Background
Spirometry is conventionally used to diagnose airway diseases in children with sickle cell disease (C‐SCD). However, spirometry is difficult for younger children to perform, is effort dependent, and it provides limited information on respiratory mechanics. Impulse oscillometry (IOS) is an effort‐independent pulmonary function test (PFT), which measures total airway resistance (R5Hz) and reactance (AX). IOS could be advantageous without certain limitations of spirometry.
Aim
To compare the accuracy of IOS vs spirometry in making the diagnosis of asthma and assessing age‐related pulmonary changes in C‐SCD.
Study design
Retrospective chart review.
Subject selection
Fifty‐six C‐SCD and thirty‐six controls (asthmatics without SCD) followed at Penn State with PFTs obtained during the initial pulmonary evaluation.
Methodology
We grouped C‐SCD into asthmatics and non‐asthmatics based on pre‐referral diagnosis and compared PFTs between two groups. Receiver operating characteristic (ROC) curve analyses and machine learning tools (XGBoost and artificial neural network) were used to rank the spirometry and IOS measures based on their ability to predict a diagnosis of asthma. Robust linear regression was used to analyze association among height/age with various PFT measures.
Results
Both ROC and XGBoost indicated that FEF25‐75%, forced expiratory volume in 1 second (FEV1)/forced vital capacity, and R5Hz(%) were the top three predictors for asthma diagnosis. R5Hz(%) and AX had superior bronchodilator response (BDR) than FEV1. IOS parameters had significant association with height/age in C‐SCD (possibly due to the stiff lungs) but not in controls.
Conclusion
IOS had advantages over spirometry in C‐SCD because it is feasible in early childhood, provides insights into the pulmonary mechanics, and is more sensitive to detect BDR.
The American Academy of Pediatrics has previously expressed concerns about the thematic content of television (TV) and the amount of time children spend viewing TV. The objective of this study was to determine the positive and negative themes depicted in a select number of TV shows targeted toward adolescents. We analyzed the thematic content depicted in the first season of 26 Netflix TV shows. The mean occurrences/h for positive and negative themes were 39.53 and 47.20, respectively. The most common positive themes were “encouragement from a friend/peer,” “demonstrating honesty,” and “staying true to oneself” (5.98, 5.38, and 3.72 mean occurrences/h, respectively). The most common negative themes were “dishonesty,” “cursing,” and “selfishness,” (5.30, 4.96, and 4.85 mean occurrences/h, respectively). We suggest that health care providers become aware of TV thematic content and promote media education, and we encourage co-viewing and active mediation by parents/guardians with their children.
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