Pathogen screening and prognostic factors in children with severe ARDS of pulmonary origin
Identifieur interne : 000380 ( Pmc/Checkpoint ); précédent : 000379; suivant : 000381Pathogen screening and prognostic factors in children with severe ARDS of pulmonary origin
Auteurs : Thuy Thi Bich Phung ; Tadaki Suzuki ; Phuc Huu Phan ; Shoji Kawachi ; Hiroyuki Furuya ; Huong Thu Do ; Tsutomu Kageyama ; Tuan Anh Ta ; Nam Huu Dao ; Hiroyuki Nunoi ; Dien Minh Tran ; Hai Thanh Le ; Noriko NakajimaSource :
- Pediatric Pulmonology [ 8755-6863 ] ; 2017.
Abstract
Acute respiratory distress syndrome (ARDS) is one of the most lethal diseases encountered in the pediatric intensive care unit (PICU). The etiological pathogens and prognostic factors of severe ARDS of pulmonary origin in children with respiratory virus infections were prospectively investigated.
Enrolled children fulfilled the following criteria: (1) PICU admission; (2) age of 1 month to 16 years; (3) diagnosis of infectious pneumonia and respiratory virus infection; and (4) development of severe ARDS within 72 h after PICU admission. Pathogens were detected in the blood and tracheal lavage fluid using molecular techniques and a conventional culture system. The serum levels of inflammatory mediators on the day of PICU admission were examined.
Fifty‐seven patients (32 boys; median age, 9 months) were enrolled. Multiple virus infections, co‐infection with bacteria/fungus, and bacteremia/fungemia were observed in 60%, 49%, and 32% of children, respectively. Adenovirus‐B, measles virus, and cytomegalovirus were detected predominantly in tracheal lavage fluid. There were no statistically significant differences between non‐survivors and survivors regarding the types of pathogen, incidence of multiple virus infection, gender, age, clinical features, and treatment. The serum levels of interferon (IFN)‐γ and the IFN‐γ/interleukin (IL)‐10 ratio were higher in non‐survivors.
IFN‐γ upregulation as detected on the day of PICU admission was found to be one of the possible prognostic factors affecting a fatal outcome. These results suggest that modulation of inflammatory responses is critical for the clinical management of children with ARDS.
Url:
DOI: 10.1002/ppul.23694
PubMed: 28703486
PubMed Central: 5697698
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id="ppul23694-aff-0004"></nlm:aff></affiliation></author><author><name sortKey="Furuya, Hiroyuki" sort="Furuya, Hiroyuki" uniqKey="Furuya H" first="Hiroyuki" last="Furuya">Hiroyuki Furuya</name><affiliation><nlm:aff id="ppul23694-aff-0005"></nlm:aff></affiliation></author><author><name sortKey="Do, Huong Thu" sort="Do, Huong Thu" uniqKey="Do H" first="Huong Thu" last="Do">Huong Thu Do</name><affiliation><nlm:aff id="ppul23694-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Kageyama, Tsutomu" sort="Kageyama, Tsutomu" uniqKey="Kageyama T" first="Tsutomu" last="Kageyama">Tsutomu Kageyama</name><affiliation><nlm:aff id="ppul23694-aff-0006"></nlm:aff></affiliation></author><author><name sortKey="Ta, Tuan Anh" sort="Ta, Tuan Anh" uniqKey="Ta T" first="Tuan Anh" last="Ta">Tuan Anh Ta</name><affiliation><nlm:aff id="ppul23694-aff-0003"></nlm:aff></affiliation></author><author><name sortKey="Dao, Nam Huu" sort="Dao, Nam Huu" uniqKey="Dao N" first="Nam Huu" last="Dao">Nam Huu Dao</name><affiliation><nlm:aff id="ppul23694-aff-0003"></nlm:aff></affiliation></author><author><name sortKey="Nunoi, Hiroyuki" sort="Nunoi, Hiroyuki" uniqKey="Nunoi H" first="Hiroyuki" last="Nunoi">Hiroyuki Nunoi</name><affiliation><nlm:aff id="ppul23694-aff-0007"></nlm:aff></affiliation></author><author><name sortKey="Tran, Dien Minh" sort="Tran, Dien Minh" uniqKey="Tran D" first="Dien Minh" last="Tran">Dien Minh Tran</name><affiliation><nlm:aff id="ppul23694-aff-0008"></nlm:aff></affiliation></author><author><name sortKey="Le, Hai Thanh" sort="Le, Hai Thanh" uniqKey="Le H" first="Hai Thanh" last="Le">Hai Thanh Le</name><affiliation><nlm:aff id="ppul23694-aff-0009"></nlm:aff></affiliation></author><author><name sortKey="Nakajima, Noriko" sort="Nakajima, Noriko" uniqKey="Nakajima N" first="Noriko" last="Nakajima">Noriko Nakajima</name><affiliation><nlm:aff