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The article presents a case study of two infants with respiratory syncytial virus (RSV) acute bronchiolitis, examining the changes in lung sounds before and after inhalation of salbutamol. Topics discussed include the efficacy of bronchodilators, the distinction between wheezes and rhonchi, and the potential implications for future asthma development in children with acute bronchiolitis.

Parainfluenza virus (PIV) is a respiratory pathogen in young children and is second only to the respiratory syncytial virus (RSV) as a cause of lower respiratory tract infection. PIV type 3 (PIV3) is the most severe. Herein we describe an outbreak of PIV3 in three infants in a neonatal intensive care unit. They were diagnosed on virus culture from pharyngeal swabs. We prevented the spread of the virus using standard infection control procedures and isolation of the symptomatic infants. One infant had severe chronic lung disease and was complicated with recurrent wheezing for a long time. Because RSV and PIV have many structural, pathogenic, epidemiologic, and clinical similarities, we speculate that PIV infection causes recurrent wheezing, as observed with RSV infection. Therefore, physicians must consider recurrent wheezing at the time of treatment of PIV infection early in life. [ABSTRACT FROM AUTHOR]

Background: Acute fire smoke inhalation injury involves inflammatory mediators whose roles are poorly understood. We carried out a prospective observational study of fire smoke victims to identify clinical and biochemical markers that may predict pulmonary dysfunction and investigated possible correlations between dysfunction and cytokines in bronchoalveolar lavage (BAL) fluid and blood.Methods: Forty patients with respiratory and/or neurological symptoms following acute fire smoke inhalation had pulmonary function tests and blood gas analyses performed on admission, at discharge, and after 3 months. Cytokines were measured using BioPlex/XMap technology.Results: On admission, 30 (75%) patients had dyspnea. Patients presenting with bronchial wheezing (n = 14) had significantly lower PEF (201 l/min, 82-360) than non-wheezing patients (406 l/min, 100-683) (n = 16, P = 0.03). Bronchial wheezing predicted need for ICU treatment with OR = 93.3 at 95% CI (P < 0.001) and was associated with gas exchange impairment, with mean pa O2 /FiO2 ratio 34.4 (11.8-49.8) kPa on admission and 21.3 (8.3-44.5) kPa 48 h later. Blood HbCO also predicted ICU treatment, with OR = 1.58 at 95% CI (P < 0.001). Serum CRP, IL-6, IL-8, and MCP-1 were significantly higher in wheezing patients after 12-24 h compared with non-wheezing patients and study controls. Cytokine levels were still elevated after 3 months. BAL fluid had significantly higher levels of IL-8, MCP-1, IL-1β, and G-CSF compared with healthy controls.Conclusion: In victims of fire smoke inhalation, pulmonary wheezing predicts inflammation, pulmonary dysfunction, respiratory failure, and need for intensive care. [ABSTRACT FROM AUTHOR]

Airway management in patients with periglottic tumour is a high-risk procedure with potentially serious consequences. There is no consensus on how best to secure the airway in this group of patients. We conducted a feasibility study of awake tracheal intubation using a King Vision® videolaryngoscope with a channelled blade in a cohort of 25 patients, with a periglottic tumour requiring diagnostic or radical surgery. We used 10% and 4% lidocaine to topicalise the airway and midazolam and remifentanil for sedation. We recorded the success rate, number of attempts, time to obtain glottic view, time to intubation and complications. Twenty-three of the 25 patients (92%, 95%CI 75-98%) were intubated with the awake videolaryngoscope-assisted technique, with 17/23 (74%, 95%CI 54-87%) intubations achieved at the first attempt. Five patients required two and one patient, three attempts at intubation. Two patients (8%, 95%CI 2-25%) could not tolerate the procedure due to inadequate topical anaesthesia. Median (IQR [range]) times to obtain glottic view and to intubate were 19 (17-22 [10-30]) s and 49 (42-71 [33-107]) s, respectively. Traces of blood in the airway were observed in 4/25 (16%, 95%CI 6-35%) patients. Although airway management in this group of patients was expected to be difficult, successful awake intubation with the King Vision videolaryngoscope was achieved in the majority of patients within less than a minute. This study highlights a number of potential advantages of awake videolaryngoscope-assisted intubation over other awake methods of securing the airway in patients with upper airway obstruction due to periglottic mass. [ABSTRACT FROM AUTHOR]

The article discusses the case of a 1 year old patient who showed signs of Catathrenia in Pitt–Hopkins syndrome that is associated with 18q interstitial deletion. Is mentioned that Pitt–Hopkins syndrome is a autosomal dominant disorder and Catathrenia is associated with production of loud groaning sounds during the episodes of prolonged expiration.

