scholarly journals Mathematical Behavior of MEFV Curves in Childhood Asthma and the Role of Curvature in Quantifying Flow Obstruction

2012 ◽  
Vol 2012 ◽  
pp. 1-13
Author(s):  
Ben Spycher ◽  
Urs Frey ◽  
Johannes H. Wildhaber ◽  
Josué Sznitman
Keyword(s):  
Pediatric Patients ◽  
Quadratic Function ◽  
Asthma Severity ◽  
Flow Modeling ◽  
Maximal Expiratory Flow ◽  
Average Curvature ◽  
Curvature Index ◽  
Expiratory Flow ◽  
Mathematical Behavior

Maximal expiratory flow-volume (MEFV) curves of pediatric patients are investigated using differentiation schemes and by computing their second derivative, d2V˙/dV2. Results show that spirometric tracings illustrate a characteristic well-defined behavior, where two distinct regions of the MEFV curve may be identified: (1) a concave profile during the initial expiratory maneuver, and (2) a convex profile over the greater lower region of the descending phase of the MEFV curve; this latter region is characterized by an approximately constant positive value of d2V˙/dV2 such that the descending MEFV limb may be captured by a quadratic function. Based on simple expiratory flow modeling, we show that d2V˙/dV2, and alternatively the local geometrical curvature κ(V), yield a measure of the relative degree of flow obstruction. In view of future clinical applications, we make use of an “average curvature index”, to assist clinician’s assessment of asthma severity, by quantifying curvature and summarizing global information in MEFV curves.

Sidestream cigarette smoke exposure and airway reactivity during early life

1994 ◽  
Vol 77 (4) ◽  
pp. 1868-1874 ◽  
Author(s):  
Y. L. Lai ◽  
A. Thacker ◽  
C. G. Gairola
Keyword(s):  
Cigarette Smoke ◽  
Early Life ◽  
Airway Hyperreactivity ◽  
Cigarette Smoke Exposure ◽  
Bronchial Reactivity ◽  
Group 4 ◽  
Maximal Expiratory Flow ◽  
Expiratory Flow ◽  
Guinea Pig Model

We established a guinea pig model to investigate effects of in utero and neonatal exposure to sidestream cigarette smoke (SSCS) on bronchial reactivity during early life. Animals were divided into four groups: 1) room air/room air, 2) sham/sham, 3) SSCS/room air, and 4) SSCS/SSCS. Pregnant and neonatal animals of group 1 breathed room air and those of group 2 were sham treated. Pregnant animals of both groups 3 and 4 as well as neonates of group 4 were exposed to SSCS. SSCS exposure was limited to between days 28 and 55 of pregnancy and days 8 and 24 of the neonatal period. Bronchial response to acetylcholine (ACh) and substance P (SP) were determined in very young animals at 25 days of age. Maximal expiratory flow was used as an index of airway dimension. SP, but not ACh, induced a significantly larger decrease in peak maximal expiratory flow in group 4, indicating an important role of neonatal SSCS exposure in augmenting bronchial response to SP. To further investigate the role of tachykinins in cigarette smoke-induced changes in bronchial reactivity, four additional groups (the same as above) of neonates were pretreated with capsaicin to deplete tachykinins. In the SSCS/SSCS group, SP-induced airway hyperreactivity was abolished by capsaicin pretreatment. Furthermore, in all four groups, capsaicin pretreatment abolished the bronchial response to SP but not the response to ACh. In additional very young animals, acute SSCS caused a nonsignificant increase in bronchial response to SP. These results indicate that chronic neonatal SSCS exposure induces bronchial hyperreactivity to SP; this hyperreactivity is abolished by capsaicin pretreatment.

ACE2/Angiotensin-(1-7)/Mas Receptor Axis in Human Cancer: Potential Role for Pediatric Tumors

2020 ◽  
Vol 21 (9) ◽  
pp. 892-901 ◽  
Author(s):  
Ana Luiza Ataide Carneiro de Paula Gonzaga ◽  
Vitória Andrade Palmeira ◽  
Thomas Felipe Silva Ribeiro ◽  
Larissa Braga Costa ◽  
Karla Emília de Sá Rodrigues ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Angiotensin Ii ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Human Cancer ◽  
Experimental Studies ◽  
At1 Receptor ◽  
Pediatric Tumors ◽  
Mas Receptor