id="ppul23694-aff-0002"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno 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Phung</name><affiliation><nlm:aff id="ppul23694-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Suzuki, Tadaki" sort="Suzuki, Tadaki" uniqKey="Suzuki T" first="Tadaki" last="Suzuki">Tadaki Suzuki</name><affiliation><nlm:aff id="ppul23694-aff-0002"></nlm:aff></affiliation></author><author><name sortKey="Phan, Phuc Huu" sort="Phan, Phuc Huu" uniqKey="Phan P" first="Phuc Huu" last="Phan">Phuc Huu Phan</name><affiliation><nlm:aff id="ppul23694-aff-0003"></nlm:aff></affiliation></author><author><name sortKey="Kawachi, Shoji" sort="Kawachi, Shoji" uniqKey="Kawachi S" first="Shoji" last="Kawachi">Shoji Kawachi</name><affiliation><nlm:aff id="ppul23694-aff-0004"></nlm:aff></affiliation></author><author><name sortKey="Furuya, Hiroyuki" sort="Furuya, Hiroyuki" uniqKey="Furuya H" first="Hiroyuki" last="Furuya">Hiroyuki Furuya</name><affiliation><nlm:aff id="ppul23694-aff-0005"></nlm:aff></affiliation></author><author><name sortKey="Do, Huong Thu" sort="Do, Huong Thu" uniqKey="Do H" first="Huong Thu" last="Do">Huong Thu Do</name><affiliation><nlm:aff id="ppul23694-aff-0001"></nlm:aff></affiliation></author><author><name sortKey="Kageyama, Tsutomu" sort="Kageyama, Tsutomu" uniqKey="Kageyama T" first="Tsutomu" last="Kageyama">Tsutomu Kageyama</name><affiliation><nlm:aff id="ppul23694-aff-0006"></nlm:aff></affiliation></author><author><name sortKey="Ta, Tuan Anh" sort="Ta, Tuan Anh" uniqKey="Ta T" first="Tuan Anh" last="Ta">Tuan Anh Ta</name><affiliation><nlm:aff id="ppul23694-aff-0003"></nlm:aff></affiliation></author><author><name sortKey="Dao, Nam Huu" sort="Dao, Nam Huu" uniqKey="Dao N" first="Nam Huu" last="Dao">Nam Huu Dao</name><affiliation><nlm:aff id="ppul23694-aff-0003"></nlm:aff></affiliation></author><author><name sortKey="Nunoi, Hiroyuki" sort="Nunoi, Hiroyuki" uniqKey="Nunoi H" first="Hiroyuki" last="Nunoi">Hiroyuki Nunoi</name><affiliation><nlm:aff id="ppul23694-aff-0007"></nlm:aff></affiliation></author><author><name sortKey="Tran, Dien Minh" sort="Tran, Dien Minh" uniqKey="Tran D" first="Dien Minh" last="Tran">Dien Minh Tran</name><affiliation><nlm:aff id="ppul23694-aff-0008"></nlm:aff></affiliation></author><author><name sortKey="Le, Hai Thanh" sort="Le, Hai Thanh" uniqKey="Le H" first="Hai Thanh" last="Le">Hai Thanh Le</name><affiliation><nlm:aff id="ppul23694-aff-0009"></nlm:aff></affiliation></author><author><name sortKey="Nakajima, Noriko" sort="Nakajima, Noriko" uniqKey="Nakajima N" first="Noriko" last="Nakajima">Noriko Nakajima</name><affiliation><nlm:aff id="ppul23694-aff-0002"></nlm:aff></affiliation></author></analytic><series><title level="j">Pediatric Pulmonology</title><idno type="ISSN">8755-6863</idno><idno type="eISSN">1099-0496</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec id="ppul23694-sec-0001"><title>Background</title><p>Acute respiratory distress syndrome (ARDS) is one of the most lethal diseases encountered in the pediatric intensive care unit (PICU). The etiological pathogens and prognostic factors of severe ARDS of pulmonary origin in children with respiratory virus infections were prospectively investigated.</p></sec><sec id="ppul23694-sec-0002"><title>Methods</title><p>Enrolled children fulfilled the following criteria: (1) PICU admission; (2) age of 1 month to 16 years; (3) diagnosis of infectious pneumonia and respiratory virus infection; and (4) development of severe ARDS within 72 h after PICU admission. Pathogens were detected in the blood and tracheal lavage fluid using molecular techniques and a conventional culture system. The serum levels of inflammatory mediators on the day of PICU admission were examined.</p></sec><sec id="ppul23694-sec-0003"><title>Results</title><p>Fifty‐seven patients (32 boys; median age, 9 months) were enrolled. Multiple virus infections, co‐infection with bacteria/fungus, and bacteremia/fungemia were observed in 60%, 49%, and 32% of children, respectively. Adenovirus‐B, measles virus, and cytomegalovirus were detected predominantly in tracheal lavage fluid. There were no statistically significant differences between non‐survivors and survivors regarding the types of pathogen, incidence of multiple virus infection, gender, age, clinical features, and treatment. The serum levels of interferon (IFN)‐γ and the IFN‐γ/interleukin (IL)‐10 ratio were higher in non‐survivors.