{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T16:10:36Z","timestamp":1771431036627,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the clinical implications of the obstructive pattern on plain chest radiography, defined as peribronchial cuffing or hyperinflation, in young children with severe lower respiratory tract infections (LRTIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed all children aged 3\u201259 months with LRTIs who underwent radiography and polymerase chain reaction in a Korean emergency department from 2016 through 2020. The radiographs were read as consolidation, peribronchial cuffing, or hyperinflation, with each interrater reliability computed. As per the obstructive pattern, we compared their clinical features, therapeutic interventions, outcomes, and microbiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 599 children with LRTIs, 465 were enrolled, of whom 98 (21.1%) had consolidation (\u03ba\u2009=\u20090.60; 95% confidence interval, 0.50\u20120.70), and 367 (78.9%) had peribronchial cuffing (0.55; 0.46\u20120.65) or hyperinflation (0.59; 0.52\u20120.67). The obstructive pattern was significantly associated with more frequent wheezing (obstructive, 28.6% vs. consolidation, 10.2%) and the use of inhaled albuterol or systemic steroids (39.0% vs. 23.5%), and lower median values or frequencies of age (22.0 vs. 35.0 months), crackle or diminished breath sound (42.0% vs. 61.2%), C\u2010reactive protein (1.4 vs. 2.9\u2009mg\/dL), antibiotic therapy (72.2% vs. 93.9%), length of hospital stay (4.0 vs 5.0 days), fever lasting 3 days or longer (7.9% vs. 29.6%), and complications (0.5% vs. 9.2%). Microbiologically, viruses, such as respiratory syncytial virus, were more frequently detected in children with the obstructive pattern or at a younger age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study confirms an association of the obstructive pattern on radiography with viral infection and inflammatory airway obstruction\u2010relieving therapy in young children with severe LRTIs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.27458","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T08:16:03Z","timestamp":1734941763000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Implications of the Obstructive Pattern on Chest Radiography in Children Aged 3\u201359 Months With Severe Lower Respiratory Tract Infections"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-5652","authenticated-orcid":false,"given":"Moon Ki","family":"Shim","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Ajou University School of Medicine Suwon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1305-0931","authenticated-orcid":false,"given":"Ji Eun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiology and Center for Imaging Science Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8990-7083","authenticated-orcid":false,"given":"Hyelynn","family":"Jeon","sequence":"additional","affiliation":[{"name":"Office of Biostatistics, Medical Research Collaborating Center Ajou Research Institute for Innovative Medicine, Ajou University Medical Center Suwon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5271-1571","authenticated-orcid":false,"given":"Bumhee","family":"Park","sequence":"additional","affiliation":[{"name":"Office of Biostatistics, Medical Research Collaborating Center Ajou Research Institute for Innovative Medicine, Ajou University Medical Center Suwon Republic of Korea"},{"name":"Department of Biomedical Informatics Ajou University School of Medicine Suwon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7303-0241","authenticated-orcid":false,"given":"Jung Heon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Ajou University School of Medicine Suwon Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.15172\/pneu.2014.5\/482"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2361041278"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-0971(84)90111-6"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201907-569CME"},{"issue":"5","key":"e_1_2_10_6_1","first-page":"353","article-title":"Standardized Interpretation of Paediatric Chest Radiographs for the Diagnosis of Pneumonia in Epidemiological Studies","volume":"83","author":"Cherian T.","year":"2005","journal-title":"Bulletin of the World Health Organization"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-017-3834-9"},{"key":"e_1_2_10_8_1","unstructured":"Y.Weerakkody A.Vibhakar Y.Glick et al. \u201cPeribronchial Cuffing.\u201d Radiopaedia.org 2024 cited Aug 03 2024 https:\/\/radiopaedia.org\/articles\/peribronchial-cuffing-1?lang=us."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.963548"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922818795902"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70017-4"},{"issue":"47","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.56786\/PHWR.2023.16.47.1","article-title":"2022\ub144 \uc804\uad6d \uc5b4\ub9b0\uc774 \uc608\ubc29\uc811\uc885\ub960 \ud604\ud669","volume":"16","author":"\uc774 \uc7ac\uc601","year":"2023","journal-title":"Public Health Weekly Report"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.22470\/pemj.2015.2.2.53"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.22470\/pemj.2023.00843"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000007028"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529786"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2019.1436"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.5.438"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/20276974"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.2008.02678.x"},{"issue":"002708","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2020-002708","article-title":"An Analysis of Clinical Predictive Values for Radiographic Pneumonia in Children","volume":"5","author":"Rees C. A.","year":"2020","journal-title":"BMJ Global Health"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-021-03091-3"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02386862"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000232706.35674.2f"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20112"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir531"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2742"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-2816"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-021-03996-2"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-2659.2012.00340.x"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.27458","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.27458","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.27458","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T15:31:57Z","timestamp":1771428717000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.27458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,23]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/ppul.27458"],"URL":"https:\/\/doi.org\/10.1002\/ppul.27458","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,23]]},"assertion":[{"value":"2024-08-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e27458"}}