Role of Spirometry, Radiology, and Flexible Bronchoscopy in Assessing Chronic Cough in Children.

Chronic cough in children is a common and multifaceted symptom, often requiring a comprehensive approach for accurate diagnosis and effective management. This review explores the use of spirometry, radiology (chest X-rays and computed tomography (CT) scans), and flexible bronchoscopy in the assessment of chronic cough in children through current guidelines and studies. The strengths, clinical indications, and limitations of each modality are examined.

Clinical utility of elective paediatric flexible bronchoscopy and impact on the quality of life: protocol for a single-centre, single-blind, randomised controlled trial.

Introduction: Elective flexible bronchoscopy (FB) is now widely available and standard practice for a variety of indications in children with respiratory conditions. However, there are no randomised controlled trials (RCTs) that have examined its benefits (or otherwise).Our primary aim is to determine the impact of FB on the parent-proxy quality-of-life (QoL) scores.

The utility of elective flexible bronchoscopy to improve quality of life and clinical outcomes for children: A systematic review.

Introduction: Elective flexible bronchoscopy (FB) is now widely available and standard practice for a variety of indications in children with respiratory conditions. However, there is limited evidence regarding the utility of elective FB in children. This systematic review (SRs) aimed to determine the utility of FB on its impact in clinical decision making and quality of life (QoL).

The 'knee' pattern in spirometry flow-volume curves in children: Does it relate to tracheomalacia?

Background: There is little data on patterns of spirometry curves in children with tracheomalacia but convex inflection on flow-volume curves (identified as the 'knee') is thought to represent tracheomalacia.

Objectives: To determine (a) the prevalence of tracheomalacia in children with the 'knee' pattern on spirometry, and (b) whether spirometry parameters and visual characteristics of the 'knee' can identify presence/absence or severity of tracheomalacia.

Patients/methods: We reviewed the spirometry undertaken at Queensland Children's Hospital between 2016 and 2019 and retrieved spirometry with the 'knee' pattern in the flow-volume curves.

Pulmonary function of children with tracheomalacia and associated clinical factors.

Objectives: Spirometry is easily accessible yet there is limited data in children with tracheomalacia. Availability of such data may inform clinical practice. We aimed to describe spirometry indices of children with tracheomalacia, including Empey index and flow-volume curve pattern, and determine whether these indices relate with bronchoscopic features.

Lung parenchymal calcifications in a child with cystic fibrosis.

We describe a 6-year-old girl with homozygous p.Phe508del cystic fibrosis with severe multi-lobar bronchiectasis and obstructive lung disease who was found to have prominent parenchymal calcifications in the right middle lobe on a computed tomography scan of the chest. Histopathology from the calcified area of lung biopsy showed fibrous tissue with chronic inflammation with CD3+ T-lymphocytes and macrophages with no granulomas.

Association of childhood tracheomalacia with bronchiectasis: a case-control study.

Objective: Children with tracheomalacia can develop chronic lower airway infection and neutrophilic inflammation. It is plausible children with tracheomalacia are at increased risk of developing bronchiectasis. We hypothesised that compared with controls, tracheomalacia in children is associated with bronchiectasis.

Flexible Bronchoscopy Diagnosis of Uncommon Congenital H-type Tracheoesophageal Fistula, Dual Fistulae, Bronchoesophageal Fistula, and Recurrence of Fistula in Children: A 20-year Experience.

Background: Interventional pediatric flexible bronchoscopy has many advantages over radiologic investigations in diagnosing uncommon congenital H-type tracheoesophageal fistula (TEF), dual TEF, bronchoesophageal fistula (BEF) and fistula recurrence including higher rates of identification and anatomic localization with guide wire cannulation. We compare the diagnostic utility of flexible bronchoscopy to radiologic techniques for congenital aerodigestive fistula.

Methods: A single center retrospective review was completed of all cases of pediatric TEF and BEF diagnosed with flexible bronchoscopy between January 2000 and November 2020.

Smartphone videos to predict the severity of obstructive sleep apnoea.