</p></sec><sec id="ppul23694-sec-0004"><title>Conclusions</title><p>IFN‐γ upregulation as detected on the day of PICU admission was found to be one of the possible prognostic factors affecting a fatal outcome. These results suggest that modulation of inflammatory responses is critical for the clinical management of children with ARDS.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Pediatr Pulmonol</journal-id><journal-id journal-id-type="iso-abbrev">Pediatr. Pulmonol</journal-id><journal-id journal-id-type="doi">10.1002/(ISSN)1099-0496</journal-id><journal-id journal-id-type="publisher-id">PPUL</journal-id><journal-title-group><journal-title>Pediatric Pulmonology</journal-title></journal-title-group><issn pub-type="ppub">8755-6863</issn><issn pub-type="epub">1099-0496</issn><publisher><publisher-name>John Wiley and Sons Inc.</publisher-name><publisher-loc>Hoboken</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28703486</article-id><article-id pub-id-type="pmc">5697698</article-id><article-id pub-id-type="doi">10.1002/ppul.23694</article-id><article-id pub-id-type="publisher-id">PPUL23694</article-id><article-categories><subj-group subj-group-type="overline"><subject>Original Article</subject></subj-group><subj-group subj-group-type="heading"><subject>Original Articles</subject><subj-group subj-group-type="heading"><subject>Outcomes</subject></subj-group></subj-group></article-categories><title-group><article-title>Pathogen screening and prognostic factors in children with severe ARDS of pulmonary origin</article-title><alt-title alt-title-type="left-running-head">PHUNG <sc>et al.</sc></alt-title></title-group><contrib-group><contrib id="ppul23694-cr-0001" contrib-type="author"><name><surname>Phung</surname><given-names>Thuy Thi Bich</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0001"><sup>1</sup></xref></contrib><contrib id="ppul23694-cr-0002" contrib-type="author"><name><surname>Suzuki</surname><given-names>Tadaki</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0002"><sup>2</sup></xref></contrib><contrib id="ppul23694-cr-0003" contrib-type="author"><name><surname>Phan</surname><given-names>Phuc Huu</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0003"><sup>3</sup></xref></contrib><contrib id="ppul23694-cr-0004" contrib-type="author"><name><surname>Kawachi</surname><given-names>Shoji</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0004"><sup>4</sup></xref></contrib><contrib id="ppul23694-cr-0005" contrib-type="author"><name><surname>Furuya</surname><given-names>Hiroyuki</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0005"><sup>5</sup></xref></contrib><contrib id="ppul23694-cr-0006" contrib-type="author"><name><surname>Do</surname><given-names>Huong Thu</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="ppul23694-aff-0001"><sup>1</sup></xref></contrib><contrib id="ppul23694-cr-0007" contrib-type="author"><name><surname>Kageyama</surname><given-names>Tsutomu</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0006"><sup>6</sup></xref></contrib><contrib id="ppul23694-cr-0008" contrib-type="author"><name><surname>Ta</surname><given-names>Tuan Anh</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0003"><sup>3</sup></xref></contrib><contrib id="ppul23694-cr-0009" contrib-type="author"><name><surname>Dao</surname><given-names>Nam Huu</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="ppul23694-aff-0003"><sup>3</sup></xref></contrib><contrib id="ppul23694-cr-0010" contrib-type="author"><name><surname>Nunoi</surname><given-names>Hiroyuki</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0007"><sup>7</sup></xref></contrib><contrib id="ppul23694-cr-0011" contrib-type="author"><name><surname>Tran</surname><given-names>Dien Minh</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0008"><sup>8</sup></xref></contrib><contrib id="ppul23694-cr-0012" contrib-type="author"><name><surname>Le</surname><given-names>Hai Thanh</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="ppul23694-aff-0009"><sup>9</sup></xref></contrib><contrib