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Background: The aim of this study was to assess the prevalence of wheeze in early childhood and to characterize associated factors for wheeze that could identify potentially feasible interventions for the future prevention of wheeze. Methods: We performed a cross‐sectional analysis of the data from the International Study of Asthma and Allergies in Childhood (ISAAC)‐modified self‐administered questionnaire of parents of 4‐month‐old infants at well‐child visits (mandatory health check‐ups) in Nagoya City, Japan, between April 2016 and March 2017 (development dataset) and between April 2017 and March 2018 (validation dataset). We used a multivariable, multilevel analysis to identify significant (P < 0.05), associated factors (Bonferroni correction was applied as necessary) after adjustment for local outbreaks of virus‐transmitted diseases, access to medical facilities, and socioeconomic status. Results: Among the 20 362 questionnaires given to families of infants living in Nagoya City (development dataset), 19 104 questionnaires (93.8%) were analyzed after data cleaning. In all, 1,446 (7.6%) infants experienced wheeze at least once within 4 months of age, 991 (5.2%) visited the clinic/hospital with wheeze, and 244 (1.3%) underwent hospitalization at that time. In the multilevel, multivariable model for hospitalization with wheeze, significant associated factors were male sex (adjusted odds ratio 1.8; 95% confidence interval 1.4–2.3), maternal current smoking (3.3; 2.0–5.5), and having at least one sibling (3.0; 2.2–4.1). These factors were also associated with wheeze and clinic/hospital visit with wheeze, and the results were confirmed in the validation dataset. Conclusions: Our study highlights that smoking cessation among mothers and improved hand hygiene at home are two interventions that could potentially decrease wheeze in early infancy. [ABSTRACT FROM AUTHOR]

Background: To evaluate the frequency of wheezing in infants, the presence of wheezing was examined in normal infants using a breath sound analyzer, Methods: A total of 443 infants (age range, 3–24 months) were included in the present study. The existence of audible wheezing and faint wheezing/inaudible wheezing‐like noises (FW) was confirmed on chest auscultation and a sound spectrogram. The breath sound parameters of the sound spectrum, frequency limiting 99% of power spectrum (F99), roll‐off from 600 to 1,200 Hz (slope) and spectrum curve indices, total area under the curve of dB data (A3/AT and B4/AT), and ratio of power and frequency at 50% and 75% of the highest frequency of the power spectrum (RPF50 and RPF75) were calculated. Using an original Japanese questionnaire, we examined the characteristics of the airway condition of all infants. Results: Finally, a total of 398 infants were analyzed in the present study, and 283 were in good health while 115 had acute respiratory infection (ARI) in the last 7 days. No infants had audible wheezing on auscultation. Three infants without ARI (1.1%) and 10 infants with ARI (8.7%) had FW. In the evaluation of breath sound parameters, there were no marked differences between the infants with and without FW. Conclusions: Using a breath sound analyzer, wheezing and FW were recognized in only a few infants in good health. Infants recognized to have audible wheezing in daily practice may be at risk of developing recurrent wheezing/asthma. [ABSTRACT FROM AUTHOR]

The article presents two case study of cardiovocal syndrome, also known as Ortner's syndrome, in pediatric patients. It is reported that cardiovocal syndrome is a rare condition characterized by left recurrent laryngeal nerve paralysis due to cardiac disease. It is further reported that in both cases, the children presented with hoarseness and stridor secondary to left vocal cord paralysis.

