Automatic identification of wet and dry cough in pediatric patients with respiratory diseases

Cough is the most common symptom of several respiratory diseases. It is a defense mechanism of the body to clear the respiratory tract from foreign materials inhaled accidentally or produced internally by infections. The identification of wet and dry cough is an important clinical finding, aiding in the differential diagnosis especially in children. Wet coughs are more likely to be associated with lower respiratory track bacterial infections. At present during a typical consultation session, the wet/dry decision is based on the subjective judgment of a physician. It is not available for the non-trained person, long term monitoring or in the assessment of treatment efficacy. In this paper we address these issues and develop an automated technology to classify cough into 'wet' and 'dry' categories. We propose novel features and a Logistic regression model (LRM) for the classification of coughs into wet/dry classes. The performance of the method was evaluated on a clinical database of pediatric coughs (C = 536) recorded using a bed-side non-contact microphone from N = 78 patients. Results of the automatic classification were compared against two expert human scorers. The sensitivity and specificity of the LRM in picking wet coughs were between 87 and 88% with 95% confidence interval on training/validation dataset (310 cough events from 60 patients) and 84 and 76% respectively on prospective dataset (117 cough events from 18 patients). The kappa agreement with two expert human scorers on prospective dataset was 0.51. These results indicate the potential of the method as a useful clinical tool for cough monitoring, especially at home settings

In young children, persistent wheezing is associated with bronchial bacterial infection: A retrospective analysis

Background: Young children with persistent wheezing pose a diagnostic and therapeutical challenge to the pediatrician.We aimed to evaluate bacterial bronchial infection as a possible reason for non response to conventional asthma therapy, and to identify and characterise the predominant pathogens involved.Methods: We retrospectively analysed microbiological and cytological findings in a selected population of young wheezers with symptoms unresponsive to inhaled corticosteroid (ICS) therapy, who underwent flexible bronchoscopy with bronchoalveolar lavage (BAL). Procedural measures were taken to limit contamination risk and quantitative bacterial culture of BAL fluid (significance cut-off ≥ 104 colony-forming units/ml) was used. Modern microbiological methods were used for detection of a wide panel of pathogens and for characterisation of the bacterial isolates.Results: 33 children aged between 4 and 38 months, without structural anomalies of the conductive airways were evaluated. Significant bacterial BAL cultures were found in 48,5 % of patients. Haemophilus influenzae was isolated in 30,3 %, Streptococcus pneumoniae in 12,1 % and Moraxella catarrhalis in 12,1 %. All H. influenzae isolates were non-encapsulated strains and definitely distinguished from non-haemolytic H. haemolyticus. Respiratory viruses were detected in 21,9 % of cases with mixed bacterial-viral infection in 12,1 %. Cytology revealed a marked neutrophilic inflammation.Conclusions: Bacterial infection of the bronchial tree is common in persistent preschool wheezers and provides a possible explanation for non response to ICS therapy. Non-typeable H. influenzae seems to be the predominant pathogen involved, followed by S. pneumoniae and M. catarrhalis. © 2012 De Schutter et al. licensee BioMed Central Ltd.SCOPUS: ar.jinfo:eu-repo/semantics/publishe