id="ppul23694-cr-0013" contrib-type="author" corresp="yes"><name><surname>Nakajima</surname><given-names>Noriko</given-names></name><degrees>MD, PhD</degrees><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-1824-0603</contrib-id><address><email>tenko@nih.go.jp</email></address><xref ref-type="aff" rid="ppul23694-aff-0002"><sup>2</sup></xref></contrib></contrib-group><aff id="ppul23694-aff-0001"><label><sup>1</sup></label><named-content content-type="organisation-division">Department of Research of Biomolecular for Infectious Disease</named-content><institution>Vietnam National Children's Hospital</institution><named-content content-type="city">Hanoi</named-content><country country="VN">Vietnam</country></aff><aff id="ppul23694-aff-0002"><label><sup>2</sup></label><named-content content-type="organisation-division">Department of Pathology</named-content><institution>National Institute of Infectious Diseases</institution><named-content content-type="city">Tokyo</named-content><country country="JP">Japan</country></aff><aff id="ppul23694-aff-0003"><label><sup>3</sup></label><named-content content-type="organisation-division">Department of Pediatrics Intensive Care Unit</named-content><institution>Vietanm National Children's Hospital</institution><named-content content-type="city">Hanoi</named-content><country country="VN">Vietnam</country></aff><aff id="ppul23694-aff-0004"><label><sup>4</sup></label><named-content content-type="organisation-division">Department of Anesthesiology and Intensive Care</named-content><institution>National Center for Global Health and Medicine</institution><named-content content-type="city">Tokyo</named-content><country country="JP">Japan</country></aff><aff id="ppul23694-aff-0005"><label><sup>5</sup></label><named-content content-type="organisation-division">Department of Preventive Medicine, Tokai University School of Medicine</named-content><institution>Center for Molecular Prevention and Environmental Medicine</institution><named-content content-type="city">Isehara</named-content><country country="JP">Japan</country></aff><aff id="ppul23694-aff-0006"><label><sup>6</sup></label><named-content content-type="organisation-division">Influenza Virus Research Center</named-content><institution>National Institute of Infectious Diseases</institution><named-content content-type="city">Tokyo</named-content><country country="JP">Japan</country></aff><aff id="ppul23694-aff-0007"><label><sup>7</sup></label><named-content content-type="organisation-division">Faculty of Medicine, Division of Pediatrics, Department of Developmental and Urinological‐Reproductive Medicine</named-content><institution>University of Miyazaki</institution><named-content content-type="city">Miyazaki</named-content><country country="JP">Japan</country></aff><aff id="ppul23694-aff-0008"><label><sup>8</sup></label><named-content content-type="organisation-division">Department of Surgeon Intensive Care Unit</named-content><institution>Vietnam National Children's Hospital</institution><named-content content-type="city">Hanoi</named-content><country country="VN">Vietnam</country></aff><aff id="ppul23694-aff-0009"><label><sup>9</sup></label><named-content content-type="organisation-division">Department of Emergency</named-content><institution>Vietnam National Children's Hospital</institution><named-content content-type="city">Hanoi</named-content><country country="VN">Vietnam</country></aff><author-notes><corresp id="correspondenceTo"><label>*</label><bold>Correspondence</bold><break></break>Noriko Nakajima, MD, PhD, Department of Pathology, National Institute of Infectious Diseases, 1‐23‐1, Toyama, Shinjuku‐ku, Tokyo 162‐8640, Japan.<break></break>Email:
<email>tenko@nih.go.jp</email><break></break></corresp></author-notes><pub-date pub-type="epub"><day>13</day><month>7</month><year>2017</year></pub-date><pub-date pub-type="ppub"><month>11</month><year>2017</year></pub-date><volume>52</volume><issue>11</issue><issue-id pub-id-type="doi">10.1002/ppul.v52.11</issue-id><fpage>1469</fpage><lpage>1477</lpage><history><date date-type="received"><day>16</day><month>11</month><year>2016</year></date><date date-type="accepted"><day>26</day><month>2</month><year>2017</year></date></history><permissions><pmc-comment> © 2017 Wiley Periodicals, Inc. </pmc-comment>
