Search Our Scientific Publications & Authors

Clin Infect Dis 2020 Jun 3. Epub 2020 Jun 3.

Assistance Publique-Hôpitaux de Paris, Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France.

A time series analysis of 871,543 pediatric emergency visits revealed that the COVID-19 lockdown and school closure were associated with a significant decrease in infectious diseases disseminated through airborne or fecal-oral transmissions: common cold, gastro-enteritis, bronchiolitis, acute otitis. No change was found for urinary tract infections. Read More

J Hosp Med 2020 May 21. Epub 2020 May 21.

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Background: Hospitals are increasingly adopting ward-based high-flow nasal cannula (HFNC) protocols that allow HFNC treatment of bronchiolitis outside of the intensive care unit (ICU). Our objective was to determine whether adoption of a ward-based HFNC protocol reduces ICU utilization.

Methods: We examined a retrospective cohort of infants aged 3 to 24 months hospitalized with bronchiolitis at hospitals in the Pediatric Health Information System database. Read More

CJEM 2020 Jun 2:1-9. Epub 2020 Jun 2.

Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB.

Objective: Despite strong evidence recommending supportive care as the mainstay of management for most infants with bronchiolitis, prior studies show that patients still receive low-value care (e.g., respiratory viral testing, salbutamol, chest radiography). Read More

Allergy 2020 Jun;75(6):1529-1530

Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.

Allergy 2020 Jun;75(6):1531-1532

Women's and Children's Health Department, University of Padova, Padova, Italy.

Clin Infect Dis 2020 May 28. Epub 2020 May 28.

Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, USA.

Background: Respiratory syncytial virus (RSV) is a leading cause of viral pneumonia and bronchiolitis during the first six months of life. Placentally-transferred antibodies can prevent severe RSV illness, and maternal immunization may reduce illness in young infants. Identifying protective antibody levels will facilitate the advancement of vaccine candidates and maternal immunization. Read More

Pediatr Allergy Immunol 2020 May 27. Epub 2020 May 27.

Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: Bronchiolitis is the leading cause of infant hospitalizations in the U.S. Growing evidence supports the heterogeneity of bronchiolitis. Read More

J Leukoc Biol 2020 May 25. Epub 2020 May 25.

Departments of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Respiratory syncytial virus (RSV) is associated with bronchiolitis in infancy and the later development of asthma. Research on RSV in vitro requires preparation of a purified RSV stock. The objective for this work was to develop best methods for RSV purification, while monitoring the samples for potential contaminating proinflammatory mediators. Read More

J Antimicrob Chemother 2020 May 25. Epub 2020 May 25.

Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004 Paris, France.

Objectives: To assess recent community antibiotic prescribing for French children and identify areas of potential improvement.

Methods: We analysed 221 768 paediatric (<15 years) visits in a national sample of 680 French GPs and 70 community paediatricians (IQVIA's EPPM database), from March 2015 to February 2017, excluding well-child visits. We calculated antibiotic prescription rates per 100 visits, separately for GPs and paediatricians. Read More

Front Pediatr 2020 5;8:218. Epub 2020 May 5.

Division of Paediatrics and Child Health, Perth Children's Hospital, University of Western Australia, Nedlands, WA, Australia.

The diagnosis and management of infants and children with a significant viral lower respiratory tract illness remains the subject of much debate and little progress. Over the decades various terms for such illnesses have been in and fallen out of fashion or have evolved to mean different things to different clinicians. Terms such as "bronchiolitis," "reactive airways disease," "viral wheeze," and many more are used to describe the same condition and the same term is frequently used to describe illnesses caused by completely different dominant pathologies. Read More

Harefuah 2020 May;159(5):349-351

Department of Pediatrics, Laniado Medical Center, Netanya, Israel.

Introduction: Inhalations of hypertonic saline is a known therapy for infants diagnosed with acute bronchiolitis. Recent meta-analysis has shown that it can reduce the length of hospitalization and decrease the chances of admission.

Aims: To assess the extent of use of hypertonic saline inhalations in the pediatric wards in Israel in 2018. Read More

Med Intensiva 2020 May 13. Epub 2020 May 13.

Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Pediatrics Istanbul, Turkey.

Objective: To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children.

