Common respiratory symptoms and illnesses: a graded evidence-based approach
Gespeichert in:
| Weitere Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa.
Saunders
2009
|
| Schriftenreihe: | Pediatric clinics of North America
56,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVI, 315 S. Ill., graph. Darst. |
| ISBN: | 1416057951 9781416057956 |
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| 245 | 1 | 0 | |a Common respiratory symptoms and illnesses |b a graded evidence-based approach |c guest ed. Anne B. Chang |
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| adam_text | Common Respiratory Symptoms and Illnesses: A Graded Evidence-Based Approach
Contents
Preface xv
Anne B. Chang
System Based Approach
Respiratory Noises: How Useful are They Clinically? 1
Craig Mellis
Although clinicians place considerable weight on the identification of the
various forms of noisy breathing, there are serious questions regarding
both the accuracy (validity) and the reliability (repeatability) of these noises.
To avoid diagnostic errors, clinicians need to consider the whole constel¬
lation of symptoms and signs, and not focus on the specific type of
noise. Given the high error rate with parent-reported wheeze there is
a need to reexamine the extensive literature on the epidemiology of
wheeze in infants and young children, because parent-reported wheeze
is unconfirmed by a clinician. It is obvious we need more high-quality re¬
search evidence to derive better evidence on the clinical utility of these
noises, and their natural history.
Cough 19
Anne B. Chang
The management of cough in children should be etiologically based. This
requires that all children with cough should be carefully evaluated and
managed differently than adults because the etiologic factors and treat¬
ment in children are significantly different than that in adults. In all children
with cough, exacerbation factors should be sought and intervention
options for cessation advised or initiated. Parental expectations and spe¬
cific concerns should also be sought and addressed.
Perceptions and Pathophysiology of Dyspnea and Exercise Intolerance 33
Miles Weinberger and Mutasim Abu-Hasan
Dyspnea is a complex psychophysiologic sensation that requires intact
afferent and efferent pathways for the full perception of the neuromechan-
ical dissociation between the respiratory effort attempted and the work
actually accomplished. The sensation is triggered or accentuated by a va¬
riety of receptors located in the chest wall, respiratory muscles, lung
parenchyma, carotid body, and brain stem. The sensation of dyspnea is
stronger in patients with higher scores for anxiety and has been reported
in patients with anxiety disorders with no cardiopulmonary disease. These
observations demonstrate the importance of cerebral cognition in this
complex symptom. Ten cases are presented that illustrate different clinical
manifestations of dyspnea.
x Contents
Chest Pain and Chest Wall Deformity 49
Janaki Gokhale and Steven M. Selbst
Chest pain and chest wall deformities are common in children. Although
most children with chest pain have a benign diagnosis, some have a serious
etiology for pain, so the complaint must be addressed carefully. Unfortu¬
nately, there are few prospective studies to evaluate this complaint in chil¬
dren. Serious causes for chest pain are rare, making it difficult to develop
clear guidelines for evaluation and management. The child who appears
well, has a normal physical examination, and lacks worrisome history
deserves reassurance and careful follow-up rather than extensive studies.
Multicenter studies are needed to better define this important symptom.
Recurrent Respiratory Infections 67
Andrew Bush
The child who has recurrent infections poses one of the most difficult diag¬
nostic challenges in pediatrics. The clinician faces a two-fold challenge in
determining first whether the child is normal or has a serious disease, and
then, in the latter case, how to confirm or exclude the diagnosis with the
minimum number of the least invasive tests. It is hoped that, in the absence
of good-quality evidence for most clinical scenarios, the experience-based
approach described in this article may prove a useful guide to the clinician.
Disease Based Approach
Upper Respiratory Tract Infections (Including Otitis Media) 101
Peter S. Morris
Upper respiratory tract infections (including otitis media) are the most com¬
mon illnesses affecting children. Most illnesses are mild and resolve com¬
pletely without specific treatment, but the frequency of infection and
association with fever and constitutional symptoms creates significant dis¬
tress for the child and the family. By understanding the evidence available
from high-quality studies, the clinician can advise the families on appropri¬
ate action. The goal of this article is to support clinicians in answering the
following questions: (1) What happened to children with these conditions
when no additional treatment was provided? (2) Which interventions have
been assessed in well-designed studies? (3) Which interventions have
been shown to improve outcomes? (4) How large is the overall benefit?
Acute Bronchiolitis and Croup 119
Mark L. Everard
Croup and acute bronchiolitis are common forms of virally induced respi¬
ratory disease in infancy and early childhood. There is good evidence that
corticosteroids can ameliorate disease severity and alter the natural his¬
tory of symptoms in patients who have croup and that temporary symp¬
tomatic benefit can be obtained from the use of nebulized adrenaline.
Contents xi
The principle weakness when reviewing therapeutic interventions for acute
bronchiolitis is the lack of a clear diagnostic test or definition. Current
evidence suggests that oxygen is the only useful pharmacologic agent
for correcting hypoxia.
Pneumonia and Other Respiratory Infections 135
Sarath C. Ranganathan and Samatha Sonnappa
Pneumonia is a leading killer of children in developing countries and results
in significant morbidity worldwide. This article reviews the management of
pneumonia and its complications from the perspective of both developed
and resource-poor settings. In addition, evidence-based management of
other respiratory infections, including tuberculosis, is discussed. Finally,
the management of common complications of pneumonia is reviewed.
Bronchiectasis in Children 157
Gregory J. Redding
Bronchiectasis is a chronic disease of the conducting airways that pro¬
duces persistent productive cough, recurrent respiratory infectious exac¬
erbations, and obstructive lung disease in children and adults. This article
focuses on the grading and recommendations for chronic therapies of
bronchiectasis caused by cystic fibrosis (CF)- and non-CF-related condi¬
tions. The scope of this article is to focus on outpatient treatment and not
include as-needed treatment for mild or severe pulmonary exacerbations
associated with bronchiectasis.