<copyright-statement content-type="article-copyright">© 2017 The Authors. <italic>Pediatric Pulmonology</italic> Published by Wiley Periodicals, Inc.</copyright-statement><license license-type="creativeCommonsBy-nc"><license-p>This is an open access article under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">Creative Commons Attribution‐NonCommercial</ext-link> License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="file:PPUL-52-1469.pdf"></self-uri><abstract><title>Abstract</title><sec id="ppul23694-sec-0001"><title>Background</title><p>Acute respiratory distress syndrome (ARDS) is one of the most lethal diseases encountered in the pediatric intensive care unit (PICU). The etiological pathogens and prognostic factors of severe ARDS of pulmonary origin in children with respiratory virus infections were prospectively investigated.</p></sec><sec id="ppul23694-sec-0002"><title>Methods</title><p>Enrolled children fulfilled the following criteria: (1) PICU admission; (2) age of 1 month to 16 years; (3) diagnosis of infectious pneumonia and respiratory virus infection; and (4) development of severe ARDS within 72 h after PICU admission. Pathogens were detected in the blood and tracheal lavage fluid using molecular techniques and a conventional culture system. The serum levels of inflammatory mediators on the day of PICU admission were examined.</p></sec><sec id="ppul23694-sec-0003"><title>Results</title><p>Fifty‐seven patients (32 boys; median age, 9 months) were enrolled. Multiple virus infections, co‐infection with bacteria/fungus, and bacteremia/fungemia were observed in 60%, 49%, and 32% of children, respectively. Adenovirus‐B, measles virus, and cytomegalovirus were detected predominantly in tracheal lavage fluid. There were no statistically significant differences between non‐survivors and survivors regarding the types of pathogen, incidence of multiple virus infection, gender, age, clinical features, and treatment. The serum levels of interferon (IFN)‐γ and the IFN‐γ/interleukin (IL)‐10 ratio were higher in non‐survivors.</p></sec><sec id="ppul23694-sec-0004"><title>Conclusions</title><p>IFN‐γ upregulation as detected on the day of PICU admission was found to be one of the possible prognostic factors affecting a fatal outcome. These results suggest that modulation of inflammatory responses is critical for the clinical management of children with ARDS.</p></sec></abstract><kwd-group kwd-group-type="author-generated"><kwd id="ppul23694-kwd-0001">critical care</kwd><kwd id="ppul23694-kwd-0002">IFN‐γ</kwd><kwd id="ppul23694-kwd-0003">pneumonia</kwd><kwd id="ppul23694-kwd-0004">respiratory virus infection</kwd></kwd-group><funding-group><award-group><funding-source>Ministry of Health, Labor, and Welfare, Japan</funding-source></award-group><award-group><funding-source>Agency for Medical Research and Development, Japan</funding-source></award-group></funding-group><counts><fig-count count="1"></fig-count><table-count count="5"></table-count><page-count count="9"></page-count><word-count count="5525"></word-count></counts><custom-meta-group><custom-meta><meta-name>source-schema-version-number</meta-name><meta-value>2.0</meta-value></custom-meta><custom-meta><meta-name>component-id</meta-name><meta-value>ppul23694</meta-value></custom-meta><custom-meta><meta-name>cover-date</meta-name><meta-value>November 2017</meta-value></custom-meta><custom-meta><meta-name>details-of-publishers-convertor</meta-name><meta-value>Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.6 mode:remove_FC converted:21.11.2017</meta-value></custom-meta></custom-meta-group></article-meta><notes><p content-type="self-citation"><mixed-citation publication-type="journal" id="ppul23694-cit-000A"><string-name><surname>Phung</surname><given-names>TTB</given-names></string-name>,
<string-name><surname>Suzuki</surname><given-names>T</given-names></string-name>,
<string-name><surname>Phan</surname><given-names>PH</given-names></string-name>, et al. <article-title>Pathogen screening and prognostic factors in children with severe ARDS of pulmonary origin</article-title>.
