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As shown on Figure 1, panel A, IL-33 measured by ELISA was significantly higher in sputum supernatants of allergic rhinitis (median 9.4 pg/mL, range 0-51.1 pg/mL) and asthma patients (5.2 pg/mL, range 0-45.4 pg/mL) when compared to atopic asymptomatic subjects (median 0 pg/mL, range 0-8 pg/mL; I p i < .001 and I p i = .006) and controls (median 0 pg/mL, range 0-13 pg/mL; I p i < .001). This is particularly relevant since IL-33 has been shown to be involved in asthma airway remodelling.5 Its potential overproduction in the lower airways of patients suffering primarily from allergic rhinitis might, therefore, contribute to them developing asthma. Increased expression of IL-33 is found in the lower airways of patients with seasonal allergic rhinitis and is not related to natural allergen exposure. [Extracted from the article]

Serbal (2019) is an unpublished collection of poems by Leonce Lupette (Göttingen, 1986), a French-German writer, poet and translator who has lived in Argentina for several years. In this collection of poems, structured alphabetically as a sort of encyclopedia or incomplete notes, the explorer-botanist-poet proposes an expanded way of seeing and inhabiting reality, exploring ways to describe reality and expressing oneself in a playful exercise of blurring the borders between names and languages. The poems are written in Spanish, but also in German, French, English, Portuguese, Portunhol, among other languages and dialects, and they compel us to look at the world and to inhabit it from the small differences and to build what we could call "inessential communities", paraphrasing Agamben (1996). [ABSTRACT FROM AUTHOR]

Objectives: To estimate the variability of X-ray diagnostic reference levels (DRLs) depending on the number of X-ray devices and data per device.Methods: Dose-area products (DAP) were collected by the national nuclear control agency from the 590 devices installed in 345 medical centers in the country. From 2015 to 2017, the number of chest (postero-anterior (PA) view alone, and both postero-anterior and lateral views (PA/LAT)), abdomen, pelvis, and lumbar spine examinations collected in these centers ranged from 23,000 to 77,000. The impact of the number of devices and DAP data per device on DRLs' variabilities (95th confidence intervals divided by medians) is estimated using a bootstrapping method as a function of the number of devices and DAP per device.Results: The DRLs' variabilities ranged from 30 to 200% depending on the number of devices and DAP data per device but stabilized at 30% when the number of devices was higher than 200 for chest PA and abdomen examinations, 300 for lumbar spine and pelvis examinations, and 400 for chest PA/LAT examinations, regardless of the number of DAP data per device. Extrapolations of our results suggest that thousands of devices are necessary to reduce DRLs' variabilities to 10%.Conclusion: DAP-related DRL variabilities are high but only moderately influenced by the number of DAP data per device and of devices provided this number is higher than 200 to 400 devices according to the type of examination. Harmonization of methods of data collection between the authorities of the EU states should be recommended.Key Points: • DAP-related DRLs are not fixed values but ranges of values with at least 30% variability. • DAP-related DRLs strongly depend on the number of devices included when lower than 100. • If the number of devices included exceeds 200 to 400, the DRLs' variabilities do not depend on the number of DAP per device and should not exceed 30%. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the variability of CT diagnostic reference levels (DRLs) according to the methods used for computing collected data.Methods: Dose-length products (DLP) were collected by our national nuclear control agency from the 250 devices installed in 140 medical centers in the country. In 2015, the number of head, thorax, abdomen, and lumbar spine examinations collected in these centers ranged from approximately 20,000 to 42,000. The impact on DRLs of the number of devices considered, as well as the differences in descriptive statistics (mean vs. median DLP) or methods of pooling DLP data (all devices vs. all patients), was investigated. Variability in DRLs was investigated using a bootstrapping method as a function of the numbers of devices and examinations per device.Results: As expected, DRLs derived from means were higher than those from medians, with substantial differences between device- and patient-related DRLs. Depending on the numbers of devices and DLP data per device, the variability ranged from 10 to 40% but was stabilized at a level of 10-20% if the number of devices was higher than 50 to 60, regardless of the number of DLP data per device.Conclusion: Number of devices and of DLP data per device, descriptive statistics, and pooling data influence DRLs. As differences in methods of computing survey data can artificially influence DRLs, harmonization among national authorities should be recommended.Key Points: • Due to CT dose variability, that of DRLs is at least of 10%. • DRLs derived from medians are lower than from means and differ from those obtained by pooling all patient data. • Fifty to 60 devices should be sufficient for estimating national DRLs, regardless of the number of data collected per device. [ABSTRACT FROM AUTHOR]