The anaesthesia practice in children observational trial of 31,127 patients in 261 European hospitals revealed a high (5.2%) incidence of severe critical events in the peri-operative period and wide variability in practice. A sub-analysis of the UK data was undertaken to investigate differences compared with the non-UK cohort in the incidence and nature of peri-operative severe critical events and to attempt to identify areas for quality improvement. In the UK cohort of 7040 paediatric patients from 43 hospitals, the overall incidence of peri-operative severe critical events was lower than in the non-UK cohort (3.3%, 95%CI: 2.9-3.8 vs. 5.8%, 95%CI: 5.5-6.1, RR 0.57, p < 0.001). There was a lower rate of bronchospasm (RR 0.22, 95%CI: 0.14-0.33; p < 0.001), stridor (RR 0.42, 95%CI: 0.28-0.65; p < 0.001) and cardiovascular instability (RR 0.69, 95%CI: 0.55-0.86; p = 0.001) than in the non-UK cohort. The proportion of sicker patients where less experienced teams were managing care was lower in the UK than in the non-UK cohort (10.4% vs. 20.4% of the ASA physical status 3 and 9% vs. 12.9% of the ASA physical status 4 patients). Differences in work-load between centres did not affect the incidence and outcomes of severe critical events when stratified for age and ASA physical status. The lower incidence of cardiovascular and respiratory complications could be partly attributed to more experienced dedicated paediatric anaesthesia providers managing the higher risk patients in the UK. Areas for quality improvement include: standardisation of serious critical event definitions; increased reporting; development of evidence-based protocols for management of serious critical events; development and rational use of paediatric peri-operative risk assessment scores; implementation of current best practice in provision of competent paediatric anaesthesia services in Europe; development of specific training in the management of severe peri-operative critical events; and implementation of systems for ensuring maintenance of skills. [ABSTRACT FROM AUTHOR]

Aim: In children presenting to an emergency department (ED) with an acute coughing illness, the aims of this study were to: (i) describe the frequency of doctor visits and medication use; and (ii) describe management and relate it to current evidence-based guidelines.Methods: This was a cross-sectional study in ED of a major teaching hospital (Royal Children's Hospital, Brisbane, Australia). Participants included 537 children (<15 years) presenting with acute (<2 weeks) cough, with a median age of 2.2 years (interquartile range 1.0-4.0); 61.5% were boys. Hospitalised children and those with asthma, pneumonia or chronic illnesses were excluded. Main outcome measures were: (i) frequency of pre-ED doctor visits and medication use; and (ii) comparison of management to current evidence-based recommendations related to four discharge diagnoses: bronchiolitis, 'wheeze/reactive airway disease (RAD)', croup and 'non-specific acute respiratory illness'.Results: A total of 300 children (55.9%) had seen a doctor prior to their ED presentation, and use of medications pre-ED was high (53.4%). While 93.4% of children with croup were treated in accordance with guidelines, concordance was lower for children with bronchiolitis or 'wheeze/RAD'. The majority of children with a discharge diagnosis of 'wheeze/RAD' (95.6%) received bronchodilators, and 72.7% also received oral corticosteroids but were not diagnosed with asthma. More than half (55.1%) of the children with non-specific acute respiratory illness received medication(s) either prior to or during their ED presentation.Conclusions: The burden of acute cough-related illnesses in children is high, and there is a need for improved uptake of evidence-based guidelines. In addition, the large number of children diagnosed with 'wheeze/RAD' suggests asthma is likely under-diagnosed in this setting. [ABSTRACT FROM AUTHOR]

Objective: This study evaluates associations of maternal eating disorders (bulimia nervosa, anorexia nervosa, and purging behaviors) with infant wheezing and examines the effects of eating disorders on several wheezing determinants. Method: We studied 5,150 singletons from the NINFEA birth cohort. Maternal bulimia nervosa and anorexia nervosa diagnoses were ascertained from the questionnaires completed in pregnancy and 6 months after delivery, and were analyzed as: ever diagnosis, only before pregnancy, and during pregnancy. Purging behaviors were assessed for 12 months before or during pregnancy. The associations with wheezing between 6 and 18 months of age were assessed in models adjusted for a priori selected confounders. Results: Children born to mothers with lifetime eating disorders were at an increased risk of developing wheezing (adjusted OR 1.68; [95% CI: 1.08, 2.60]), and this risk further increased when the disorders were active during pregnancy (2.52 [1.23, 5.19]). Increased risk of offspring wheezing was observed also for purging behaviors without history of eating disorder diagnosis (1.50 [1.10, 2.04]). The observed associations were not explained by comorbid depression and/or anxiety. Bulimia nervosa and/or anorexia nervosa during pregnancy were also associated with several risk factors for wheezing, including maternal smoking, adverse pregnancy outcomes, shorter breastfeeding duration, and day‐care attendance. Discussion: The associations of maternal eating disorders with offspring wheezing suggest long‐term adverse respiratory outcomes in children of mothers with eating disorders. A better understanding of mechanisms implicated is necessary to help reduce the respiratory disease burden in these children. [ABSTRACT FROM AUTHOR]

