We mapped the evidence on the use of respiratory oscillometry (RO) in infants through a scoping review of the literature. We conducted a systematic search of Medline, Embase, Cochrane Library, Web of Science, Google Scholar, Cochrane Controlled Register of Trials, and clinical trial registries from inception to 1st September 2025. We included documents on the use of RO in infants up to 1 year. We assessed risk of bias using the Risk of Bias In Non-randomised studies of Interventions (ROBINS-I) and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Reporting adheres to the PRISMA extension for Scoping Reviews. We included 45 papers and 7 protocols. Five themes emerged: feasibility and methodology; RO for assessing pathological conditions and exposures; prognostication of respiratory outcomes; ability to evaluate treatment response in the neonatal intensive care (NICU); role in bronchodilator/bronchoconstrictor testing in infants with wheezing. RO was feasible and may be a reliable modality for epidemiological studies of early lung function determinants and long-term follow-up of infants. It may also support individualised respiratory care in the NICU, although it has been used primarily as a research tool in this setting. Wider adoption requires infant-specific devices, standardised methodologies, and reference values. IMPACT: This is the first comprehensive scoping review mapping the evidence on respiratory oscillometry in neonates and infants under one year of age. Respiratory oscillometry may be a reliable modality for long-term monitoring of lung function starting in infancy. Respiratory oscillometry may support individualised respiratory care and prognostication in the neonatal intensive care unit.

BACKGROUND Foreign body aspiration (FBA) is a life-threatening pediatric emergency, most common in 1-3-year-olds due to immature swallowing reflexes and exploratory oral behaviors. Common aspirated items include nuts, food particles and small toys, presenting with variable symptoms such as cough, dyspnea, wheezing or acute respiratory failure. Delayed diagnosis or improper management causes severe complications like post-obstructive pneumonia, atelectasis, bronchiectasis and irreversible airway stenosis, increasing morbidity and treatment complexity. CASE REPORT A 16-month-old girl was admitted with persistent cough, progressive dyspnea, intermittent fever, hoarseness, and occasional cyanosis that developed 6 days after accidental pine nut ingestion. Initial flexible bronchoscopy at a local hospital failed due to the foreign body's rigid texture and deep impaction in the right lower lobe basilar bronchus. Chest CT confirmed a pine nut shell in the B9/B10 segmental bronchus with surrounding inflammation. She was transferred for combined rigid-flexible bronchoscopy to establish a secure airway and enable precise visualization before holmium laser fragmentation broke the shell into retrievable fragments for complete removal. Two-week follow-up showed symptomatic B9/B10 stenosis, which improved significantly after sequential 3.5 mm and 4.0 mm balloon dilation. Her respiratory symptoms resolved and imaging confirmed restored lobar ventilation. CONCLUSIONS Rigid-flexible bronchoscopy synergy benefits removal of large rigid foreign bodies in sub-main bronchi by combining rigid bronchoscopy's airway security with flexible bronchoscopy's maneuverability and visualization. Holmium laser safely fragments hard foreign bodies with minimal airway trauma, and sequential balloon dilation effectively treats post-FBA stenosis. Individualized application guided by clinical assessment and imaging optimizes pediatric FBA outcomes.