Design: A prospective descriptive study was carried out.

Setting: Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey. Read More

Indian J Pediatr 2020 May 13. Epub 2020 May 13.

Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.

Pediatr Allergy Immunol 2020 May 8. Epub 2020 May 8.

Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway.

We highly appreciate Korppi and Riikonen's comment to our article regarding trajectories of lung function and bronchial hyperreactivity (BHR) during puberty in children with bronchiolitis in infancy. Read More

J Eval Clin Pract 2020 May 7. Epub 2020 May 7.

Department of Educational Studies, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada.

Rationale, Aims And Objectives: The onset of acute illness may be accompanied by a profound sense of disorientation for patients. Addressing this vulnerability is a key part of a physician's purview, yet well-intended efforts to do so may be impeded by myriad competing tasks in clinical practice. Resolving this dilemma goes beyond appealing to altruism, as its limitless demands may lead to physician burnout, disillusionment, and a narrowed focus on the biomedical aspects of care in the interest of self-preservation. Read More

NPJ Prim Care Respir Med 2020 May 6;30(1):18. Epub 2020 May 6.

The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Under-diagnosis of asthma in 'under-fives' may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 'under-fives' with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensus diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Read More

Eur Ann Allergy Clin Immunol 2020 May 6. Epub 2020 May 6.

Hacettepe University Medical School, Department of Pediatric Immunology, Ankara, Turkey.

Summary: Primary Immunodeficiency diseases(PID) are common in patients with non-cystic fibrosis bronchiectasis(NCFB). Our objective was to determine ratio/types of PID in NCFB. Seventy NCFB patients followed up in a two-year period were enrolled. Read More

PLoS One 2020 5;15(5):e0231782. Epub 2020 May 5.

Department of Medicine, University of California, San Francisco, CA, United States of America.

Rationale: Severe early-life respiratory illnesses, particularly those caused by respiratory syncytial virus (RSV) and human rhinovirus (HRV), are strongly associated with the development of asthma in children. Puerto Rican children in particular have a strikingly high asthma burden. However, prior studies of the potential associations between early-life respiratory illnesses and asthma in Puerto Rican and other minority populations have been limited. Read More

Pediatrics 2020 Jun 4;145(6). Epub 2020 May 4.

Department of Pediatrics, Children's Mercy Kansas City and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri.

Background: Improvement initiatives promote safe and efficient care for hospitalized children. However, these may be associated with limited cost savings. In this article, we sought to understand the potential financial benefit yielded by improvement initiatives by describing the inpatient allocation of costs for common pediatric diagnoses. Read More

Pediatr Pulmonol 2020 May 4. Epub 2020 May 4.

Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) during early childhood may be associated with subsequent pulmonary sequelae, including recurrent wheezing and asthma. We undertook a systematic review to investigate the pulmonary function sequelae following RSV LRTI in the first 3 years of life. The systematic review protocol was registered on PROSPERO (CRD42018087168). Read More

BMC Pediatr 2020 May 1;20(1):189. Epub 2020 May 1.

Children's Emergency Department, Starship Children's Hospital, Private Bag 92024, Auckland, 1142, New Zealand.

Background: Bronchiolitis is the most common reason for infants under one year of age to be hospitalised. Despite management being well defined with high quality evidence of no efficacy for salbutamol, adrenaline, glucocorticoids, antibiotics or chest x-rays, substantial variation in practice occurs. Understanding factors that influence practice variation is vital in order to tailor knowledge translation interventions to improve practice. Read More

Vaccines (Basel) 2020 Apr 26;8(2). Epub 2020 Apr 26.

Fundación INFANT, Buenos Aires 1406, Argentina.

Numerous preventive strategies against respiratory syncytial virus (RSV) are undergoing late stage evaluation in humans and, in addition to their intended benefit for acute illness, may impact long term consequences of infection in infants. Severe RSV infection has been repeatedly associated in the literature with long term complications, including impaired lung function, recurrent wheezing, and asthma. However, whether RSV lower respiratory tract infection (LRTI) causally affects the odds for developing wheezing and/or asthma during childhood requires further study, and the biological mechanisms underlying this hypothetical progression from viral illness to chronic lung disease are poorly characterized. Read More

J Pediatr Intensive Care 2020 Jun 21;9(2):87-91. Epub 2019 Nov 21.

Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States.

Fluid balance management, including diuretic administration, may influence outcomes among mechanically ventilated children. We retrospectively compared oxygenation saturation index (OSI) before and after the initial furosemide bolus among 65 mechanically ventilated children. Furosemide was not associated with a significant change in median OSI (6. Read More

Pediatr Crit Care Med 2020 Jun;21(6):e333-e341

Pediatric Critical Care Research Group, Child Health Research Center, The University of Queensland, Brisbane, QLD, Australia.

Objectives: Viral infections are common in children, but there is a lack of data on severe viral infections in critically ill children. We investigated testing for viral infections in children requiring PICU admission and describe the epidemiology and outcomes.

Design: Multicenter retrospective study. Read More

Acad Med 2020 Apr 21. Epub 2020 Apr 21.

D.J. Schumacher is associate professor of pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio. A. Martini is a clinical research coordinator, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. B. Sobolewski is associate professor of pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio. C. Carraccio is vice president of competency-based assessment, American Board of Pediatrics, Chapel Hill, North Carolina. E. Holmboe is senior vice president for milestones development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. J. Busari is associate professor of medical education, Maastricht University, Maastricht, The Netherlands. S. Poynter is professor of pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio. C. van der Vleuten is professor of education, Department of Educational Development and Research, Faculty of Health, Medicine, and Life Sciences, and scientific director, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands. L. Lingard is professor and scientist, Department of Medicine, and director, Center for Education Research & Innovation, Schulich School of Medicine and Dentistry at Western University, London, Ontario, Canada.

Purpose: Resident-sensitive quality measures (RSQMs) are quality measures that are likely performed by an individual resident and are important to care quality for a given illness of interest. This study sought to explore how individual clinical competency committee (CCC) members interpret, use, and prioritize RSQMs alongside traditional assessment data when making a summative entrustment decision.

Method: In this constructivist grounded theory study, 19 members of the pediatric residency CCC at Cincinnati Children's Hospital Medical Center were purposively and theoretically sampled between February and July 2019. Read More

JAMA 2020 04;323(15):1467-1477

Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Importance: US national guidelines discourage the use of continuous pulse oximetry monitoring in hospitalized children with bronchiolitis who do not require supplemental oxygen.

Objective: Measure continuous pulse oximetry use in children with bronchiolitis.

Design, Setting, And Participants: A multicenter cross-sectional study was performed in pediatric wards in 56 US and Canadian hospitals in the Pediatric Research in Inpatient Settings Network from December 1, 2018, through March 31, 2019. Read More

JAMA 2020 04;323(15):1449-1450

Boston University School of Medicine, Boston Medical Center, Department of Pediatrics, Boston, Massachusetts.

Adv Exp Med Biol 2020 Apr 21. Epub 2020 Apr 21.

Department of Pediatrics, Medical Center of Postgraduate Medical Education, Warsaw, Poland.

The goal of this study was to define the prevalence of respiratory complications, other than bronchiolitis, such as pneumonia, acute otitis media, and conjunctivitis in children treated in a hospital due to respiratory syncytial virus (RSV) infection, with reference to the plausible risk factors. The study included 111 children, aged up to 22 months (median 3 months). Complications were observed in 68 (61%) children, with 32 (29%) children presenting more than one. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2020 Apr;22(4):339-345

Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Research Center for Child Health and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.

Objective: To study the predictive factors for the failure of continuous positive airway pressure (CPAP) treatment in infants with bronchiolitis.

Methods: A retrospective analysis was performed on the clinical data of 310 hospitalized children (aged 1-12 months) with bronchiolitis treated with CPAP. Their clinical features were compared between the successful treatment group (270 cases) and the failed treatment group (40 cases). Read More

Allergy 2020 Apr 18. Epub 2020 Apr 18.

Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

J Med Toxicol 2020 Apr 16. Epub 2020 Apr 16.

North Texas Poison Center, Parkland Health and Hospital System, Dallas, TX, USA.

