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dc.contributor.authorByrnes, Catherine Ann
dc.contributor.authorVidmar, Suzanna
dc.contributor.authorCheney, Joyce L
dc.contributor.authorCarlin, John B
dc.contributor.authorArmstrong, David S
dc.contributor.authorCooper, Peter J
dc.contributor.authorGrimwood, Keith
dc.contributor.authorMoodie, Marj
dc.contributor.authorRobertson, Colin F
dc.contributor.authorRosenfeld, Margaret
dc.contributor.authorTiddens, Harm A
dc.contributor.authorWainwright, Claire E
dc.date.accessioned2017-05-03T13:14:22Z
dc.date.available2017-05-03T13:14:22Z
dc.date.issued2013
dc.date.modified2014-06-12T23:41:39Z
dc.identifier.issn0040-6376
dc.identifier.doi10.1136/thoraxjnl-2012-202342
dc.identifier.urihttp://hdl.handle.net/10072/60094
dc.description.abstractBackground Newborn screening allows novel treatments for cystic fibrosis (CF) to be trialled in early childhood before irreversible lung injury occurs. As respiratory exacerbations are a potential trial outcome variable, we determined their rate, duration and clinical features in preschool children with CF; and whether they were associated with growth, lung structure and function at age 5 years. Methods Respiratory exacerbations were recorded prospectively in Australasian CF Bronchoalveolar Lavage trial subjects from enrolment after newborn screening to age 5 years, when all participants underwent clinical assessment, chest CT scans and spirometry. Results 168 children (88 boys) experienced 2080 exacerbations, at an average rate of 3.66 exacerbations per person-year; 80.1% were community managed and 19.9% required hospital admission. There was an average increase in exacerbation rate of 9% (95% CI 4% to 14%; p<0.001) per year of age. Exacerbation rate differed by site (p<0.001) and was 26% lower (95% CI 12% to 38%) in children receiving 12 months of prophylactic antibiotics. The rate of exacerbations in the first 2 years was associated with reduced forced expiratory volume in 1 s z scores. Ever having a hospital-managed exacerbation was associated with bronchiectasis (OR 2.67, 95% CI 1.13 to 6.31) in chest CT scans, and lower weight z scores at 5 years of age (coefficient -0.39, 95% CI -0.74 to -0.05). Conclusions Respiratory exacerbations in young children are markers for progressive CF lung disease and are potential trial outcome measures for novel treatments in this age group.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.format.extent447237 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglish
dc.language.isoeng
dc.publisherB M J Group
dc.publisher.placeUnited Kingdom
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom643
dc.relation.ispartofpageto651
dc.relation.ispartofjournalThorax: an international journal of respiratory medicine
dc.relation.ispartofvolume68
dc.rights.retentionY
dc.subject.fieldofresearchClinical Sciences not elsewhere classified
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode110399
dc.subject.fieldofresearchcode1103
dc.titleProspective evaluation of respiratory exacerbations in children with cystic fibrosis from newborn screening to 5 years of age
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.rights.copyright© The Author(s) 2013. The attached file is reproduced here in accordance with the copyright policy of the publisher. For information about this journal please refer to the journal’s website or contact the authors.
gro.hasfulltextFull Text
gro.griffith.authorGrimwood, Keith


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