{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T19:00:29Z","timestamp":1782154829396,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2011,12,7]],"date-time":"2011-12-07T00:00:00Z","timestamp":1323216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["DK 34108"],"award-info":[{"award-number":["DK 34108"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"crossref","award":["A001-5-01"],"award-info":[{"award-number":["A001-5-01"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Progression of lung disease is a major event in children with cystic fibrosis (CF), but regional differences in its evolution are unclear. We hypothesized that regional differences occur beginning in early childhood. We examined this issue by evaluating 132 patients followed in the Wisconsin Neonatal Screening Project between 1985 and 2010. We scored chest X\u2010rays obtained every 1\u20132 years with the Wisconsin chest X\u2010ray system, in which we divided the lungs into quadrants, and gave special attention to ratings for bronchiectasis (BX) and nodular\/branching opacities. We compared the upper and lower quadrant scores, and upper right and left quadrant scores, as patients aged using a multivariable generalized estimation equation (GEE) model. We did a confirmatory analysis for a subset of 81 patients with chest computerized tomography (CT) images obtained in 2000 and scored using the Brody scoring system. The chest X\u2010ray analysis shows that the upper quadrants have higher BX (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and nodular\/branching opacities (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) scores than the lower quadrants. CT analysis likewise reveals that the upper quadrants have more BX (<jats:italic>P<\/jats:italic>\u2009=\u20090.02). Patients positive for mucoid PA showed significantly higher BX scores than patients with non\u2010mucoid PA (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). Chest X\u2010ray scoring also revealed that the upper right quadrant has more BX (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) than the upper left quadrant, and CT analysis was again confirmatory (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). We conclude that pediatric patients with CF develop more severe lung disease in the upper lobes than the lower lobes in association with mucoid PA infections and also have more severe lung disease on the right side than on the left side in the upper quadrants. A variety of potential explanations such as aspiration episodes may be clinically relevant and provide insights regarding therapies. Pediatr Pulmonol. 2012; 47:635\u2013640. \u00a9 2011 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ppul.21604","type":"journal-article","created":{"date-parts":[[2011,12,7]],"date-time":"2011-12-07T21:46:19Z","timestamp":1323294379000},"page":"635-640","source":"Crossref","is-referenced-by-count":25,"title":["Regional differences in the evolution of lung disease in children with cystic fibrosis"],"prefix":"10.1002","volume":"47","author":[{"given":"Zhanhai","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don B.","family":"Sanders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Rock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Kosorok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannette","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G.","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan S.","family":"Brody","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip M.","family":"Farrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,12,7]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199607183350307"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005382-199601110-00002"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(05)80220-X"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200603-343OC"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.171.5.9798870"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.156.5.9701098"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199710023371403"},{"key":"e_1_2_6_9_2","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S0065-3101(23)00095-6","article-title":"Improving the health of patients with cystic fibrosis through newborn screening. Wisconsin Cystic Fibrosis Neonatal Screening Study Group","volume":"47","author":"Farrell PM","year":"2000","journal-title":"Adv Pediatr"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0496(200006)29:6<457::AID-PPUL8>3.0.CO;2-9"},{"key":"e_1_2_6_11_2","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1542\/peds.91.2.488","article-title":"Wisconsin cystic fibrosis chest radiograph scoring system","volume":"91","author":"Weatherly M","year":"1993","journal-title":"Pediatrics"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.107.1.1"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.10227"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2522081882"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.5.581"},{"key":"e_1_2_6_16_2","first-page":"535","article-title":"Regional distribution of macroscopic lung disease in cystic fibrosis","volume":"133","author":"Tomashefski JF","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_6_17_2","first-page":"1075","article-title":"Early pulmonary inflammation in infants with cystic fibrosis","volume":"151","author":"Khan TZ","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.05.005"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21434"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.09.001"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0496(199911)28:5<321::AID-PPUL3>3.0.CO;2-V"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.21604","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.21604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.21604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T13:30:03Z","timestamp":1713187803000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.21604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12,7]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2012,7]]}},"alternative-id":["10.1002\/ppul.21604"],"URL":"https:\/\/doi.org\/10.1002\/ppul.21604","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12,7]]}}}