The article discusses the case study of Retropharyngeal lymph nodes are physiologically large in early childhood, so RPA is most prevalent from 1 to 4 years of age. It mentions Rapid antigen tests for respiratory syncytial virus and loop-mediated isothermal amplification for pertussis yielded negative results. Brain computed tomography (CT) revealed no intracranial hemorrhage or tumors.

Abstract: Objective: To measure scenario participant and faculty self‐reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre‐based simulations. Methods: A prospective survey of scenario participants and faculty completing in situ and centre‐based paediatric simulations. Results: There were 382 responses, 276 from scenario participants and 106 from faculty with 241 responses from in situ and 141 from centre‐based simulations. Scenario participant responses showed significantly higher ratings for the centre‐based simulations for respiratory rate (P = 0.007), pulse (P = 0.036), breath sounds (P = 0.002), heart sounds (P < 0.001) and patient noises (P < 0.001). There was a significant difference in overall rating of the scenario reality by scenario participants in favour of the centre‐based simulations (P = 0.005); however, there was no significant difference when rating participant engagement (P = 0.11) and participant learning (P = 0.77). With the centre‐based scenarios, nurses rated the reality of the respiratory rate (P < 0.001), blood pressure (P = 0.016) and abdominal signs (P = 0.003) significantly higher than doctors. Nurses rated the overall reality higher than doctors for the centre simulations (96.8% vs 84.2% rated as realistic, P = 0.041), which was not demonstrated in the in situ scenarios (76.2% vs 73.5%, P = 0.65). Conclusion: Some aspects of in situ simulations may be less ‘real’ than centre‐based simulations, but there was no significant difference in self‐reported engagement or learning by scenario participants. Low fidelity, in situ simulation provides adequate realism for engagement and learning. [ABSTRACT FROM AUTHOR]

Background Human leukocyte antigen ( HLA)-G is a non-classical major histocompatibility complex class I antigen characterized by limited polymorphism in its coding region, unique tissue expression pattern in physiologic conditions and immunomodulatory properties. Recently, the level of soluble (s) HLA-G was found to be higher in atopic asthma and allergic rhinitis, but this remains to be clarified in wheezy infants. The aim of the present study was therefore to investigate sHLA-G in wheezy infants. Methods The subjects consisted of infants with persistent wheezing and positive modified asthma predictive index ( mAPI; n = 30; persistent group) and those with transient wheezing and negative mAPI ( n = 17; transient group). sHLA-G was measured in plasma using enzyme-linked immunosorbent assay. Total immunoglobulin E (IgE) and eosinophil count were measured, and skin testing was performed with a battery of 13 antigens with appropriate positive and negative controls. Results sHLA-G was significantly higher in the persistent wheezing (positive mAPI) group compared with the transient wheezing (negative mAPI) group ( P = 0.008). There was no significant difference in peripheral blood eosinophil count and total IgE between the groups. Conclusions The increased sHLA-G in infants with persistent wheeze suggests that sHLA-G may be able to be used to distinguish persistent from transient wheeze. Further comprehensive studies are needed on this topic. [ABSTRACT FROM AUTHOR]

