Desmond W. Cox

Longitudinal assessment of airway responsiveness from 1 month to 18 years in the PIAF birth cohort

The Perth Infant Asthma Follow-up (PIAF) study involves a birth cohort of unselected subjects who have undergone longitudinal assessments of airway responsiveness at 1, 6 and 12 months and 6, 11 and 18 years of age. The aim of this study was to determine the relationship between increased airway responsiveness throughout childhood and asthma in early adult life. Airway responsiveness to histamine, assessed as a dose–response slope (DRS), and a respiratory questionnaire were completed at 1, 6 and 12 months and 6, 11 and 18 years of age. 253 children were initially recruited and studied. Airway responsiveness was assessed in 203, 174, 147, 103, 176 and 137 children at the above-mentioned time points, respectively (39 participants being assessed on all test occasions). Asthma at 18 years was associated with increased airway responsiveness at 6, 12 and 18 years, but not during infancy (slope 0.24, 95% CI 0.06–0.42; p=0.01; slope 0.25, 95% CI 0.08–0.49; p=0.006; and slope 0.56, 95% CI 0.29–0.83; p<0.001, respectively). Increased airway responsiveness and its association with asthma at age 18 years is established between infancy and 6 years. We propose that airway responsiveness in early life reflects the initial airway geometry and airway responsiveness later in childhood increasingly reflects immunological responses to environmental influences. Early-life airway responsiveness is related to inherent factors; later, environmental exposures have greater effect http://ow.ly/PDmWm

Multicentre chest computed tomography standardisation in children and adolescents with cystic fibrosis: The way forward

Progressive cystic fibrosis (CF) lung disease is the main cause of mortality in CF patients. CF lung disease starts in early childhood. With current standards of care, respiratory function remains largely normal in children and more sensitive outcome measures are needed to monitor early CF lung disease. Chest CT is currently the most sensitive imaging modality to monitor pulmonary structural changes in children and adolescents with CF. To quantify structural lung disease reliably among multiple centres, standardisation of chest CT protocols is needed. SCIFI CF (Standardised Chest Imaging Framework for Interventions and Personalised Medicine in CF) was founded to characterise chest CT image quality and radiation doses among 16 participating European CF centres in 10 different countries. We aimed to optimise CT protocols in children and adolescents among several CF centres. A large variety was found in CT protocols, image quality and radiation dose usage among the centres. However, the performance of all CT scanners was found to be very similar, when taking spatial resolution and radiation dose into account. We conclude that multicentre standardisation of chest CT in children and adolescents with CF can be achieved for future clinical trials. Multicentre chest CT standardisation is necessary and feasible to maximise image quality and reduce radiationhttp://ow.ly/ZfsaE

Rhinovirus is the most common virus and rhinovirus-C is the most common species in paediatric intensive care respiratory admissions

Acute respiratory illnesses (ARIs) account for 10–15% of all admissions to the paediatric intensive care unit (PICU) [1]. Historically, respiratory syncytial virus was reported to be the most common viral pathogen resulting in admission to the PICU [2]. Recent studies, using more sensitive molecular techniques, have shown that rhinoviruses may be the most frequent virus detected in respiratory admissions to a PICU [3–5]. This is first report to examine the role of different RV species in ARIs in children admitted to paediatric ICU. Our study found that RV-C is the most common RV species in paediatric intensive care respiratory admissions. http://ow.ly/P6EN30k9UnX