Background: Pediatric tumors remain the highest cause of death in developed countries. Research on novel therapeutic strategies with lesser side effects is of utmost importance. In this scenario, the role of Renin-Angiotensin System (RAS) axes, the classical one formed by angiotensinconverting enzyme (ACE), Angiotensin II and AT1 receptor and the alternative axis composed by ACE2, Angiotensin-(1-7) and Mas receptor, have been investigated in cancer. Objective: This review aimed to summarize the pathophysiological role of RAS in cancer, evidence for anti-tumor effects of ACE2/Angiotensin-(1-7)/Mas receptor axis and future therapeutic perspectives for pediatric cancer. Methods: Pubmed, Scopus and Scielo were searched in regard to RAS molecules in human cancer and pediatric patients. The search terms were “RAS”, “ACE”, “Angiotensin-(1-7)”, “ACE2”, “Angiotensin II”, “AT1 receptor”, “Mas receptor”, “Pediatric”, “Cancer”. Results: Experimental studies have shown that Angiotensin-(1-7) inhibits the growth of tumor cells and reduces local inflammation and angiogenesis in several types of cancer. Clinical trials with Angiotensin-( 1-7) or TXA127, a pharmaceutical grade formulation of the naturally occurring peptide, have reported promising findings, but not enough to recommend medical use in human cancer. In regard to pediatric cancer, only three articles that marginally investigated RAS components were found and none of them evaluated molecules of the alternative RAS axis. Conclusion: Despite the potential applicability of Angiotensin-(1-7) in pediatric tumors, the role of this molecule was never tested. Further clinical trials are necessary, also including pediatric patients, to confirm safety and efficiency and to define therapeutic targets.

scholarly journals ROLE OF PHYSICAL THERAPY IN THE TREATMENT OF POSTERIOR ANKLE IMPINGEMENT IN PEDIATRIC ATHLETES - A PROSPECTIVE STUDY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Adam Saloom ◽  
Nick Purcell ◽  
Matthew Ruhe ◽  
Jorge Gomez ◽  
Jonathan Santana ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Prospective Study ◽  
Conservative Management ◽  
Pediatric Patients ◽  
Weight Bearing ◽  
Return To Sport ◽  
Time To Surgery ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement

Background: Posterior ankle impingement (PAI) is a known cause of posterior ankle pain in athletes performing repetitive plantarflexion motion. Even though empirically recommended in adult PAI, there is minimal literature related to the role of conservative physical therapy (PT) in pediatric patients. Purpose: To identify patient characteristics and determine if there is a difference in pediatric patients with PAI who were successful with conservative PT and those who were unsuccessful, requiring surgical intervention. Methods: Prospective study at a tertiary children’s hospital included patients <18 years diagnosed with PAI and underwent PT. Patients who received PT at an external facility were excluded. Collected data included demographics, initial presentation at PT evaluation, treatment throughout PT, patient presentation at PT discharge, time to return to sport (RTS) from initial PT evaluation (if successful), time to surgery from initial PT evaluation (if unsuccessful). Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were collected. Group comparisons were conducted using independent t-tests or chi-square analyses (alpha level set at .05). Results: 31 (12 males, 19 females) patients diagnosed with PAI were enrolled with a mean age 12.61 years (range: 8-17). Gymnastics, football, and basketball were the most commonly implicated sports (42% patients). All patients underwent initial conservative PT for an average of 16.24 weeks (9.23 visits ±7.73). 20/31(64.5%) patients failed conservative management and underwent arthroscopic debridement. PAI pathology was predominantly bony in 61.3% and soft tissue 38.7%. Between the successful PT group and unsuccessful PT group, there was no difference in the proportion of athletes/non-athletes (p=.643). Average RTS time for successful group was 11.47 weeks and average time to surgery for unsuccessful group was 17.82 weeks. There were no significant differences in sex (p=.332), age (p=.674), number of PT visits (p=.945), initial weight-bearing status (p=.367), use of manual therapy (p=.074) including manipulation (p=.172) and mobilization (p=.507), sport (p=.272), initial evaluation ankle ROM (p>.05). Initial AOFAS scores for pain, function, alignment, or total were not significantly different (p=.551, .998, .555, .964 respectively). Conclusion: The first prospective study in pediatric patients with PAI demonstrates that even though success of PT is not dependent on age, sex, sport or PAI pathology, a notable proportion of patients who undergo PT do not need surgery. Conservative management including PT should be the initial line of management for PAI. PT treatment and surgery (if unsuccessful with PT) allowed patients to return to prior level of activity/sports. Tables/Figures: [Table: see text]

scholarly journals Current Evidence on the Role of the Gut Microbiome in ADHD Pathophysiology and Therapeutic Implications

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 249
Author(s):  
Ana Checa-Ros ◽  
Antonio Jeréz-Calero ◽  
Antonio Molina-Carballo ◽  
Cristina Campoy ◽  
Antonio Muñoz-Hoyos
Keyword(s):  
Gut Microbiome ◽  
Pediatric Patients ◽  
Neurodevelopmental Disorder ◽  
Current Evidence ◽  
Omega 3 ◽  
Therapeutic Implications ◽  
Neuropsychiatric Diseases ◽  
Bidirectional Relationship ◽  
The Central Nervous System

Studies suggest that the bidirectional relationship existent between the gut microbiome (GM) and the central nervous system (CNS), or so-called the microbiome–gut–brain axis (MGBA), is involved in diverse neuropsychiatric diseases in children and adults. In pediatric age, most studies have focused on patients with autism. However, evidence of the role played by the MGBA in attention deficit/hyperactivity disorder (ADHD), the most common neurodevelopmental disorder in childhood, is still scanty and heterogeneous. This review aims to provide the current evidence on the functioning of the MGBA in pediatric patients with ADHD and the specific role of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in this interaction, as well as the potential of the GM as a therapeutic target for ADHD. We will explore: (1) the diverse communication pathways between the GM and the CNS; (2) changes in the GM composition in children and adolescents with ADHD and association with ADHD pathophysiology; (3) influence of the GM on the ω-3 PUFA imbalance characteristically found in ADHD; (4) interaction between the GM and circadian rhythm regulation, as sleep disorders are frequently comorbid with ADHD; (5) finally, we will evaluate the most recent studies on the use of probiotics in pediatric patients with ADHD.