The article presents a case study of a 6 year old girl with psychomotor retardation, cough, high fever and hemoptysis is presented. It is noted that she had already undergone a cardiac catheterization operation at the age of one. The article diagnoses vascular injury and the presence of blood clots and bloody mucus which was discovered during flexible bronchoscopy.

Cardiac asthma or cardiac wheezing (CW) refers to a syndrome of dyspnea and wheezing that mimicks asthma clinically. Reported herein is the case of a 2-month-old boy who presented with refractory wheezing as a sign of cor triatriatum sinister (CTS) that culminated in overwhelming multiple organ failure in a short time. On the day of admission, oxygen saturation (SpO2) was < 80%. Heart rate was 198 beats/min and respiratory rate 58 breaths/min. Chest radiogram showed pulmonary edema. Electrocardiogram showed right atrial enlargement and right ventricular hypertrophy. N-terminal pro-brain natriuretic peptide (NTproBNP) was very high at >20 000 pg/mL. Two-dimensional echocardiography with Doppler showed CTS, which was complicated with severe pulmonary arterial hypertension due to flagrant pulmonary venous obstruction. Cardiac surgery was undertaken, after which pulmonary edema subsided, SpO2 increased to =96%, and NTproBNP dropped to normal. He was discharged 11 days later, and was free of cardiac, pulmonary, renal, and neurological sequelae at 24 month follow up. [ABSTRACT FROM AUTHOR]

The article discusses the study of the congenital stridor induced by cytomegalovirus infection. Topics discussed include this study was performed retrospectively from February 2016 to March 2020 at the Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan; and enrolled patients who demonstrated neurological symptoms of unknown cause and/or abnormal findings on brain imaging, with or without congenital stridor.

Objective: To estimate the prevalence of asthma among pregnant women with dyspnea.Methods: Pregnant women referred for prenatal care visits who had complaints of dyspnea were included. All pregnant women were evaluated by a respiratory specialist. Spirometry was performed by a single trained physician.Results: Asthma was diagnosed in 38.8% of participants. Dyspnea was diagnosed as being physiologic in 36.4% of cases, but 24.8% of cases were of probable asthma (spirometric values were within normal range but symptoms and signs were suggestive of asthma). Cough, wheezing, and post-exercise symptoms were significantly more prevalent in asthmatic and probable-asthmatic women than in women without asthma.Conclusion: Dyspnea in pregnancy can be physiologic, but when it is accompanied by other symptoms such as cough or wheezing it is likely to be caused by asthma. Because of the high prevalence of asthma during pregnancy, it seems logical to evaluate dyspnea via physical examination and response to bronchodilators. [ABSTRACT FROM AUTHOR]

Unlabelled: The objective of this study was to investigate the association hypothesis that outcome following respiratory syncytial virus (RSV) induced bronchiolitis (RSVB) and RSV induced wheeze (RSVW) are different. At 3 years respiratory symptoms were more common in those with RSV infection than the control group but there was no increase in allergic sensitisation (11% vs 10%). Those with RSVW were more likely to have evidence of allergic sensitisation when compared with RSVB subjects (22% vs 7%), and have increased symptoms and increased use of inhaled steroids.Conclusion: The data argue that RSV infection during infancy does not induce allergic asthma and that host factors rather than the virus determine long-term outcomes. [ABSTRACT FROM AUTHOR]

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]

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 presents several abstracts on pediatrics, including abstracts on acne, the electronic medication management requirements for pediatrics and cardiac safety with selective serotonin receptor uptake inhibitors.