Objectives: To determine the variabilities of dose-area-products (DAP) of frequent X-ray examinations collected for comparison with diagnostic reference levels (DRLs).Methods: DAP values of chest, abdomen, and lumbar spine examinations obtained on devices from two manufacturers were collected in three centers over 1 to 2 years. The variability of the average DAP results defined as the 95% confidence interval in percentage of their median value was calculated for increasing sample sizes, each examination and center. We computed the sample sizes yielding variabilities lower or equal to 25% and 10%. The effect of narrowing patient selection based on body weight was also investigated (ranges of 67-73 Kg, or 60-80 Kg).Results: DAP variabilities ranged from 75 to 170% of the median value when collecting small samples (10 to 20 DAP). To reduce this variability, larger samples are needed, collected over up to 2 years, regardless of the examination and center. A variability ≤ 10% could only be reached for chest X-rays, requiring up to 800 data. For the abdomen and lumbar spine, the lowest achievable variability was 25%, regardless of the body weight selection, requiring up to 400 data.Conclusion: Variabilities in DAP collected through small samples of ten data as recommended by authorities are very high, but can be reduced down to 25% (abdomen and lumbar spine) or even 10% (chest) through a substantial increase in sample sizes. Our findings could assist radiologists and regulatory authorities in estimating the reliability of the data obtained when performing X-ray dose surveys.Key Points: • Low but reasonable variabilities cannot be reached with samples sized as recommended by regulatory authorities. Higher numbers of DAP values are required to reduce the variability. • Variabilities of 10% for the chest and 25% for abdomen and lumbar spine examinations are achievable, provided large samples of data are collected over 1 year. • Our results could help radiologists and authorities interpret X-rays dose surveys. [ABSTRACT FROM AUTHOR]

Background: There is a link between breathing and balance and posture. When the inspiratory loads are increased by pathologies, there is a decrease of postural control. The increase of the inspiratory load on respiratory muscles is a common feature in various chronic pulmonary pathologies. Consequently, the balance of those patients is likely affected.Research Question: The aim of this study is to validate the use of the Nintendo Wii Balance Board (WBB) to assess balance modifications induced by increased respiratory loads in healthy subjects.Methods: Thirty-seven healthy young participants (25 ± 4 years old, 17 women) participated in this study. Five different conditions were tested: without anything (control), throughout a mouthpiece, and throughout three inspiratory threshold loads (ITL) at 10% (low), 40% (mid) and 60% (high) of the maximal inspiratory pressure. Each trial lasted for 60 s. Nine parameters were extracted based on center of pressure displacement based on a previously-validated method. ANOVA tests were used to compare the different conditions followed by Bonferroni's corrections.Results: Highly statistically significant differences (all p <  0.01) and large effect sizes (all ω2 > 0.24) were obtained for all parameters between the different loads and the mouthpiece condition. There is a linear relationship between the load and balance perturbation.Significance: In this study, we demonstrated the validity of the WBB to detect the effect of the inspiratory load on balance in young healthy subjects. Further studies are needed to determine if such a kind of evaluation can be used in clinics with patients suffering from chronic respiratory disease. [ABSTRACT FROM AUTHOR]