Objective: Diagnosis of obstructive sleep apnoea (OSA) is made on overnight polysomnography (PSG). Given the widespread availability of smartphone video technology, we aimed to develop and test a standardised scoring system for smartphone videos and compare these scores to PSG results.

Methods: Children aged 1-16 years undergoing PSG for suspected OSA were included.

Evaluation of dyspnea of unknown etiology in HIV patients with cardiopulmonary exercise testing and cardiovascular magnetic resonance imaging.

Aim: Human Immunodeficiency Virus (HIV) patients commonly experience dyspnea for which an immediate cause may not be always apparent. In this prospective cohort study of HIV patients with exercise limitation, we use cardiopulmonary exercise testing (CPET) coupled with exercise cardiovascular magnetic resonance (CMR) to elucidate etiologies of dyspnea.

Methods And Results: Thirty-four HIV patients on antiretroviral therapy with dyspnea and exercise limitation (49.

Verbal feedback enhances motor learning during post-stroke gait retraining.

Background: Fast treadmill walking combined with functional electrical stimulation to ankle muscles (FastFES) is a well-studied gait intervention that improves post-stroke walking function. Although individualized verbal feedback is commonly incorporated during clinical gait training, and a variable practice structure is posited to enhance learning, the influence of these two factors on motor learning during locomotor interventions such as FastFES is poorly understood.

Objectives: To determine if the addition of individualized verbal feedback or variable practice to a FastFES training session enhances motor learning of targeted gait patterns.

Multidisciplinary approach to paediatric aerodigestive disorders: A single-centre longitudinal observational study.

Aim: Aerodigestive clinics (ADCs) are multidisciplinary programmes for the care of children with complex congenital or acquired conditions affecting breathing, swallowing and growth. Our objective was to describe the demographic, clinical, etiological and investigational profile of children attending the inaugural ADC at a tertiary paediatric centre in Queensland.

Methods: Children referred to the ADC at Queensland Children's Hospital from August 2018 to December 2019 were included.

Development and validation of a bronchoscopically defined bronchitis scoring tool in children.

Introduction/aim: A validated tool for scoring bronchitis during flexible bronchoscopy (FB) is potentially useful for clinical practice and research. We aimed to develop a bronchoscopically defined bronchitis scoring system in children (BScore) based on our pilot study.

Methods: Children undergoing FB were prospectively enrolled.

Simultaneous Mapping of T and T Using Cardiac Magnetic Resonance Fingerprinting in a Cohort of Healthy Subjects at 1.5T.

Background: Cardiac MR fingerprinting (cMRF) is a novel technique for simultaneous T and T mapping.

Purpose: To compare T /T measurements, repeatability, and map quality between cMRF and standard mapping techniques in healthy subjects.

Study Type: Prospective.

Low dose contrast CT for transcatheter aortic valve replacement assessment: Results from the prospective SPECTACULAR study (spectral CT assessment prior to TAVR).

Background: Computed tomographic angiography (CTA) based planning for transcatheter aortic valve replacement (TAVR) is essential for reduction of periprocedural complications. Spectral CT based imaging provides several advantages, including better contrast/signal to noise ratio and increased soft tissue contrast, permitting better delineation of contrast filled structures at lower doses of iodinated contrast media. The aim of this prospective study was to assess the initial feasibility of a low dose iodinated contrast protocol, utilizing monoenergetic 40 keV reconstruction, using a dual-layer CT scanner (DLCT) for CTA in patients undergoing TAVR planning.

Bronchiectasis in the setting of aplasia of the epiglottis.

Aplasia of the epiglottis is a rare airway abnormality requiring airway and feeding interventions. We report a case of bronchiectasis in the setting of congenital aplasia of the epiglottis, secondary to early-life aspiration events. Compensatory mechanisms for airway protection likely develop later in life.

Impact of residual coronary atherosclerosis on transfemoral transcatheter aortic valve replacement.

Objectives: This study reports on the clinical effects of complete vs incompletely revascularized coronary artery disease on transcatheter aortic valve replacement (TAVR).

Background: There is a high prevalence of active coronary artery disease (CAD) in patients undergoing TAVR but preemptive revascularization remains controversial.

