scholarly journals Heiner Syndrome and Milk Hypersensitivity: An Updated Overview on the Current Evidence

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1710
Author(s):  
Stefania Arasi ◽  
Carla Mastrorilli ◽  
Luca Pecoraro ◽  
Mattia Giovannini ◽  
Francesca Mori ◽  
...  
Keyword(s):  
Respiratory Tract Infections ◽  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Signs And Symptoms ◽  
Current Evidence ◽  
Recurrent Fever ◽  
X Rays ◽  
Critical Approach ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Infants affected by Heiner syndrome (HS) display chronic upper or lower respiratory tract infections, including otitis media or pneumonia. Clinically, gastrointestinal signs and symptoms, anemia, recurrent fever and failure to thrive can be also present. Chest X-rays can show patchy infiltrates miming pneumonia. Clinical manifestations usually disappear after a milk-free diet. The pathogenetic mechanism underlying HS remains unexplained, but the formation of immune complexes and the cell-mediated reaction have been proposed. Patients usually outgrow this hypersensitivity within a few years. The aim of this review is to provide an updated overview on the current evidence on HS in children, with a critical approach on the still undefined points of this interesting disease. Finally, we propose the first structured diagnostic approach for HS.

scholarly journals Inter-observer agreement in interpreting chest X-rays on children with acute lower respiratory tract infections and concurrent wheezing

2007 ◽  
Vol 125 (3) ◽  
pp. 150-154 ◽  
Author(s):  
Carlos Bada ◽  
Nilton Yhuri Carreazo ◽  
Juan Pablo Chalco ◽  
Luis Huicho
Keyword(s):  
Respiratory Tract Infections ◽  
Observer Variation ◽  
Observer Agreement ◽  
X Rays ◽  
Lower Respiratory Tract Infections ◽  
Emergency Ward ◽  
X Ray ◽  
Alveolar Infiltrate ◽  
Chest X Ray ◽  
Tract Infections

CONTEXT AND OBJECTIVE: Many children with acute lower respiratory tract infections (ALRI) present to the emergency ward with concurrent wheezing. A chest x-ray is often requested to rule out pneumonia. We assessed inter-observer agreement in interpreting x-rays on such children. DESIGNS AND SETTING: Prospective consecutive case study at Instituto de Salud del Niño, Lima, Peru. METHODS: Chest x-rays were obtained from eligible children younger than two years old with ALRI and concurrent wheezing who were seen in the emergency ward of a nationwide pediatric referral hospital. The x-rays were read independently by three different pediatric residents who were aware only that the children had a respiratory infection. All the children had received inhaled beta-adrenergic agonists before undergoing chest x-rays. Lobar and complicated pneumonia cases were excluded from the study. RESULTS: Two hundred x-rays were read. The overall kappa index was 0.2. The highest individual kappa values for specific x-ray findings ranged from 0.26 to 0.34 for rib horizontalization and from 0.14 to 0.31 for alveolar infiltrate. Inter-observer variation was intermediate for alveolar infiltrate (kappa 0.14 to 0.21) and for air bronchogram (kappa 0.13 to 0.23). Reinforcement of the bronchovascular network (kappa 0.10 to 0.16) and air trapping (kappa 0.05 to 0.20) had the lowest agreement. CONCLUSIONS: There was poor inter-observer agreement for chest x-ray interpretation on children with ALRI and concurrent wheezing seen at the emergency ward. This may preclude reliable diagnosing of pneumonia in settings where residents make management decisions regarding sick children. The effects of training on inter-observer variation need further studies.

Clinical and Microbiological Evaluation of Pefloxacin in Lower Respiratory Tract Infections

1996 ◽  
Vol 24 (6) ◽  
pp. 478-481 ◽  
Author(s):  
G Tatsis ◽  
G Tsoukalas ◽  
V Hatzinikolaou ◽  
G Boulbasakos ◽  
J Jordanoglou
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
X Rays ◽  
Gram Stain ◽  
Complete Elimination ◽  
Lower Respiratory Tract Infections ◽  
Gram Negative ◽  
Sputum Volume ◽  
Tract Infections

Patients with Gram-negative lower respiratory tract infections (acute exacerbation of chronic bronchitis ( n = 23), pneumonia ( n = 4), and bronchiectasis ( n = 5) were treated with pefloxacin, 400 mg twice daily, given either intravenously or orally. Symptoms, signs and sputum volume and colour were monitored daily. Chest X-rays, sputum culture and Gram-stain examinations were carried out on days 1 and 5, and immediately after the end of the treatment. There was a clinical improvement, as indicated by the incidence of cough, dyspnoea and rales, and by sputum volume and colour in 31 patients (97%). Microbiological improvement, as indicated by the complete elimination of sputum pathogens and pus cells, was achieved in 28 of the patients (88%). In one patient, an adverse effect, renal failure, occurred. These results suggest that pefloxacin is both clinically and microbiologically effective for the treatment of Gram-negative lower respiratory tract infections.

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