Electronic cigarettes (e-cigarettes) are battery-operated devices to insufflate nicotine or other psychoactive e-liquid aerosols. Despite initial claims of e-cigarettes as a nicotine-cessation device, aggressive marketing of e-cigarettes has led to an explosion in adolescents' and young adults' use over the last few years. Coupled with a lack of adequate investigation and regulation of e-cigarettes, the USA is facing an outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) starting in mid-2019. Read More

Front Pediatr 2020 2;8:121. Epub 2020 Apr 2.

Division of Pediatric Pulmonary and Sleep Medicine. Center for Genetic Research, Children's National Medical Center, George Washington University, Washington, DC, United States.

Viral bronchiolitis is a term often used to group all infants with the first episode of severe viral respiratory infection. However, this term encompasses a collection of different clinical and biological processes. We hypothesized that the first episode of severe viral respiratory infection in infants can be subset into clinical phenotypes with distinct outcomes and underlying airway disease patterns. Read More

Ir Med J 2020 01 16;113(1). Epub 2020 Jan 16.

Children's Health Ireland at Crumlin (CHI@Crumlin), Dublin, Ireland.

Aim Determine the seasonal incidence of hospital Respiratory Syncytial Virus (RSV) bronchiolitis and explore the variables associated with admission to ward versus the Paediatric Intensive Care Unit (PICU). Method Retrospective case-control study. Children, aged ≤2 years, between November and March, over a 3 year period with a positive RSV nasopharyngeal aspirate test. Read More

Hosp Pediatr 2020 May 13;10(5):385-391. Epub 2020 Apr 13.

Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.

Background And Objectives: Quality improvement (QI) initiatives have increased provider adherence to individual components of a bronchiolitis clinical practice guideline (CPG). Few have evaluated complete adherence to a guideline in multiple types of care settings. Our aim with this study was to increase complete adherence to our institutional bronchiolitis CPG in urgent care center, emergency department, and inpatient settings. Read More

Allergol Immunopathol (Madr) 2020 Apr 8. Epub 2020 Apr 8.

Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Avenida Calle 127 No. 20-78, Bogota, Colombia; Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogota, Colombia. Electronic address:

Introduction And Objectives: Despite the recommendation against routine use of inhaled bronchodilators in infants with viral bronchiolitis given in the main clinical practice guidelines (CPGs) on viral bronchiolitis, albuterol is widely prescribed to patients with this disease. The aim of this study was to identify predictors of prescription of albuterol in a population of infants hospitalized for viral bronchiolitis.

Material And Methods: An analytical cross-sectional study performed during the period from March 2014 to August 2015, in a random sample of patients <2 years old hospitalized in the Fundacion Hospital La Misericordia, a hospital located in Bogota, Colombia. Read More

Arch Dis Child 2020 Apr 10. Epub 2020 Apr 10.

Paediatric Critical Care Research Group, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia

Background: Bronchiolitis is the most common reason for hospital admission in infants. High-flow oxygen therapy has emerged as a new treatment; however, the cost-effectiveness of using it as first-line therapy is unknown.

Objective: To compare the cost of providing high-flow therapy as a first-line therapy compared with rescue therapy after failure of standard oxygen in the management of bronchiolitis. Read More

J Trop Pediatr 2020 Apr;66(2):234-243

Department of Pediatrics, University of Rwanda, Kigali, Rwanda.

Eur J Pediatr 2020 May 31;179(5):711-718. Epub 2020 Mar 31.

Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.

Bronchiolitis is a common respiratory illness in early childhood, often leading to hospitalization and associated healthcare costs. Low flow 100% oxygen through nasal prongs is the standard therapy for infants with bronchiolitis and hypoxemia. Nasal continuous positive airway pressure (nCPAP) or invasive ventilation is used in case of progressive respiratory failure. Read More

J Infect Dis 2020 Mar 30. Epub 2020 Mar 30.

National Heart and Lung Institute, Imperial College, London, UK.

Background: . Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in young infants. However, it is also a significant pathogen in older adults. Read More

Front Pediatr 2020 11;8:42. Epub 2020 Mar 11.

Faculty of Medicine and University Hospital Cologne, Institute of Human Genetics, University of Cologne, Cologne, Germany.