Aspiration Lung Disease 173
Fernando M. de Benedictis, Virgilio P. Carnielli, and Diletta de Benedictis
The term aspiration lung disease describes several clinical syndromes,
with massive aspiration and chronic lung aspiration being at two extremes
of the clinical spectrum. Over the years, significant advances have been
made in understanding the mechanisms underlying dysphagia, gastro-
esophageal function, and airway protective reflexes and new diagnostic
techniques have been introduced. Despite this, characterizing the pres¬
ence or absence of aspiration, and under what circumstances a child
might be aspirating what, is extremely challenging. Many children are still
not adequately diagnosed or treated for aspiration until permanent lung
damage has occurred. A multidisciplinary approach is mandatory for a cor¬
rect diagnosis in addition to timely and appropriate care.
xii Contents
Asthma in Childhood 191
Paul D. Robinson and Peter Van Asperen
Management decisions for pediatric asthma (in patients younger than 12
years of age) based on extrapolation from available evidence in adolescents
and adults (age 12 years and older) is common but rarely appropriate. This
article addresses the disparity in response between the two age groups,
presents the available pediatric evidence, and highlights the important
areas in which further research is required. Evidence-based recommenda¬
tions for acute and interval management of pediatric asthma are provided.
Congenital Airway Lesions and Lung Disease 227
Ian Brent Masters
Structural upper and lower airway disorders and parenchymal disorders
are uncommon in pediatric practice, but many pediatricians will encounter
them and be responsible for the ongoing care of these patients. Pediatri¬
cians need to be cognizant of these diagnoses because, even though
management of these disorders generally lacks an evidence base, existing
principles of good care surrounding accurate diagnosis, classifications of
severity, judicious use of investigations, medication, and surgical ap¬
proaches are essential to good outcomes.
Obstructive Sleep Breathing Disorders 243
Chung Ting Au and Albert Martin Li
Obstructive sleep apnea (OSA) is increasingly recognized in children. There
is accumulating robust evidence to support early diagnosis and treatment
of this condition. The purpose of this review is to provide an update on
the epidemiology, clinical features, complications, and treatment of child¬
hood OSA. The authors have also proposed an easy-to-follow flowchart
on the management of children with snoring or sleep disturbance for clinical
use by busy pediatricians.
Chronic Respiratory Failure and Neuromusclar Disease 261
J. Declan Kennedy and A. James Martin
The outlook for children with respiratory complications of neuromuscular
disease has improved significantly in the past 15 years. This has been
the result of many advances in clinical care, including improved monitoring
of lung function and hypoventilation during sleep; coordinated respiratory
care by experienced physicians with access to specialized respiratory ser¬
vices, especially physiotherapy; and, most importantly, the widespread
introduction of noninvasive ventilation.
Contents xiii
Domiciliary Oxygen for Children 275
Ian M. Balfour-Lynn
Domiciliary oxygen is used increasingly in pediatric practice, and the larg¬
est patient group to receive it is ex-premature babies with chronic neonatal
lung disease. Because of a scarcity of good evidence to inform clinicians,
there is a lack of consensus over many issues, even those as fundamental
as the optimum target oxygen saturation. Nevertheless, many children
benefit from receiving supplemental oxygen at home, particularly because
it helps to keep them out of the hospital.
Index 297
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| dewey-search | 618.922 |
| dewey-sort | 3618.922 |
| dewey-tens | 610 - Medicine and health |
| discipline | Medizin |
| format | Book |
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| spelling | Common respiratory symptoms and illnesses a graded evidence-based approach guest ed. Anne B. Chang Philadelphia, Pa. Saunders 2009 XVI, 315 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Pediatric clinics of North America 56,1 Child Respiratory Tract Diseases diagnosis Respiratory Tract Diseases therapy Respiratory infections Respiratory organs Diseases Atemwegskrankheit (DE-588)4003360-0 gnd rswk-swf Kind (DE-588)4030550-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Kind (DE-588)4030550-8 s Atemwegskrankheit (DE-588)4003360-0 s DE-604 Chang, Anne B. edt Pediatric clinics of North America 56,1 (DE-604)BV000001093 56,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017168912&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Common respiratory symptoms and illnesses a graded evidence-based approach Pediatric clinics of North America Child Respiratory Tract Diseases diagnosis Respiratory Tract Diseases therapy Respiratory infections Respiratory organs Diseases Atemwegskrankheit (DE-588)4003360-0 gnd Kind (DE-588)4030550-8 gnd |
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| title | Common respiratory symptoms and illnesses a graded evidence-based approach |
| title_auth | Common respiratory symptoms and illnesses a graded evidence-based approach |
| title_exact_search | Common respiratory symptoms and illnesses a graded evidence-based approach |
| title_full | Common respiratory symptoms and illnesses a graded evidence-based approach guest ed. Anne B. Chang |
| title_fullStr | Common respiratory symptoms and illnesses a graded evidence-based approach guest ed. Anne B. Chang |
| title_full_unstemmed | Common respiratory symptoms and illnesses a graded evidence-based approach guest ed. Anne B. Chang |
| title_short | Common respiratory symptoms and illnesses |
| title_sort | common respiratory symptoms and illnesses a graded evidence based approach |
| title_sub | a graded evidence-based approach |
| topic | Child Respiratory Tract Diseases diagnosis Respiratory Tract Diseases therapy Respiratory infections Respiratory organs Diseases Atemwegskrankheit (DE-588)4003360-0 gnd Kind (DE-588)4030550-8 gnd |
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