In long-term smokers and former smokers the bronchodilator response is not related to the fall in FEV.

BACKGROUND: Cigarette smoking is the cardinal cause of chronic obstructive pulmonary disease (COPD), but only a relatively small percentage of smokers are developing clinically overt disease, suggesting, therefore, that other risk factors than smoking are involved. Several studies have shown that the bronchodilator response (BR) is related to the progress of COPD, as assessed by the fall in forced expiratory volume in 1 s (FEV(1)). However, the relationship between BR and fall in FEV(1), is a disputed one. OBJECTIVE: To assess the relationship between BR and fall in FEV(1) in a group of long-term smokers and ex-smokers who were 60 years old on the average. METHODS: Questionnaire, spirographic tests and BR were assessed in 56 smokers and ex-smokers of mean age 62.5 +/- (SD) 2.7 years at the end of a 13-year follow-up period. BR was expressed as a percentage change of the prebronchodilator value ('% initial') and as a percentage change of predicted value ('% predicted'). RESULTS: The FEV(1)/VC vital capacity was 68.9 +/- 7.6% at the start and 64.5 +/- 11.3% at the end of the study. The average fall in FEV(1) over 13 years was 26 +/- 25 ml/year. The FEV(1) increased after albuterol on the average with 5.9 +/- 6.6%, 4.5 +/- 3.9% of predicted, and the vital capacity with 2.5 +/- 6.5%, 2.3 +/- 6.4% of predicted. BR and fall in FEV(1) were correlated: the greater the BR, the more rapid the fall in FEV(1) (r = 0.4 and p 0.05). CONCLUSIONS: In long-term smokers and ex-smokers, the BR measured at the end of the follow-up period was correlated with the fall in FEV(1). However, after adjusting for prebronchodilator FEV(1) values, BR was no more related to the decline in FEV(1). The BR appears not to be associated with the development of COPD

Clinical and phylogenetic influenza dynamics for the 2019-20 season in the global influenza hospital surveillance network (GIHSN) - Pilot study

Background: The Global Influenza Hospital Surveillance Network (GIHSN) has operated with the aim of investigating epidemiological and clinical factors related to severe influenza-related hospitalisations. Study design: A common GIHSN core protocol for prospective patient enrolment was implemented. Hospital personnel completed a standardized questionnaire regarding the included patients' medical history, compiled a hospitalisation summary, collected an upper respiratory swab sample for laboratory diagnosis, and genome sequencing was performed for a subset of samples. Patient data were compared according to influenza subtype, lineage, and phylogenetic groups using the Fisher's exact test. Results: From September 2019 to May 2020, 8791 patients aged ≥5 years were included. Among them, 3021 (34.4%) had a laboratory-confirmed influenza diagnosis. Influenza A(H1N1)pdm09 dominated the season among all age groups, while the B/Victoria-like lineage accounted for over half of the infections among younger age groups (5-49 years). Sequencing of the hemagglutinin segment was possible for 623 samples and revealed an influenza A and B clade frequency among severe influenza hospitalisations similar to other medically attended surveillance networks, such as the WHO GISRS. No phylogenetic clustering was observed among hemagglutinin substitutions depending on the administration of supplemental oxygen or vaccine failure. Conclusions: The GIHSN confirms its ability as an international hospital-based active surveillance network to provide valuable information on influenza infection dynamics in hospital settings. Increasing the number of participating sites and compiling more complete data, such as genome sequencing, will allow the exploration of associations between viral factors, vaccine protection, and disease severity

[New morpho-functional rehabilitation methods in cleft lip and palate]

The interdisciplinary, complex therapeutic protocol of the cleft lip and palate patients, applied in the Clinic of Cranio-Maxillo-Facial Surgery of "I. Ha?ieganu" University of Medicine and Pharmacy Cluj-Napoca, involves the morphologic reconstruction as well as the functional rehabilitation. Functional rehabilitation is the aspect, which gives the esthetics, social and familial integration of the patient, offering good quality of life