Background Vascular rings may cause pressure on the trachea and/or esophagus of varying degree, resulting in symptoms. This study assessed the presentation symptoms, diagnostic methods and treatment results after surgery in children with vascular ring. Methods Symptomatic vascular ring patients undergoing surgery between January 2010 and August 2014 at Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, were retrospectively assessed. The presentation symptoms, demographic characteristics, and diagnostic tests were evaluated. Operative data and postoperative follow up, complications and problems were also examined in detail. Results Twenty-one patients underwent surgery, 13 (63%) of whom were male. Median age was 12 months (range, 1 month-8 years). Among these patients, 62% ( n = 13) had double aortic arch, 24% ( n = 5) had right-sided aortic arch + ligamentum arteriosum, 10% ( n = 2) had left-sided aortic arch + aberrant right subclavian artery, and 4% ( n = 1) had pulmonary sling abnormality. Computed tomography ( CT) angiography was performed in 17/21 patients. All the patients were successfully operated on. In the early postoperative period, two patients had chylothorax and one had nerve paralysis of nervus laryngeus recurrens. One patient died in the early period, and two patients had ongoing stridor on follow up. Conclusions CT angiography is effective for the differential diagnosis and visualization of vascular ring abnormality. In such cases, full recovery can be assured with early diagnosis and surgery. [ABSTRACT FROM AUTHOR]

The article describes three cases of plastic bronchitis in children with influenza B virus Yamagata lineage in the 2015/2016 and 2017/2018 influenza seasons. The three patients were aged 11, 7, and 6 years, in which the two patients had allergies, patient 3 had bronchial asthma, and patient 2 had a food allergy with atopic dermatitis. The patients' progressive dyspnea and hypoxia showing decreased breath sounds in the unilateral lung during physical examination.

Background In 2008, the European Respiratory Society Task Force proposed the terms multiple-trigger wheeze ( MTW) and episodic (viral) wheeze ( EVW) for children with wheezing episodes. We determined MTW and EVW prevalence, their 24-month stability and predictiveness for asthma. Methods In total, 565 preschoolers (1-, 2- and 3-year-olds) in primary care with respiratory symptoms were followed until the age of 6 years when asthma was diagnosed. MTW status and EVW status were determined using questionnaire data collected at baseline and after one and 2 years. We distinguished 3 phenotypes and determined their 24-month stability, also accounting for treatment with inhaled corticosteroids ( ICS). Logistic regression was used to analyse the phenotypes' associations with asthma. Results Two hundred and eighty-one children had complete information. MTW and EVW were stable in 10 of 281 (3.6%) and 24 of 281 (8.5%), respectively. The odds of developing asthma for children with stable MTW and stable EVW were 14.4 (1.7-119) and 3.6 (1.2-11.3) times greater than those for children free of wheeze (for at least 1 year). ICS was associated with increased stability of MTW and EVW. Conclusions Stable multiple-trigger and stable episodic viral wheeze are relatively uncommon. However, 1- to 3-year-olds with stable MTW are at much increased risk of asthma. [ABSTRACT FROM AUTHOR]

Background: Preterm birth, early term birth, and low birthweight are associated with childhood wheezing disorders in developed Western settings, but observed associations could be confounded by socio-economic position. This study aims to clarify such associations in a developed non-Western setting with a different confounding structure.Methods: Using Cox regression, we examined the adjusted associations of gestational age and birthweight for gestational age with time to first public hospital admission for asthma, bronchitis, and bronchiolitis (International Classification of Diseases, Ninth Version Clinical Modification 466, 490, and 493) from 9 days to 12 years in a population-representative birth cohort of 8327 Chinese children in Hong Kong, a developed setting with less clear social patterning of prematurity or birthweight. Analyses were adjusted for infant and parental characteristics and socio-economic position.Results: Children born late preterm (34 to <37 weeks) had higher risk of hospitalisation for asthma and other wheezing disorders [hazard ratio (HR) 1.99, 95% confidence interval (CI) 1.48, 2.67] than children born full term (39 to <41 weeks). Early term births (37 to <39 weeks) had HR 1.01 (95% CI 0.84, 1.22), late term births (41 to <42 weeks) had HR 0.77 (95% 0.59, 1.01), and post-term births (≥42 weeks) had HR 0.56 (95% CI 0.32, 0.98). Large for gestational age was associated with lower risk of hospitalisation (HR 0.76, 95% CI 0.57, 0.99).Conclusion: The association of preterm birth with childhood wheezing could be biologically mediated. We cannot rule out an association for early term births. [ABSTRACT FROM AUTHOR]

