pathogenic agents or unknown host reactions to these agents may modify the clinical picture of pleuropneumonia caused by M. pneumoniae. Pediatr Pulmonol 1990; 8:182‐187.
Effect of the thermodynamics of an infant plethysmograph on the measurement of thoracic gas volume
Authors: Sly Peter D. , Lanteri Celia , Bates Jason H. T. 
Published: March 2007

AbstractAdult plethysmographs have frequency responses that are essentially flat over the range of frequencies encountered in the measurement of thoracic gas volume (TGV). An infant plethysmograph is necessarily much smaller than an adult model. This means that there is a smaller mean distance over which heat diffusion must occur between the air in the plethysmograph and its walls. This in turn leads to a much reduced thermal time constant. We examined the effects of thermal time constant of a 60 L infant plethysmograph on measurements of TGV in infants. The thermal time constant was measured by rapidly injecting 20 mL of air into the plethysmograph, and found to be 0.16 ± 0.09 s when the box was empty. We calculated from this time constant that measurements of TGV should be quite dependent on the frequency at which the associated panting maneuvers are performed. TGV was measured in 5 infants less than 6 months old in the recovery phase following acute viral bronchiolitis. When we performed a digital correction of the measurements, to compensate for the thermal time constant of the plethysmograph, the TGV values decreased by a mean of 12%. Agitating the air in the plethysmograph with a fan decreased the thermal time constant of the box and reduced measured TGV by a mean of 8.4%. These results indicate that thermodynamics of infant plethysmographs can be an important source of error in TGV measurements. Pediatr Pulmonol 1990; 8:203‐208.
Reintroduction of continuous negative pressure ventilation in neonates: Two‐year experience
Authors: Cvetnic William G. , Cunningham M. Douglas , Sills Jack H. , Gluck Louis 
Published: March 2007

AbstractContinuous negative pressure ventilation utilizes subatmospheric pressure around the thorax to improve oxygenation. It has not been routinely used since the mid‐1970s. We treated 37 infants with the combination of continuous negative pressure (CNP) and intermittent mandatory ventilation (IMV), after failing to attain a Pa of ≥50 torr on IMV alone. Lung diseases included pulmonary interstitial emphysema (PIE), respiratory distress syndrome (RDS), and pulmonary artery hypertension (PAH) due either to meconium aspiration syndrome (MAS) or other causes (non‐MAS). All infants had evidence of severe parenchymal pulmonary disease, or pulmonary artery hypertension resulting in persistent hypoxemia and hypotension. In the PIE group, CNP was started later in the course of the disease, and both positive pressure and oxygen were maintained for a longer period. The group of infants with non‐MAS PAH required CNP and positive pressure ventilation for the shortest period of time. The infants with PIE also had a greater incidence of bronchopulmonary dysplasia (BPD) and intraventricular hemorrhage (IVH). In addition, three patients with PIE died. In the non‐MAS patients with PAH, no complications and no deaths occurred. The response to CNP was a rapid improvement in oxygenation in all groups with the greatest increase of Pa in the non‐MAS PAH infants: from 30 torr prior to the initiation of CNP to 140 torr within 30 minutes. No significant changes in pH or Pa occurred in any group. Significant decreases in ventilator rate, mean airway pressure (Paw) and FI in peak inspiratory pressure were possible by 12 hours of CNP. CNP and Paw were decreased from −5 cm H2O and 12.8 cm H2O prior to initiation of CNP to −1 cm H2O and 5.0 cm H2O at 72 hours of treatment. FI at 72 hours was decreased to a mean of 0.57. Combined CNP and IMV ventilator therapy improved oxygenation with lessened Paw in infants with refractory hypoxemia due to MAS and PAH and in larger infants with RDS. While we cannot advocate the routine use of CNP, it would appear to have a role in the management of infants who have failed conventional ventilator therapy. Pediatr Pulmonol 1990; 8:245‐253.
Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated newborns
Authors: Rigal E. , Roze J. C. , Villers D. , Derriennic M. , David‐Melon V. , Lacroix‐Mechinaud F. , Mouzard A. 
Published: March 2007

