No association between glucocorticoid receptor polymorphisms and long-term respiratory outcome after very preterm birth

Developmen

Gender differences in respiratory symptoms in 19-year-old adults born preterm

Objective: To study the prevalence of respiratory and atopic symptoms in (young) adults born prematurely, differences between those who did and did not develop Bronchopulmonary Disease (BPD) at neonatal age and differences in respiratory health between males and females. Methods: Design: Prospective cohort study. Setting: Nation wide follow-up study, the Netherlands. Participants: 690 adults (19 year old) born with a gestational age below 32 completed weeks and/or with a birth weight less than 1500g. Controls were Dutch participants of the European Community Respiratory Health Survey (ECRHS). Main outcome measures: Presence of wheeze, shortness of breath, asthma, hay fever and eczema using the ECRHS-questionnaire

Nocturnal non-invasive ventilation in addition to rehabilitation in hypercapnic patients with COPD

Background: Long-term non-invasive positive pressure ventilation (NIPPV) might improve the outcomes of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) with chronic respiratory failure. A study was undertaken to investigate whether nocturnal NIPPV in addition to pulmonary rehabilitation improves health-related quality of life, functional status and gas exchange compared with pulmonary rehabilitation alone in patients with COPD with chronic hypercapnic respiratory failure. Methods: 72 patients with COPD were randomly assigned to nocturnal NIPPV in addition to rehabilitation (n = 37) or rehabilitation alone (n = 35). Outcome measures were assessed before and after the 3-month intervention period. Results: The Chronic Respiratory Questionnaire total score improved 15.1 points with NIPPV + rehabilitation compared with 8.7 points with rehabilitation alone. The difference of 7.5 points was not significant (p = 0.08). However, compared with rehabilitation alone, the difference in the fatigue domain was greater with NIPPV + rehabilitation (mean difference 3.3 points, p<0.01), as was the improvement in the Maugeri Respiratory Failure questionnaire total score (mean difference -10%, p<0.03) and its cognition domain (mean difference -22%, p<0.01). Furthermore, the addition of NIPPV improved daytime arterial carbon dioxide pressure (mean difference -0.3 kPa; p<0.01) and daily step count (mean difference 1269 steps/day, p<0.01). This was accompanied by an increased daytime minute ventilation (mean difference 1.4 l; p<0.001). Conclusion: Non-invasive ventilation augments the benefits of pulmonary rehabilitation in patients with COPD with chronic hypercapnic respiratory failure as it improves several measures of health-related quality of life, functional status and gas exchange

Aerodynamic SARS-CoV-2 transport in non-invasive ventilatory support methods: a passive tracer study

Non-invasive ventilatory support is used in COVID-19 treatment, but little is known about associated virus transport, putting healthcare professionals at risk. This study reveals treatment-related aerodynamics by passive tracer visualisation. All therapies showed extensive jet dispersion, illustrating the risk of droplet-driven transmission that depends on jet-extension and jet-orientation. Aerosol transport is inevitable in non-filtered methods. Further research is needed to guide therapy setup adjustments depending on actual infectious SARS-CoV-2 spread

Supplementary Material for: Passive Tracer Visualization to Simulate Aerodynamic Virus Transport in Noninvasive Respiratory Support Methods

Background: Various forms of noninvasive respiratory support methods are used in the treatment of hypoxemic COVID-19 patients, but limited data are available about the corresponding respiratory droplet dispersion. Objectives: The aim of this study was to estimate the potential spread of infectious diseases for a broad selection of oxygen and respiratory support methods by revealing the therapy-induced aerodynamics and respiratory droplet dispersion. Methods: The exhaled air-smoke plume from a 3D-printed upper airway geometry was visualized by recording light reflection during simulated spontaneous breathing, standard oxygen mask application, nasal high-flow therapy (NHFT), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP). The dispersion of 100 μm particles was estimated from the initial velocity of exhaled air and the theoretical terminal velocity. Results: Estimated droplet dispersion was 16 cm for unassisted breathing, 10 cm for Venturi masks, 13 cm for the nebulizer, and 14 cm for the nonrebreathing mask. Estimated droplet spread increased up to 34 cm in NHFT, 57 cm in BiPAP, and 69 cm in CPAP. A nonsurgical face mask over the NHFT interface reduced estimated droplet dispersion. Conclusions: During NHFT and CPAP/BiPAP with vented masks, extensive jets with relatively high jet velocities were observed, indicating increased droplet spread and an increased risk of droplet-driven virus transmission. For the Venturi masks, a nonrebreathing mask, and a nebulizer, estimated jet velocities are comparable to unassisted breathing. Aerosols are transported unboundedly in all these unfiltered therapies. The adequate use of protective measures is of vital importance when using noninvasive unfiltered therapies in infectious respiratory diseases