Background Human metapneumovirus (hMPV) is one of the main pathogens responsible for respiratory tract infection in children. Methods From 2011 to 2013, nasopharyngeal aspirates were obtained from Korean children and tested for hMPV on reverse transcription-polymerase chain reaction (RT-PCR). The genotype of hMPV in each sample was identified on PCR-restriction length polymorphism analysis of the fusion gene. We divided patients into three groups according to degree of fever. Patients with fever peaking at >39.5°C or lasting >7 days were classified as the high fever (HF) group; those with fevers peaking at <38.5°C and lasting <72 h were classified as the low fever (LF) group; and the other subjects were classified as the moderate fever group. Results Among 457 samples positive for hMPV, hMPV genotype was able to be identified in 399 (87.3%); of these, A2a was found in 97 (24.3%), B1 in 186 (46.6%), and B2 in 116 (29.1%). Clinical features of hMPV infection were compared between the HF and LF groups. We classified 80 subjects into the HF group and 84 subjects into the LF group. Mean absolute neutrophil count (5625 ± 4418 vs 4072 ± 3076/μL, P = 0.010) and C-reactive protein (2.39 ± 3.39 vs 0.96 ± 1.77 mg/dL, P = 0.001) were higher in the HF group. Wheezing (5.0% vs 32.1%, P < 0.001) and dyspnea (2.5% vs 15.5%, P = 0.010) were more frequently seen in the LF group. Genotype distribution was similar in the two groups. Conclusion Two distinct clinical presentations of hMPV infection were identified in this study. [ABSTRACT FROM AUTHOR]

Neonatal stridor is a rare condition usually caused by laryngomalacia. Congenital laryngeal cyst represents an uncommon cause of stridor in the neonatal population and may be misinterpreted as laryngomalacia, leading to serious morbidity and mortality if diagnosis and treatment are delayed. Herein we report the case of a full-term infant with stridor, feeding problems and failure to thrive. Initially, direct laryngoscopy diagnosed only laryngomalacia. As stridor worsened, however, and respiratory distress appeared, repeat laryngoscopy showed vallecular laryngeal cyst, visible macroscopically. The patient was successfully treated with endoscopic marsupialization. There was no evidence of recurrence at follow up after 3 months. This case highlights the importance of laryngoscopic assessment for suspected laryngeal abnormalities in infants with stridor. If symptoms worsen, endoscopy should be repeated, because congenital laryngeal cysts may not be immediately visible macroscopically. [ABSTRACT FROM AUTHOR]

Staley KG, Kuehni CE, Strippoli MPF, McNally T, Silverman M, Stover C. Properdin in childhood and its association with wheezing and atopy. Pediatr Allergy Immunol 2010: 21: e787–e791. © 2010 John Wiley & Sons A/S Properdin, a serum glycoprotein, is an important component of innate immunity, the only known positive regulator of complement, acting as an initiation point for alternative pathway activation. As an X-linked protein, we hypothesized that properdin may play a modulatory role in the pathogenesis of viral wheeze in children, which tends to be more common and more severe in boys. We aimed to determine properdin levels in a community-based paediatric sample, and to assess whether levels of properdin were associated with childhood wheeze phenotypes and atopy. We studied 137 school-children aged 8–12 yrs, a nested sample from a cohort study. Properdin was measured by a commercial enzyme-linked immunoabsorbant assay. We assessed wheeze by questionnaire, validated it by a nurse-led interview and performed skin prick tests and a methacholine challenge in all children. Forty children (29%) reported current wheeze. Serum properdin levels ranged between 18 and 40 μg/ml. Properdin was not associated with age, gender, atopy, bronchial responsiveness, current wheeze (neither the viral wheeze nor multiple-trigger wheeze phenotype) or severity of wheeze, but was slightly lower in south Asian (median 21.8 μg/ml) compared with white children (23.3 μg/ml; p = 0.006). Our data make it unlikely that properdin deficiency is common in healthy children or that levels of properdin are a major risk factor for wheeze or atopy. [ABSTRACT FROM AUTHOR]