AbstractThe precise diagnosis of lower respiratory tract infection in the critically ill newborn remains a difficult challenge. The bronchoscopic protected specimen brush (PSB) is a reliable method in intubated adults. Because the bronchoscopic procedure is not generally available for young children, Zucker proposed a blind technique for introducing the PSB into the distal airways. His results were promising but were not compared with any bacteriologic reference method. Therefore, we wanted to evaluate this technique in comparison with the open lung biopsy (OLB) when it could be ethically accomplished. Eleven PSB were collected simultaneously with an OLB. The sensitivity of the PSB procedure was 100%, its specificity 88%, its positive predictive value 66%, and its negative predictive value 100%. There were no complications secondary to the PSB procedure. In this short study, the PSB procedure using a blind technique is safe and feasible to obtain uncontaminated specimens in intubated and ventilated newborns, and is largely accurate in identifying the bacterial etiologic agent of lower respiratory tract infection. Pediatr Pulmonol 1990; 8:268‐272.
Respiratory system compliance assessed by the multiple occlusion and weighted spirometer method in non‐intubated healthy newborns
Authors: Merth Istvan T. , Quanjer Philip H. 
Published: March 2007

AbstractIn 28 healthy newborn infants (median age 3.5 days), we compared the weighted spirometer (WS) with the multiple occlusion (MO) method for measuring respiratory system compliance (Crs). The MO method was unsuccessful in 8 infants. On average the two methods gave comparable results for compliance (Crs,ws = 40.4 ± 13.8 and Crs,MO = 45.2 ± 10.4 mL·kPa−1) in the remaining 20 infants; however, within‐individual differences were often considerable, so that the methods did not give interchangeable results. Individual pressure‐volume curves almost always intercepted the volume axis below the functional residual capacity with the MO technique, compatible with dynamic elevation of end‐expiratory lung volume (EEL) due to inspiratory muscle activity during expiration. A (small) negative volume intercept occurred in less than 50% of curves with the WS method; in these cases it probably reflects alinearity of the compliance curve, an alteration in laryngeal braking or in respiratory muscle control of EEL, or all of these. Both methods provide valuable means for the non‐invasive determination of respiratory system compliance in newborn infants, the differences in Crs being small and of minimal physiological significance; however, for individual follow‐up they should not be used interchangeably. Pediatr Pulmonol 1990; 8:273‐279.
Correspondence between forced oscillation and body plethysmography during bronchoprovocation with carbachol in children
Authors: Buhr Wernfrid , Jörres Rudolf , Berdel Dietrich , Làndsér Ferenc J. 
Published: March 2007

AbstractWe compared dose–response curves obtained with the forced oscillation technique (FOT) and with body plethysmography during bronchoprovocation in children.In 40 stable asthmatic children (age, 5–16 yr) we performed challenges with doubling concentrations of inhaled carbachol (0.15–10 mg/mL) until specific airway resistance SRaw had increased by 100% (PC100SRaw). The FOT‐response was assessed by total respiratory system resistance (Rrs, cmH2O·1−1·s) and reactance (Xrs, cmH2O·1−1·s) from 8 to 26 Hz, expressed as mean Rrs (Rrs), mean Xrs (Xrs), Rrs at 8 Hz (Rrs8), and mean slope of Rrs (dRrs/df). Dose–response curves were analyzed for threshold concentrations (TC) causing a 3 SD change from baseline and sensitivity indices (SI) defined as differences between baseline and postchallenge values (at PC100SRaw) divided by baseline SD.Median TC of Rrs8, Rrs, Xrs, dRrs/df, and SRaw was 0.21, 0.30, 0.34, 0.41, and 0.42 mg/mL, respectively, indicating a slightly higher sensitivity for FOT. Median SI values of SRaw and Xrs (12.0 and 8.2; difference n.s.) were significantly higher than those of the other parameters.Multiple regression analysis revealed only the absolute change of Xrs (ΔXrs), baseline Rrs and age as significantly (P < 0.001) correlated with the percentage change of SRaw (Δ%SRaw). Best correlation (r = 0.86) with Δ%SRaw was found for the function: FOT score = −102.5 · ΔXrs · exp(−0.196 · Rrs + 0.038 · age). Provocative concentrations estimated by this FOT score differed from PC100SRaw by less than one (two) concentration steps in 34 (40) out of 40 children.We conclude that FOT is as sensitive as plethysmography during bronchoprovocation and that with the FOT score practically equivalent dose–response curves to those of SRaw can be obtained in children. Pediatr Pulmonol 1990; 8:280‐288.