Road map to developing a fellowship program in a tertiary care hospital.

Background: The American Academy of Pediatrics has identified the need for more subspecialists. Beginning a pediatric pulmonary fellowship program in a tertiary care hospital can be a challenging process. Persistence, perseverance, and working through barriers to education are important strides to take toward achieving this goal.

Cough in asthma triggered by reflux episodes.

With combined pH and impedance monitoring, non-acid, as well as acid reflux episodes, are more commonly detected immediately prior to cough in asthma in children. Gastroesophageal reflux should be evaluated as a trigger for cough in difficult childhood asthma.

Cystic fibrosis infant care challenges in diagnosis and management in the era of newborn screening.

With newborn screening for cystic fibrosis (CF) now accessible in every state in the US, more infants are being diagnosed. Currently, no large-scale randomized studies are available to assist clinicians in providing evidence-based medical care for the youngest CF patients. We review the standard of diagnostic evaluation, the sweat test, showing a slightly altered range for infants less than 6 months of age.

Association between practice patterns and body mass index percentile in infants and young children with cystic fibrosis.

Background: Few guidelines focus on the preventive and maintenance care of infants with cystic fibrosis (CF). We explored how practice variability at accredited CF centers affected nutritional outcomes.

Methods: A retrospective cohort study using Cystic Fibrosis Foundation registry data (1993-2004) from three CF centers compared the initial management with respiratory, antimicrobial, and nutritional agents in infants.

Parapneumonic effusion and empyema in children: retrospective review of the duPont experience.

Management of pediatric parapneumonic effusions and empyema remains controversial. Treatment includes antibiotics, chest tube, fibrinolytic therapy, video-assisted thoracoscopy and debridement, and open thoracotomy and decortication. A retrospective 10-year study was done to identify patient selection variables for specific therapies.

Infant care patterns at epidemiologic study of cystic fibrosis sites that achieve superior childhood lung function.

Objective: Previous analyses of the Epidemiologic Study of Cystic Fibrosis database revealed that sites with the highest average patient lung function monitor patients and treat with antibiotics more aggressively than those where average lung function is lowest. The aim of this study was to assess whether patterns of care for infants at cystic fibrosis sites with superior average lung function in 6- to 12-year-old children showed any differences from those at the lowest outcome sites.

Methods: We divided cystic fibrosis sites with > or = 20 patients who were 6 to 12 years of age into quartiles on the basis of median forced expiratory volume in 1 second of that age group in 2003 and compared demographic and clinical characteristics and treatment patterns during the first year of enrollment for patients who were aged 0 to 3 years at those sites in 1994 to 1999.

The use of bilevel positive airway pressure for the treatment of acute chest syndrome of sickle cell disease.

Objective: To assess the outcome of bilevel positive airway pressure (BPAP) use for pediatric patients with sickle cell disease and acute chest syndrome.

Design: Retrospective chart review of 25 occurrences of acute chest syndrome in nine children from 1994 to 2000.

Setting: A tertiary care children's hospital.

Respiratory management of pediatric patients with spinal cord injuries: retrospective review of the duPont experience.

Pulmonary complications contribute to morbidity and mortality in spinal cord injuries (SCIs). A retrospective review of 20 years of experience with tracheostomy- and ventilator-dependent SCI children is presented. The authors developed and analyzed a database of 47 children (average age = 11.

The pediatric use of bilevel positive airway pressure therapy for obstructive sleep apnea syndrome: a retrospective review with analysis of respiratory parameters.

The purpose of this study was objective documentation of clinical benefits of bilevel positive airway pressure in pediatric patients with obstructive sleep apnea. We performed a retrospective chart review and data collection/analysis in a suburban tertiary care children's hospital. The study consisted of 10 pediatric patients (age range: 3 to 18 years); 3 patients had craniofacial abnormalities, 1 patient had neuromuscular disease, and 6 patients were obese.