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AIM: In this review, we aim to describe how exhaled Nitric Oxide(NO) changes during the first months of life in premature and mature infants.METHOD: Review of the literature up to August 2020, on online, tidal breathing NO measurements in unsedated infants. The association between Fractional exhaled NO(FeNO) values, postnatal age, and prematurity was analysed using linear mixed modeling and Spearman's rank correlation.RESULTS: Median FeNO during the first months of life was 5.9 and 8.5 ppb in premature and mature infants, respectively. The linear mixed model analysis showed a significant effect of postnatal age on FeNO (p = 0.007).CONCLUSION: Our study suggests that FeNO is higher in mature infants than premature infants, and FeNO increased with postnatal age at approximately the same pace in both groups.

Background: Esophageal atresia (EA) is a congenital anomaly associated with substantial pulmonary morbidity throughout childhood. Aim: The aim of this study was to evaluate pulmonary complications among 59 five to 15-year-old children and adolescents with surgically corrected congenital EA. Methods: Participants underwent a structured interview, spirometry, body plethysmography, mannitol challenge test, skin prick test, as well as measurements of the diffusion capacity, airway resistance, fraction of exhaled NO, and specific immunoglobulin E in serum. A control group consisted of 25 children being evaluated for gastroesophageal reflux disease. Results: Among the EA patients 33 (55.9%) had respiratory symptoms, 31 (53.4%) had a history of at least three pneumonias, and 32 (54.2%) reported more frequent cough episodes than peers. The Forced Vital Capacity (FVC) was 84.9% ± 13.2% of predicted, forced expiratory volume 1 sec (FEV1) was 78.2% ± 12.4% of predicted, and forced expiratory fraction 25–75% (FEF25–75%) was 71.5 ± 17.8% of predicted in EA patients, lower than disease controls (P < 0.0001 for all). In addition, the total lung capacity (TLC) was lower in patients with EA than in the controls (P < 0.0001). Fifteen patients (28.8%) with EA had obstructive ventilatory impairment, compared to nine patients (17.3%) with restrictive ventilatory impairment, while one had a combination. Conclusions: The present study demonstrated significantly decreased pulmonary characteristics in EA patients. Restrictive ventilatory impairment occurring in EA is probably due to poor lung growth after thoracotomy. No single factor predicted ventilatory impairment in children and adolescents with EA. Pediatr Pulmonol. 2017;52:98–106.

Vibeke Backer,1 Jesper Lykkegaard,2 Uffe Bodtger,3,4 Lone Agertoft,5 Lene Korshoej,6 Elvira Vaclavik Braüner7,8 1Department of Respiratory Medicine L, Bispebjerg Frederiskberg University Hospital, Copenhagen, 2Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 3Department of Respiratory Medicine, Næstved Hospital, Næstved, 4Institute of Regional Health Research, University of Southern Denmark, 5Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, 6Competence Centre for Clinical Quality and Information Technology West (KCKS West), Aarhus, 7Research Center for Prevention and Health, Center for Health, Glostrup Hospital, Capital Region of Denmark, Glostrup, 8Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Capital Region of Denmark, Copenhagen, Denmark Aim of the database: Asthma is the most prevalent chronic disease in children, adolescents, and young adults. In Denmark (with a population of 5.6 million citizens), >400,000 persons are prescribed antiasthmatic medication annually. However, undiagnosed cases, dubious diagnoses, and poor asthma management are probably common. The Danish National Database for Asthma (DNDA) was established in 2015. The aim of the DNDA was to collect the data on all patients treated for asthma in Denmark and to monitor asthma occurrence, the quality of diagnosis, and management. Study population: Persons above the age of 6 years, with a specific focus on 6–44 years, are included. The DNDA links three existing nationwide registries of administrative records in the Danish health care system: the National Patient Register, the National Health Insurance Services Register, and the National Prescription Registry. For each year, the inclusion criteria are a second purchase of asthma prescription medicine within a 2-year period (National Prescription Registry) or a diagnosis of asthma (National Patient Register). Patients with chronic obstructive pulmonary disease are excluded, but smokers are not excluded. Descriptive data: A total of 366,471 prevalent patients with asthma have been identified (year 2014 – as a preliminary test search). This number is in agreement with the estimates of ~400,000 inhabitants that are available for patients with possible asthma in Denmark. Data encompass the following quality indicators: annual asthma control visits and pharmacological therapy. Main variables: The variables included are spirometry, as well as tools for diagnosis (including allergy testing), smoking status, height, weight, and acute hospital admissions and unscheduled visits. Conclusion: DNDA is available from January 1, 2016. Keywords: indicator, asthma control, asthma management, prescription data, hospital data

AIM OF THE DATABASE: Asthma is the most prevalent chronic disease in children, adolescents, and young adults. In Denmark (with a population of 5.6 million citizens), >400,000 persons are prescribed antiasthmatic medication annually. However, undiagnosed cases, dubious diagnoses, and poor asthma management are probably common. The Danish National Database for Asthma (DNDA) was established in 2015. The aim of the DNDA was to collect the data on all patients treated for asthma in Denmark and to monitor asthma occurrence, the quality of diagnosis, and management.STUDY POPULATION: Persons above the age of 6 years, with a specific focus on 6-44 years, are included. The DNDA links three existing nationwide registries of administrative records in the Danish health care system: the National Patient Register, the National Health Insurance Services Register, and the National Prescription Registry. For each year, the inclusion criteria are a second purchase of asthma prescription medicine within a 2-year period (National Prescription Registry) or a diagnosis of asthma (National Patient Register). Patients with chronic obstructive pulmonary disease are excluded, but smokers are not excluded.DESCRIPTIVE DATA: A total of 366,471 prevalent patients with asthma have been identified (year 2014 - as a preliminary test search). This number is in agreement with the estimates of ~400,000 inhabitants that are available for patients with possible asthma in Denmark. Data encompass the following quality indicators: annual asthma control visits and pharmacological therapy.MAIN VARIABLES: The variables included are spirometry, as well as tools for diagnosis (including allergy testing), smoking status, height, weight, and acute hospital admissions and unscheduled visits.CONCLUSION: DNDA is available from January 1, 2016.