Lipopolysaccharide-responsive and beige-like anchor protein (LRBA) deficiency is characterized by autoimmunity, chronic diarrhea, and immunodeficiency. Minor renal manifestations have been found in a few patients, but kidney disease has not been systematically studied and may remain underdiagnosed in this highly variable entity. Our patient initially presented with pancytopenia, enteropathy, hypogammaglobulinemia, and failure to thrive at the age of 15 months. Read More

JAMA Pediatr 2020 Mar 23. Epub 2020 Mar 23.

Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Clin Infect Dis 2020 Mar 23. Epub 2020 Mar 23.

Global Clinical Development Infectious Diseases, Janssen Research & Development, Beerse, Belgium.

Background: This Phase 1b study evaluated the pharmacokinetics, safety and antiviral effects of the respiratory syncytial virus (RSV)-specific fusion inhibitor JNJ-53718678 (JNJ8678) in hospitalized RSVinfected patients (aged >1-≤24 months).

Methods: Patients categorized by age (Cohort 1: ≥6-≤24 months; Cohort 2: ≥3-<6 months; Cohort 3: >1-<3 months) were randomized to oral JNJ-8678 or placebo once-daily for 7 days. Dose increases followed Data Review Committee recommendations (doses respectively: Cohort 1: 2/6/8/9 mg/kg; Cohort 2: 1. Read More

ERJ Open Res 2020 Jan 16;6(1). Epub 2020 Mar 16.

Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.

Background: Acute bronchiolitis during infancy and human rhinovirus (HRV) lower respiratory tract infections increases the risk of asthma in atopic children. We aimed to explore whether specific viruses, allergic sensitisation or cortisol levels during acute bronchiolitis in infancy increase the risk of early asthma, using recurrent wheeze as a proxy.

Methods: In 294 children with a mean (range) age of 4. Read More

Indian Pediatr 2020 Mar;57(3):257

Department of Pediatrics, KGMU, Lucknow, India.

Indian Pediatr 2020 Mar;57(3):254-257

Department of Pediatrics, PGIMER, Chandigarh, India.

Can J Respir Ther 2019 28;56:5-6. Epub 2020 Feb 28.

Department of Pediatrics, Division of Pediatric Emergency Medicine, Medical University of South Carolina, Charleston, SC, USA.

Hosp Pediatr 2020 Apr 16;10(4):318-324. Epub 2020 Mar 16.

Department of Pediatrics, School of Medicine, Virginia Commonwealth University, Children's Hospital of Richmond, Richmond, Virginia.

Background And Objectives: To determine the effect of discharge criteria on discharge readiness and length of stay (LOS). Discharge inefficiency is a common barrier to hospital flow, affecting admissions, discharges, cost, patient satisfaction, and quality of care. Our center identified increasing discharge efficiency as a method to improve flow and better meet the needs of our patients. Read More

Eur Radiol 2020 Mar 14. Epub 2020 Mar 14.

Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, USA.

Objective: To compare quantitative chest CT parameters in perinatally HIV-infected adolescents with and without bronchiolitis obliterans compared with HIV-uninfected controls and their association with lung function measurements.

Materials And Methods: Seventy-eight (41 girls) HIV-infected adolescents with a mean age of 13.8 ± 1. Read More

Int Immunopharmacol 2020 Jun 12;83:106327. Epub 2020 Mar 12.

Department of Respiratory Medicine, Chongqing Key Laboratory of Pediatrics, Childreńs Hospital, Chongqing Medical University, Chongqing 400014, PR China. Electronic address:

Respiratory syncytial virus (RSV) is the most common viral pathogen causing acute lower respiratory tract infections (LRTI) in infants. Airway epithelial cells, including Club cells, are primary targets of RSV infection. The "Club cell 10-kDa protein" (CC10), produced mainly by Club cells, possesses anti-inflammatory and immunoregulatory properties that are relevant in infection, injury, and allergic reactions. Read More

Adv Exp Med Biol 2020 Mar 14. Epub 2020 Mar 14.

Department of Pediatrics, Center of Postgraduate Medical Education, Warsaw, Poland.

Seasonality of respiratory syncytial virus (RSV) infection is an area of limited knowledge. In this study, we set out to get insight into the epidemic characteristics of RSV. We retrospectively evaluated medical files of 512 hospitalizations in children due to RSV infection from January 2010 to July 2017. Read More