Julian Vyas
Julian has been a Respiratory Paediatrician for almost 15 years. He worked in Manchester Children’s Hospitals, UK for six and a half years before relocating to Auckland in Spring 2006. He was Clinical Director of the Respiratory Dept at Starship Hospital for six years. Julian did his specialist training in the UK, and Melbourne; including gaining an MD in the role of oxidants and antioxidants in the pathogenesis of chronic lung disease of prematurity!! His clinical interests relate to cystic fibrosis, inflammatory and interstitial lung diseases in children, and disorders affecting lung growth. He is the Chair of the Paediatric Society Respiratory Special interest Group, and has recently been asked to lead the development of a managed clinical network for Paediatric Cystic Fibrosis centres in New Zealand.
Accurate Diagnosis of Childhood Asthma Main Session  Saturday, 14 June 2014 Start 8:45am Duration: 15mins Baytrust Accurate diagnosis of asthma is made on the history, examination and response to treatment. Only rarely will there need to be any investigations. Axiomatic features of asthma are: Intermittent wheeze and/or chest tightness precipitated by predictable factors (e.g. exercise, certain environmental phenomena [cats, dust], ? viral infections). Brisk response of the symptoms to inhaled bronchodilator therapy. Prevention of symptoms with ICS or oral LTB4 antagonists. Associated factors may include nocturnal cough, SOBOE, FH of asthma, FH/ PMH of atopy. Investigation is only possible on children old enough to perform forced manoeuvre spirometry. This is usually form the age of 6 or 7 years. Most, but not all, DHB’s can provide this for children, but possibly in conjunction with a Gen Paediatric clinic review. Diagnosis also depends on the absence of any of… Persistent wheeze - i.e. present at all times even when well. Frequent moist cough. Chronic cough without wheeze at any time. Associated infective tendency - e.g. other sites of bacterial infection, severe viral infections. Failure to thrive - crossing 2 centiles. Focal chest signs. Abnormal CXR when clinically well. (failure to demonstrate bronchodilator reversibility - clinically or spirometry [>6y]). Ref: BPJ:42; Asthma in children Kids that Cough a Lot Concurrent Workshop Repeated Saturday, 14 June 2014 Start 11:00am Duration: 55mins Room 11 Start 12:05pm Duration: 55mins Room 11 Cough is a very common clinical sign. Chronic cough (defined as >4-6/52 daily cough) may be due to a number of underlying problems. See BPJ:29; Cough in children The workshop will allow discussion as to the best approach for timing of investigation of cough. what to investigate for, and whether to investigate within primary care, or refer the child to a paediatrician. Important specific aspects will be highlighted by case based discussion. Asthma in Kids Nurses Programme Saturday, 14 June 2014 Start 2:30pm Duration: 30mins Sportsdrome