Mastocytosis is a heterogeneous disease with an increased number and activation of mast cells. Subtypes range from benign to rare aggressive forms, and the disease may affect people of all ages. The pathogenesis involves mutations in the KIT gene in both children and adult patients. Estimated prevalence is one per 10,000, but the disease is very likely underdiagnosed. The diagnosis may be challenging and patients may present to several medical specialties. This article presents an overview of clinical signs and symptoms as well as a diagnostic algorithm and treatment options of mastocytosis.

UNLABELLED: Theme: Complex health care and chronic disease management.BACKGROUND: Evidence supports that group educational interventions improve self-perception, self-confidence and attack management in asthma care.AIM: To evaluate education and structured dialogue in enhancing knowledge and insight in the asthma disease, treatment with omalizumab and social behaviour.METHOD: A group of four 13-16-year-olds received education using question and answer cards, and were informed about the effects and adverse effects of omalizumab. The dialogue included life before and after, relation to family and friends, ability and lack of ability to perform physical activities, and dreams of the future. One week later there was a telephone interview.RESULTS: All four adolescents experienced a positive change in everyday life and ability to manage the asthma disease. Furthermore, they all experienced an enhanced physical ability. In the interview they reflected on their own disease and physical ability.CONCLUSION: Adolescents with a chronic disease benefit from sharing thoughts, emotions and knowledge about their disease and treatment.

Background:Research has shown that being born preterm may affect lung capacity later in childhood. It is though unknown if type of early nutrition influences lung capacity and the risk of developing asthma in childhood.Aim:The aim was to investigate if type of early nutrition has an impact on lung function and the possible risk of developing asthma among 6 year old children born very preterm.Method:A prospective, randomized, interventional multicentre study on nutrition of a preterm birth cohort has been established and described previously. The inclusion criteria were gestational age ≤ 32 weeks. From hospital discharge to 4 month corrected age, the children received three different types of nutrition: A: Human milk (HM) B: HM enriched with fortifier (HMF) C: Preterm formula (PF). At the age of 6 years, the children performed an occlusion test (Rocc) and a lung resistance test (SRtot). The mean of both Rocc and SRtot was calculatedResults:277 children are included in this project. So far 111 children have performed the lung function tests (Group A: 37 B: 35 C: 39 respectively). The results from the Rocc-test were very similar comparing the groups with no significant differences: A: 1.05 B: 1.05 C: 1.04 (kPa*s/L);. The SRtot test showed that group B and C had a significant lower value compared to group A: A 1.21 B: 0.98 C: 1.01 (kPa*s). P-value = 0,007 when comparing A and C, and p-value = 0,03 when A compares to B. Conclusion:This preliminary result indicates that airway resistance was within normal range for all children no mater post discharge nutrition. And there was a tendency towards a lower airway resistance among infants fed with formula or nutrient enriched human milk compared to infants fed exclusively human milk post discharge.

Background Very preterm born infants receive nutrition that ensures optimal growth during the neonatal period. New research has shown that the type of nutrition in early life may affect not only growth but also later body composition and risk of developing metabolic syndrome. Aim • To evaluate if type of nutrition in early life effects the body composition in later life among very preterm born children Method In 2004-08 a birth cohort of very preterm born infants with a gestational age ≤32+0 weeks. At time of hospital discharge, the infants were randomised into 3 different feeding groups. If possible to breastfeed, the infant was randomised to one of two groups • Breastfeeding solely (human milk) • Breastfeeding enriched with fortification (human milk fortifier) If breastfeeding was not possible the infant received • Preterm formula. They were all fed the specific nutrition from discharge to 4 month corrected age. At 6 years, a dexa scan was performed to evaluate body composition. Results A total number of 277 infants will be invited to follow up at 6 years of age. So far 79 children have had a dexa scan performed (HM 26, HMF: 22 and PF: 31). Fat mass (FM) and muscle mass (MM) was measured. Fat mass in both the HMF and PF groups was higher compared to the HM group (p

Background:New research has shown that type of nutrition in early life may affect not only growth but also later body composition and risk of developing metabolic syndrome.Method: A prospective, randomized, interventional multicentre trial on nutrition of a preterm birth cohort has been established and described previously2. Inclusion criteria were gestational age ≤32+0 weeks. From hospital discharge to 4 month corrected aged, the infants received 3 different types of nutrition: A: human milk (HM) B: HM enriched with fortifier C: preterm formula. At 6 years of age, a dexa scan was performed to evaluate body composition.Results:277 infants were included, 79 children are investigated now. (A: 26, B: 22 and C: 31). Fat mass (FM) and muscle mass (MM) was measured. FM was highest in group C (formula), and lowest in group A (HM) (A: 15,4%, B: 18,2%, C: 19,7%). The same pattern was found for FM in grams: 3270(A), 3914(B) and 4515(C). FM for group C was higher than group A (pConclusion:It seems that HM is the preferable nutrition for preterm born children if a lower fat mass and higher muscle mass is regarded optimal. The results are not all significant, which might be due to the small sample size. Investigations of the remaining infants are awaited.