Studies have shown that levels of fungal contamination and mycotoxin concentrations in oil-producing seeds vary across regions. In addition, extreme exposure to seeds dust particulate matter can lead to respiratory health problems. In Ethiopia oil-seeds processing factories workers exposure to particulate matter and magnitude of its respiratory symptoms have not been widely explored. To determine particulate matter concentration exposure levels and identify factors associated with respiratory symptoms among oil-seed processing factories workers. Using cross-sectional study design, 14 factories and 716 participants were selected through simple random sampling. Qualitative data were collected through checklist-based observation, in-depth interviews & FGDs and analyzed using qualitative content analysis. Direct particulate matter concentrations were measured using PATS + , Dylos DC1900, and Laser PM2.5 Meter-5800D/5800E devices. Descriptive statistics were used for data summarization, and analysis was conducted using STATA version 16.1. Binary logistic regression &multivariable logistic regression analysis were performed to identify associated factors, with p < 0.05 considered statistically significant. Among 716 participants, 49.9% were female. The mean PM2.5 and PM10 concentrations in oil-seeds processing factories were 19.72 ± 11.8 µg/m[3] and 55.24 ± 14.5 µg/m[3], respectively. Respiratory symptoms and bronchitis were reported by 25.28% of workers. Wheezing (23.2%), phlegm (22.5%), dyspnea (22.3%), and occupational asthma (12.57%) were the most common symptoms. Significant predictors included particulate matter exposure [AOR = 18.6, 95% CI: (9.12, 37.43)], not PPE use [AOR = 18.3, 95% CI: (2.39, 39.39)], use of wood as an energy source [AOR = 15.47, 95% CI: (4.25,36.4)], and inadequate ventilation [AOR = 14.29,95% CI:(3.01-26.70)]. Workplace exposure to oil seeds PM2.5 and PM10 among oil-seeds processing factories workers exceeded WHO guideline limits. Respiratory and asthma symptoms were highly prevalent, with greater risk among workers exposed above WHO standards. Oil seeds particulate matter exposure, not personal protective Equipment use, energy source, insufficient ventilation, and training were significant factors associated with respiratory symptoms. Necessary measures are needed to limit particulate matter exposure, including effective occupational health and safety programs that emphasize source-level dust control, routine supervision, engineering controls (e.g., adequate ventilation), administrative actions (such as training and risk assessment), and appropriate personal protective equipment use. Future study of personal measurement with case control is desirable.

A 64-year-old male presented with progressive breathlessness and wheezing, initially suspected to be worsening asthma. Inhaled therapies were commenced and further investigations were conducted, including CT thorax, bronchoscopy, pulmonary function tests and autoimmune screening. Imaging revealed tracheobronchomalacia and bronchoscopy confirmed a grossly abnormal endobronchial tree with appearances suggestive of relapsing polychondritis. A multidisciplinary discussion led to a diagnosis of tracheobronchomalacia secondary to relapsing polychondritis. Worsening symptoms of breathlessness led to commencement of corticosteroids, nocturnal non-invasive ventilation and immunosuppression with infliximab. Subsequent escalation of management included endobronchial stenting, argon laser therapy and adjustment of therapy to rituximab with the addition of intravenous immunoglobulins.Relapsing polychondritis is a rare inflammatory disease with airway involvement in up to 50% of cases. Respiratory symptoms may be the first sign, often misdiagnosed as asthma, delaying appropriate care. This case highlights the need for early recognition and treatment to prevent irreversible airway damage in relapsing polychondritis.

Individuals with classic asthma can present with wheezing, dyspnea, chest tightness, and/or cough. Notably, cough can be the main or only symptom of asthma, termed cough variant asthma. Although there are numerous guidelines for asthma, the diagnosis and management of cough in asthma remain challenging because of its complex physiology. By definition, cough variant asthma excludes individuals with normal airway sensitivity to methacholine (MCh). However, many individuals with chronic cough who are being evaluated for possible cough variant asthma have normal airway sensitivity, yet cough during MCh challenge test (termed COUGH). Despite normal airway sensitivity, individuals with COUGH develop small airway obstruction, dynamic hyperinflation, and gas trapping. The clinical importance of COUGH remains to be determined, but it may be a distinct airway disease phenotype. Previous studies examining pathophysiological differences between classic asthma, cough variant asthma, and COUGH have concluded that differences may lie in individuals' sensitivity to MCh and the degree of bronchodilation and bronchoprotection obtained from deep inspirations. These observations were made exclusively using MCh challenges; however, indirect inhalation challenges (eg, mannitol, hypertonic saline, and eucapneic voluntary hyperventilation) have greater specificity for asthma and may reveal additional pathophysiological distinctions between classic asthma, cough variant asthma, and COUGH. This review highlights opportunities to gain insight into the related airway phenotypes of classic asthma, cough variant asthma, and COUGH by examining impulse oscillometry measurements and the degree of bronchodilation and bronchoprotection from deep inspirations using indirect inhalation challenges, including eucapneic voluntary hyperventilation, hypertonic saline, and mannitol.