Methods: Patients were categorized into three cohorts: complete revascularization (CR), incomplete revascularization of a major epicardial artery (IR Major), and incomplete revascularization of a minor epicardial artery only (IR Minor).

Impact of Right Ventricular Pacing in Patients Who Underwent Implantation of Permanent Pacemaker After Transcatheter Aortic Valve Implantation.

Atrioventricular conduction disturbances requiring implantation of permanent pacemaker (PPM) are a common complication following transcatheter aortic valve implantation (TAVI). Previous registry data are conflicting but suggestive of an increased risk in heart failure admissions in the post-TAVI PPM cohort. Given the expanding use of TAVI, the present study evaluates the effects of chronic right ventricular pacing (RV pacing) in post-TAVI patients.

Towards developing a valid scoring tool for bronchitis during flexible bronchoscopy.

Background: A valid bronchoscopic scoring tool for bronchitis would be useful for clinical and research purposes as currently there are none in children. From 100 digitally recorded flexible bronchoscopies (FB), we related the various macroscopic features to airway neutrophil % to develop a FB-derived bronchitis score (BScore ). We aimed to develop a FB-derived bronchitis tool.

Unenhanced Velocity-Selective MR Angiography (VS-MRA): Initial Clinical Evaluation in Patients With Peripheral Artery Disease.

Background: Safe and accurate imaging of the peripheral arterial system is important for diagnosis and treatment planning of patients with peripheral artery disease (PAD).

Purpose: To evaluate image quality and diagnostic performance of unenhanced magnetic resonance angiography (MRA) based on velocity-selective (VS) magnetization preparation (termed VS-MRA).

Study Type: Prospective.

Comparison of fieldworker interview and a pictorial diary method for recording morbidity of infants in semi-urban slums.

Background: Cohort studies conducted in low-income countries generally use trained fieldworkers for collecting data on home visits. In industrialised countries, researchers use less resource intensive methods, such as self-administered structured questionnaires or symptom diaries. This study compared and assessed the reliability of the data on diarrhoea, fever and cough/cold in children as obtained by a pictorial diary maintained by the mother and collected separately by a fieldworker.

Establishment of the MAL-ED birth cohort study site in Vellore, Southern India.

The Indian Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) site is in Vellore, Tamil Nadu, in south India and is coordinated by the Christian Medical College, Vellore, which has many years of experience in establishing and following cohorts. India is a diverse country, and no single area can be representative with regard to many health and socioeconomic indicators. The site in Vellore is an urban semiorganized settlement or slum.

Crossing of infrainguinal peripheral arterial chronic total occlusion with a blunt microdissection catheter.

Purpose: Crossing of lower-extremity arterial chronic total occlusion (CTO) can be challenging. Use of the Viance peripheral CTO crossing device (Covidien) in the superficial femoral (SFA), popliteal, and below-the knee (BTK) arterial locations has received limited study.

Methods: Fifty-eight patients from the Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) were treated between April 2010 and November 2013 with the Viance device.

Endovascular treatment of infrainguinal chronic total occlusions using the TruePath device: features, handling, and 6-month outcomes.

Purpose: To report experience with a recently approved peripheral chronic total occlusion (CTO) crossing device in the superficial femoral (SFA), popliteal, and below-the-knee (BTK) arteries.

Methods: Thirteen patients (all men; mean age 68.6±7.

Significance of an abnormal ankle-brachial index in patients with established coronary artery disease with and without associated diabetes mellitus.

An abnormal ankle-brachial index (ABI) is associated with higher risk for future cardiovascular (CV) events; however, it is unknown whether this association is true in patients with established coronary artery disease (CAD) and associated diabetes mellitus (DM). We evaluated 679 patients with stable CAD enrolled in the Excellence in Peripheral Arterial Disease and Veterans Affairs North Texas Healthcare System peripheral arterial disease databases. ABI and 12-month major adverse CV events (MACEs, a composite of all-cause death, nonfatal myocardial infarction, need for repeat coronary revascularization, and ischemic stroke) were assessed.