<source>Pediatr Pulmonol</source>.
<year>2017</year>;<volume>52:</volume><fpage>1469</fpage>–<lpage>1477</lpage>. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1002/ppul.23694">https://doi.org/10.1002/ppul.23694</ext-link><pub-id pub-id-type="pmid">28703486</pub-id></mixed-citation></p><fn-group><fn id="ppul23694-note-0007"><p>International cooperative studies: This research was primarily done in National Children Hospital, Hanoi, Vietnam by Vietnamese and Japanese researchers.</p></fn></fn-group></notes></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Dao, Nam Huu" sort="Dao, Nam Huu" uniqKey="Dao N" first="Nam Huu" last="Dao">Nam Huu Dao</name><name sortKey="Do, Huong Thu" sort="Do, Huong Thu" uniqKey="Do H" first="Huong Thu" last="Do">Huong Thu Do</name><name sortKey="Furuya, Hiroyuki" sort="Furuya, Hiroyuki" uniqKey="Furuya H" first="Hiroyuki" last="Furuya">Hiroyuki Furuya</name><name sortKey="Kageyama, Tsutomu" sort="Kageyama, Tsutomu" uniqKey="Kageyama T" first="Tsutomu" last="Kageyama">Tsutomu Kageyama</name><name sortKey="Kawachi, Shoji" sort="Kawachi, Shoji" uniqKey="Kawachi S" first="Shoji" last="Kawachi">Shoji Kawachi</name><name sortKey="Le, Hai Thanh" sort="Le, Hai Thanh" uniqKey="Le H" first="Hai Thanh" last="Le">Hai Thanh Le</name><name sortKey="Nakajima, Noriko" sort="Nakajima, Noriko" uniqKey="Nakajima N" first="Noriko" last="Nakajima">Noriko Nakajima</name><name sortKey="Nunoi, Hiroyuki" sort="Nunoi, Hiroyuki" uniqKey="Nunoi H" first="Hiroyuki" last="Nunoi">Hiroyuki Nunoi</name><name sortKey="Phan, Phuc Huu" sort="Phan, Phuc Huu" uniqKey="Phan P" first="Phuc Huu" last="Phan">Phuc Huu Phan</name><name sortKey="Phung, Thuy Thi Bich" sort="Phung, Thuy Thi Bich" uniqKey="Phung T" first="Thuy Thi Bich" last="Phung">Thuy Thi Bich Phung</name><name sortKey="Suzuki, Tadaki" sort="Suzuki, Tadaki" uniqKey="Suzuki T" first="Tadaki" last="Suzuki">Tadaki Suzuki</name><name sortKey="Ta, Tuan Anh" sort="Ta, Tuan Anh" uniqKey="Ta T" first="Tuan Anh" last="Ta">Tuan Anh Ta</name><name sortKey="Tran, Dien Minh" sort="Tran, Dien Minh" uniqKey="Tran D" first="Dien Minh" last="Tran">Dien Minh Tran</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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