The association between exercise-induced bronchoconstriction (EIB) and exhaled nitric oxide (FENO) has not been investigated in young children with atopic or non-atopic wheeze, two different phenotypes of asthma in the early childhood. Steroid naïve 3- to 7-yr-old children with recent wheeze (n = 84) and age-matched control subjects without respiratory symptoms (n = 71) underwent exercise challenge test, measurement of FENO and skin prick testing (SPT). EIB was assessed by using impulse oscillometry, and FENO by standard online technique. Although FENO levels were highest in atopic patients with EIB, both atopic and non-atopic wheezy children with EIB showed higher FENO than atopic and non-atopic control subjects, respectively. In atopic wheezy children, a significant relationship between FENO and the severity of EIB was found ( r = 0.44, p = 0.0004), and FENO was significantly predictive of EIB. No clear association between FENO and EIB or predictive value was found in non-atopic wheezy children. Both atopic and non-atopic young wheezy children with EIB show increased FENO levels. However, the association between the severity of EIB and FENO is present and FENO significantly predictive of EIB only in atopic subjects, suggesting different interaction between bronchial responsiveness and airway inflammation in non-atopic wheeze. [ABSTRACT FROM AUTHOR]

Silva JM, Camara AA, Tobias KRC, Macedo IS, Cardoso MRA, Arruda E, Chapman MD, Platts-Mills TAE, Arruda LK, Ferriani VPL. A prospective study of wheezing in young children: The independent effects of cockroach exposure, breast-feeding and allergic sensitization. Pediatr Allergy Immunol 2005: 16: 393–401. © 2005 Blackwell Munksgaard The objective of this study was to evaluate risk factors for persistent wheezing in a group of 2–4-year-old children after an index-wheezing episode in infancy. Eighty infants who had been seen at the Emergency Department for an episode of acute wheezing were followed for 2 yr in this prospective study. Caregivers completed a questionnaire, and children underwent clinical evaluation and skin prick testing 2 yr following the index-wheezing episode. Detection of respiratory viruses and analysis of exposure to major indoor allergens were carried out at enrollment. Immunoglobin E antibodies were measured at the beginning of the study and at the end of follow-up, using the CAP system. Logistic regression analysis was performed to identify factors associated with persistent wheezing. Seventy-three children (44 boys) completed the study. After 2 yr, 38 (52%) reported three or more wheezing episodes in the past 12 months (persistent wheezers). Independent risk factors for persistence of wheezing were allergic sensitization and exposure to cockroach allergen in the kitchen. Breast-feeding for at least 1 month was a protective factor. A strong association between allergic sensitization and persistence of wheezing was found in a group of very young children living in a subtropical area. [ABSTRACT FROM AUTHOR]

The article presents a case study of a nine-month-old boy who was diagnosed with esophageal foreign body in the form of a thin vinyl object after experiencing sudden-onset cough and dry heaving while playing near a toy box. It notes the boy had put something small into his mouth based on the statement from his elder brother. It states that the condition may result in mortality in children if not diagnosed appropriately.