Nasal Dermoids in Children: Factors Influencing the Distant Result

2021 ◽  
Author(s):  
Michal Kotowski ◽  
Paulina Adamczyk ◽  
Jaroslaw Szydlowski
Keyword(s):  
Pediatric Patients ◽  
Surgical Techniques ◽  
Intracranial Extension ◽  
Recurrence Rates ◽  
Local Conditions ◽  
Aesthetic Result ◽  
Factors Influencing ◽  
Vertical Incision ◽  
External Rhinoplasty

AbstractThe aim of the study was to present a single institution’s treatment strategy for nasal dermoids and to identify factors influencing distant results. The study covered 24 surgically treated pediatric patients with nasal dermoids (NDs). The medical data concerning demographics, preoperative local inflammations and surgical procedures, form of the abnormality, imaging, surgical techniques, and a role of osteotomies and reconstructions were analyzed. The recurrence rates and distant aesthetic outcomes were assessed. The surgical approach included vertical incision in 21 patients, the external rhinoplasty approach in 2 cases, and bicoronal incision in 1 child. The intracranial extension was confirmed in 6 patients. Seven out of 8 cases with preoperative local inflammations and 3 out of 4 with secondary fistulization were < 4 years old. Nine patients required osteotomies. Three children required reconstruction of the nasal skeleton. None of the distant cosmetic results was described as hideous or unsatisfactory. The incidence of local inflammatory complications is unrelated to the age of the patients. The distant aesthetic result depends on both the initial extent of the disease and preoperative local conditions or interventions. Prompt surgical intervention is highly recommended.

Pattern and mechanism of airway response to hypocapnia in normal subjects

1979 ◽  
Vol 47 (1) ◽  
pp. 8-12 ◽  
Author(s):  
C. F. O'Cain ◽  
M. J. Hensley ◽  
E. R. McFadden ◽  
R. H. Ingram
Keyword(s):  
Vital Capacity ◽  
Normal Subjects ◽  
Oxygen Mixture ◽  
Flow Volume ◽  
Mixture Density ◽  
Lung Capacity ◽  
Airway Constriction ◽  
Maximal Expiratory Flow ◽  
Airway Response ◽  
Expiratory Flow

We examined the bronchoconstriction produced by airway hypocapnia in normal subjects. Maximal expiratory flow at 25% vital capacity on partial expiratory flow-volume (PEFV) curves fell during hypocapnia both on air and on an 80% helium- 20% oxygen mixture. Density dependence also fell, suggesting predominantly small airway constriction. The changes seen on PEFV curves were not found on maximal expiratory flow-volume curves, indicating the inhalation to total lung capacity substantially reversed the constriction. Pretreatment with a beta-sympathomimetic agent blocked the response, whereas atropine pretreatment did not, suggesting that hypocapnia affects airway smooth muscle directly, not via cholinergic efferents.

scholarly journals Multi-detector computed tomography (MDCT) as a diagnostic tool in assessment of thoracic aortic anomalies in pediatric patients

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Dawlat Nader Eltatawy ◽  
Fatma Anas Elsharawy ◽  
Aly Aly Elbarbary ◽  
Raghda Ghonimy Elsheikh ◽  
Manal Ezzat Badawy
Keyword(s):  
Computed Tomography ◽  
Aortic Arch ◽  
Pediatric Patients ◽  
Interrupted Aortic Arch ◽  
Diagnostic Tools ◽  
Non Invasive ◽  
Branching Patterns ◽  
Anatomic Variants ◽  
Multi Detector Computed Tomography

Abstract Background A wide variety of congenital thoracic aortic variants and pathological anomalies could be assessed recently in diagnostic and interventional radiology. Multi-detector computed tomography (MDCT) is one of the most important non-invasive diagnostic tools for their detection. The aim of the study was to evaluate role of MDCT scanning for diagnosis of thoracic aortic anatomic variants and diseases in pediatric patients. Results Thirty patients (15 male and 15 female), mean age (8.49 ± 20.29 months) were diagnosed with different thoracic aortic anomalies by MDCT then confirmed by surgical results. MDCT was more sensitive than echocardiography in detection of hypo plastic arch, vascular rings, interrupted aortic arch anomalies, and aortic coarctation. Both MDCT and echocardiography showed 100% sensitivity in their detection of TGA, TOF, and PDA. MDCT detected 6 cases of right-sided aortic arch while echo missed 2 cases. Different aortic arch branching patterns and coronary origin were better demonstrated by MDCT. Conclusion 320-Multi-detector computed tomography is a reliable tool for optimal detection of thoracic aortic anomalies and preoperative planning.

Sign in / Sign up

Export Citation Format

Share Document