Diagnostics Section eNews

May 2011

New Features Bring Respiratory Care into the Digital Age
Your Section eNews keeps you up-to-date with studies from the medical literature, but when it comes to respiratory care, the Journal is the first place any therapist should turn for the most relevant information. Thanks to some spiffy new features, Respiratory Care is now easier to read than ever before. Take a look at what they’ve added:

A podcast with summaries of the papers
A DigiMag version you can read on your computer screen or tablet device
Papers in HTML format with cross linking to references
New papers published ahead of print

Read more about these new features HERE.

EBC pH May Identify Young Kids at Risk for Asthma
Researchers publishing ahead of print in the Journal of Allergy and Clinical Immunology on Mar. 30 find reduced deaerated exhaled breath condensate (EBC) pH value might have a role to play in identifying young asymptomatic children who are at high risk for asthma. The study was conducted among 191 children with a median age of 4.4 years who were divided into five groups: 1) asymptomatic children with recurrent wheezy bronchitis with allergic sensitization, 2) asymptomatic children with recurrent wheezy bronchitis without allergic sensitization, 3) children with acute wheezy bronchitis, 4) children with allergic rhinoconjunctivitis without recurrent wheezy bronchitis, and 5) healthy controls. Deaerated EBC pH values were significantly lower in groups 1 and 3 than in groups 2, 4, and 5. READ ABSTRACT

Early Childhood Wheezing Erases Predictive Power of Weight on FVC, FEV1
Arizona investigators find the rate of weight gain between birth and age six only predicts pulmonary function in young people who did not experience wheezing lower respiratory tract illnesses in the first three years of life. The researchers based their findings on data from 127 non-Hispanic white children taking part in the Tucson Children’s Respiratory Study. Children were measured for weight quarterly until age three and then again at age six. All had at least one pulmonary function measurement at age 16 or 22. The standardized slope of weight growth between three and six was positively associated with higher FVC and FEV1 levels at 16 and 22 only in children without preschool wheezing. The authors conclude, “The rate of weight gain between three and six years is significantly positively related to adult FVC and FEV1 and this association is modified by early wheezy phenotypes.” The study was published ahead of print by Pediatric Pulmonary on April 25. READ ABSTRACT

Foreign Body Aspiration: One Facility’s Experience
French researchers who reviewed cases involving children who were treated for foreign body (FB) aspiration in their facility between 1998 and 2010 find:

56.6% of the children were between one and three years.
Peanuts or pistachios were found in 48% of the cases.
In 73%, the FB was bronchial, and slightly more frequently on the right side (60%).
17.8% presented in emergency immediately after inhalation; 12% presented with life-threatening symptoms; 29% presented within 24 hours, and 49% were seen later than 72 hours.
In 81% of subjects, a typical penetration syndrome was found on interviewing the parents.
Physical pulmonary examination was normal in 21% of patients and chest X-ray was normal in 21.8%.
Rigid bronchoscopy was preceded by flexible bronchoscopy in 12%.
Parental underestimation of the gravity of the situation was a significant factor in delayed diagnosis.
Among the patients, 64% examined 24 hours after inhalation were initially treated for another pathology.
Delay in diagnosis and organic vs. inorganic FB did not significantly correlate with duration of bronchoscopy.
The rate of complications did not significantly increase after a 24-hour diagnostic delay threshold.

The study appeared ahead of print in the European Annuals of Otorhinolaryngology, Head and Neck Diseases on April 5. READ ABSTRACT.

Vasodilator Response to iNO Predicts Survival in PH
Pulmonary hypertension (PH) patients who respond to vasodilators enjoy improved survival. That’s the take home message from Cleveland Clinic researchers who followed 214 consecutive treatment-naïve patients referred for evaluation between 1998 and 2008. All were assessed for vasoreactivity via inhalation of 40 parts per million nitric oxide. Results showed vasodilator responders were more likely to survive regardless of whether they had idiopathic or nonidiopathic PH or Dana Point class 1 or non-Dana Point class 1 disease. “Vasodilator responsiveness to iNO is an important method of risk stratifying PH patients, with results that apply regardless of clinical etiology,” conclude the investigators. The study was published in the April issue of the Journal of Cardiac Failure. READ ABSTRACT