Summary: Background: Overweight or obesity is increasingly recognized as a possible risk factor for childhood asthma. Objectives: We aimed to meta‐analyse the association between overweight or obesity and the risk for childhood asthma and wheeze and meanwhile explore potential causes of between‐study heterogeneity. Methods: Literature search, study selection, and data extraction were performed independently and in duplicate. Data were analysed by STATA software. Results: Eighteen articles and 73 252 children were analysed. In overall analyses, there was a significant association between overweight or obesity and the risk for childhood asthma (odds ratio [OR] = 1.30; 95% confidence interval [CI], 1.23‐1.39; P < 0.001) and wheeze (OR = 1.90; 95% CI, 1.38‐2.63; P < 0.001), with none/marginal publication bias as revealed by the Egger test (P = 0.938/0.038), respectively. Subgroup analyses showed that children with obesity (OR = 1.40; 95% CI, 1.29‐1.52) were more likely to have asthma than children with overweight (OR = 1.22; 95% CI, 1.14‐1.31), and in children with overweight or obesity, girls (OR = 1.34; 95% CI, 1.16‐1.56) were more likely to have asthma than boys (OR = 1.27; 95% CI, 1.15‐1.40). Conclusions: Our findings indicate that overweight or obesity is a significant risk factor for childhood asthma and wheeze and in children with overweight or obesity, the risk is more evident in girls than in boys. [ABSTRACT FROM AUTHOR]

Unlabelled: In Acta Paediatrica 50 y ago, Boesen published a follow-up of children with "asthmatic bronchitis". Recent reinvestigations of children hospitalized because of wheezing in early childhood are remarkably consistent with Boesen's observations.Conclusion: Young children admitted to hospital because of wheezing have a clearly increased risk of subsequent asthma. Recent studies confirm Boesen's observations of the prognostic importance of eosinophilia and an inverse relation between age at admission with wheezing and risk of subsequent asthma. Allergy or atopic dermatitis is predictive of subsequent asthma, whereas family history of allergy has low predictive value in infants. [ABSTRACT FROM AUTHOR]

The article discusses case study of a 5-month-old boy presented to the emergency department with cough and dyspnea, and was diagnosed with bridging bronchus with left pulmonary artery sling and stenosis of the right upper lobe bronchus. It has been stated that chest radiography is vital in identification of the cause of the first episode of wheezing in young infants.

The article examines if an easy to use index could be developed that can predict asthma and transient wheeze in young wheezing children. Using orthogonal partial least squares analyses, the most significant asthma predictive variables were found. Using the wheeze and asthma index, both asthma and transient wheeze were forecast at eight years of age with accuracy.

Background: It is important to determine the presence of asthma in children under the age of 3 with recurrent wheezing. Inflammatory markers have been investigated in the diagnosis and treatment of asthma. The aim of the present study was to investigate the relationship between recurrent wheezing with or without modified asthma predictive index (mAPI) positivity and high‐sensitivity‐C reactive protein (hs‐CRP) level in children aged 6–36 months. Methods: Ninety‐nine children with recurrent wheezing and 47 healthy children aged 6–36 months were included in the present cross‐sectional, case–control study. Those children with wheezing were divided into two groups according to mAPI positivity. Results: Mean serum hs‐CRP was higher in the recurrent wheezers than in the control group (0.89 ± 1.7 mg/dL vs 0.12 ± 1.3 mg/dL, respectively; P = 0.002). There was a positive correlation between serum total IgE and hs‐CRP (P = 0,003; r = 0348). mAPI positivity was detected in 46 of the recurrent wheezers (46.5%). There was no significant difference in hs‐CRP between the mAPI‐positive and ‐negative groups. The best hs‐CRP cut‐off for differentiating between the patient and control groups was 0.11 mg/dL on receiver operating characteristic analysis (area under curve, 0.658; 95%CI: 0.571–0.744; P < 0.05; sensitivity, 60%; specificity, 61.7%). Conclusions: High‐sensitivity CRP can be used to indicate respiratory and systemic inflammation independently of mAPI positivity in wheezy children. [ABSTRACT FROM AUTHOR]

Examines the association between infection-induced wheezing during infancy and asthma. Inverse relation between asthma and childhood wheezing; Analysis on the viral etiology of respiratory infections; Identification of agents that induce wheezing.