Respiratory viral infections in early childhood are major drivers of acute morbidity and long-term airway disease, yet how distinct viruses remodel the pediatric nasal mucosa at cellular resolution remains unresolved. Here, we generated a single-cell RNA sequencing atlas of 335,174 nasal epithelial and immune cells from 132 children under five years of age with SARS-CoV-2, rhinovirus, or respiratory syncytial virus (RSV) infection, alongside uninfected controls. Mapping viral transcripts to individual cells revealed virus-specific infected epithelial states: an NF-kB-responsive ciliated subset in SARS-CoV-2 and a previously undescribed KRT17+ squamous-like subset in RSV. We delineated divergent mucosal response programs, including a robust interferon (IFN) response in SARS-CoV-2, an IL-13-responsive secretory program in rhinovirus, and heightened inflammatory and cytotoxic immune activation in RSV. In RSV, specific immune subsets and elevated IFN-response signatures were associated with disease severity, whereas rhinovirus-induced wheeze was marked by expansion of a CST1 + goblet cell subset. Integration of asthma genome-wide association data with our atlas revealed a KRT13+ hillock-like squamous epithelial subset enriched for expression of childhood-onset asthma risk loci. Finally, we demonstrate that this resource enables high-resolution annotation of independent pediatric cohorts in Kolkata, India and rural Bangladesh. Together, this atlas establishes a comprehensive view of antiviral immunity in the pediatric nasal mucosa and defines virus-specific mucosal immune programs relevant to disease severity and asthma risk in early life.

Erasmus syndrome is an uncommon condition marked by the onset of systemic sclerosis (SSc) due to extended exposure to silica. In this case, we highlight the significant health risks associated with silica exposure in artisanal mining (galamsey), leading to the development of Erasmus syndrome. We present the case of a 33-year-old male artisanal miner with a 14-year work history who presented with a 2-year history of recurrent cough, difficulty breathing, and fever. He later developed hypopigmentation and skin thickening on his face, neck, torso, and knees, along with a productive cough and low-grade fever. He visited multiple healthcare facilities on account of the above complaints. At one of such visits, he was prescribed antituberculosis (TB) medication even though the sputum for GeneXpert was negative. On examination, he was in respiratory distress with an oxygen saturation of 78% on room air and required oxygen via a nonrebreather mask at 10 L/min, which raised the oxygen saturation to 94%, and had bronchial breath sounds in the right lung zones. Vocal resonance was increased bilaterally in the middle lung zones. He had salt-and-pepper dermopathy with tight and adherent skin on his face, chest, back, and knees. He additionally had microstomia, rat bite sign of the fingers, and Raynaud's phenomenon. Antinuclear antibody by indirect immunofluorescence on hep-2 cells was positive (1:320), and Antitopoisomerase 1 antibodies were also positive. Chest CT findings were consistent with complicated silicosis. The patient was diagnosed with Erasmus syndrome and started on immunosuppressive therapy. We highlight the significant health risks associated with silica exposure in artisanal mining (galamsey), leading to the development of Erasmus syndrome. Preventing silica exposure remains crucial, necessitating stringent workplace safety measures and occupational health practices to protect individuals in high-risk professions.

Asthma is a chronic lower respiratory system disease with high global prevalence and mortality rates. It is characterized by several clinical symptoms, including coughing, wheezing, dyspnea, and breathing difficulties. Despite extensive research on asthma treatment, no definitive cure exists. Current treatments primarily focus on symptom relief through corticosteroid agents and bronchodilators. Various factors contribute to the pathogenesis of asthma, with an imbalance in type 1/2 immune responses and a shift toward type 2 responses being a primary cause. Environmental factors, such as infections with rhinoviruses (RV) and respiratory syncytial virus (RSV), can increase the risk of asthma and exacerbate its symptoms. Moreover, the presence of allergic inflammation in the airways leads to an increased risk of developing these respiratory infections. One of the body's initial defence mechanisms against viruses, before the activation of adaptive immunity, involves the enhanced production of various type I and III interferons. Type I interferons include subtypes such as alpha, beta, tau, omega, kapa, zeta, delta, and epsilon, while type III interferons include lambda 1-4. By binding to their respective receptors on various cell types, interferons activate ISGs (interferon-stimulated genes), exerting antiviral effects, anti-proliferative, pro-apoptotic actions and immunomodulatory effects. These effects help eliminate viruses, which are triggers of asthma, thereby contributing to asthma alleviation. Also, deficiency of these cytokines increases the susceptibility to viral infections and asthma. The critical role of interferons in asthma associated with pathogens highlights their potential therapeutic application for this disease. This study provides a comprehensive discussion of the characteristics of type I and III interferons and their effects on signaling pathways involved in asthma pathogenesis.