Health-related quality of life in food-allergic adults from eight European countries

Background Food allergy can impair health-related quality of life (HRQL). Food Allergy Quality of Life Questionnaires (FAQLQs) have been developed and validated, including an adult form (FAQLQ-AF). HRQL has not, to date, been measured across different European countries using a uniform methodology. Objective To translate and validate the FAQLQ-AF for use in 8 European countries (Iceland, The Netherlands, Poland, France, Spain, Italy, Greece, and Sweden). Methods The English FAQLQ-AF was translated, back-translated, and compared for use in the 8 relevant European languages. Adults with a perceived food allergy were recruited from outpatient departments and through a community survey. Participants completed the FAQLQ-AF, the Food Allergy Independent Measure, and questions concerning participants&apos; characteristics. Validity of the FAQLQ-AF was analyzed for use in the 8 countries. Results The FAQLQ-AF had strong construct validity (r &gt; 0.59) and an excellent internal consistency (Cronbach α &gt; 0.95) in all countries. Total FAQLQ-AF scores (range 3.2-5.0) were significantly different across participating countries. Conclusion The FAQLQ-AF is a suitable and valid instrument for measuring HRQL in food-allergic adults in Iceland, The Netherlands, Poland, France, Spain, Italy, Greece, and Sweden. The impact of food allergy on HRQL seems to differ among adults from the 8 participating European countries. © 2014 American College of Allergy, Asthma &amp; Immunology. Published by Elsevier Inc. All rights reserved

Vroeggeboorte, intra-uteriene groeiachterstand en lichamelijke ziehten op de volwassen leeftijd; resultaten van 19 jaar POPS-follow-up [Premature birth, intrauterine growth retardation and physical disease in adulthood: Results of 19 years POPS follow-up]

Veel te vroeg geboren kinderen lopen een groter risico op neurosensorische handicaps en ontwikkelingsproblemen dan op tijd geboren kinderen. Vroeggeboorte, intra-uteriene groeiachterstand, en de combinatie hiervan, zijn ook mogelijke risicofactoren voor lichamelijke ziekten op de volwassen leeftijd. Omdat hier tot nu toe weinig onderzoek naar is verricht, zijn in de pops-cohort (Project On Preterm and Small for gestational age infants) de eerste tekenen hiervan bekeken. Vroeggeboorte lijkt een risicofactor te zijn voor het ontwikkelen van insulineresistentie. Bij een latere neiging tot vetzucht is dat risico extra groot. Nog groter wordt dat als hieraan een intra-uteriene groeiachterstand voorafging. De systolische bloeddruk is gemiddeld hoger bij ex-prematuren maar is niet gerelateerd aan de mate van intra-uteriene groeiretardatie. De nierfunctie (klaring en eiwituitscheiding) is op de jongvolwassen leeftijd minder gunstig voor die individuen die naast de vroeggeboorte ook zijn blootgesteld aan intra-uteriene groeiretardatie. Te vroeg geboren kinderen hebben als jongvolwassenen meer luchtwegklachten en een minder goede longfunctie. De conclusie is dat neonatale follow-up niet alleen noodzakelijk is voor veel te vroeg geboren kinderen maar ook voor kinderen met een ernstige intra-uteriene groeiachterstand. De kinderarts moet in het contact met zowel ouders en kind als met de huisarts benoemen dat een voorgeschiedenis van vroeggeboorte of groeiachterstand ook een mogelijke risicofactor is voor chronische ziekten op de volwassen leeftijd. Bij te vroeg geboren kinderen met intra-uteriene groeiachterstand is actieve preventie van obesitas vanaf jonge leeftijd geïndiceerd. Vanaf jongvolwassen leeftijd zal de huisarts extra alert moeten zijn op het ontstaan van met name hypertensie en microalbuminurie door dit bijvoorbeeld tweejaarlijks te controleren. Voor het kind zelf kan de voorgeschiedenis een extra reden zijn om overgewicht te vermijden, om aan sport te doen en om niet te beginnen met roken

Long-Term Neurodevelopmental and Functional Outcomes of Infants Born Very Preterm and/or with a Very Low Birth Weight

Clinical epidemiolog