Objectives: To determine variability of volume computed tomographic dose index (CTDIvol) and dose-length product (DLP) data, and propose a minimum sample size to achieve an expected precision.Methods: CTDIvol and DLP values of 19,875 consecutive CT acquisitions of abdomen (7268), thorax (3805), lumbar spine (3161), cervical spine (1515) and head (4106) were collected in two centers. Their variabilities were investigated according to sample size (10 to 1000 acquisitions) and patient body weight categories (no weight selection, 67-73 kg and 60-80 kg). The 95 % confidence interval in percentage of their median (CI95/med) value was calculated for increasing sample sizes. We deduced the sample size that set a 95 % CI lower than 10 % of the median (CI95/med ≤ 10 %).Results: Sample size ensuring CI95/med ≤ 10 %, ranged from 15 to 900 depending on the body region and the dose descriptor considered. In sample sizes recommended by regulatory authorities (i.e., from 10-20 patients), mean CTDIvol and DLP of one sample ranged from 0.50 to 2.00 times its actual value extracted from 2000 samples.Conclusions: The sampling error in CTDIvol and DLP means is high in dose surveys based on small samples of patients. Sample size should be increased at least tenfold to decrease this variability.Key Points: • Variability of dose descriptors is high regardless of the body region. • Variability of dose descriptors depends on weight selection and the region scanned. • Larger samples would reduce sampling errors of radiation dose data in surveys. • Totally or partially disabling AEC reduces dose variability and increases patient dose. • Median values of dose descriptors depend on the body weight selection. [ABSTRACT FROM AUTHOR]

Objective: Testing the hypothesis that CT densitometry indexes could be influenced by total lung capacity (TLC), gender and height in normal individuals. Methods: In this ethics committee-approved prospective study, 100 healthy non-smoking volunteers who provided written informed consent were included. From a helical scan of the chest, the relative area (RA) of the lung with attenuation coefficients lower than -960?HU and the 1st and 15th percentiles of the distribution of attenuation coefficients were calculated. Regression lines were drawn between each CT index and volunteers' height and total TLC at CT. Results: In males, there was no statistically significant correlation between any CT index and height. In females, there was a statistically significant correlation between the RA of the lung with attenuation coefficients lower than -960?HU and the 1st percentile and height but not with the 15th percentile. For both genders, there were significant correlations between all CT indexes and TLC. The relationships between CT indexes and TLC were different in males and females. Conclusion: CT indexes are correlated with TLC and height but more closely with TLC than with height, and differently in males and females. Advances in knowledge: CT indexes are influenced by TLC, gender and height in normal individuals and are more closely correlated with TLC than with height. The relationships between CT indexes and TLC or height are different in males and females. CT indexes used to quantify emphysema should thus be adjusted according to TLC and gender. [ABSTRACT FROM AUTHOR]

Introduction The fraction of NO in exhaled air (FeNO) is a marker of inflammation in asthma. The aim of the present study was to assess, in a real-world setting, whether only high (≥50ppb) FeNO levels predict improvement in asthma control when being treated with inhaled corticosteroids (ICS), as suggested by current guidelines on the clinical use of FeNO. Methods FeNO and asthma control were assessed in a retrospective observational study in 153 non-smoking, steroid-naïve, adult subjects with asthma with a mean age of 40years both before and after 6weeks (median follow-up time) of treatment with 500µg beclomethasone (median). Results Having at the initial visit intermediate FeNO (≥25 and <50ppb) and high FeNO (≥50ppb), compared to normal FeNO (<25ppb), were associated with a larger proportion of subjects achieving an improvement of Asthma Control Questionnaire (ACQ) score with ≥1 (78% and 67% vs 43%, p<0.05) or both ≥1 improvement and asthma control at follow-up (31% and 37% vs 4%, p<0.05). These associations were consistent in multiple logistic regression models after adjustments for confounders. Conclusions It is not only high but also intermediate FeNO levels that are associated with a significant improvement in asthma control after starting ICS treatment. This challenges current clinical guidelines stating that only high FeNO levels predict response to ICS treatment. [ABSTRACT FROM AUTHOR]

Abstract: In healthy subjects, axial distribution of nitric oxide (NO) airway production is likely heterogeneous: notably a distal peak of production in terminal bronchioles and a quasi-nil NO production in the most of the conducting airways. In asthma, few information exists about the contributions of the proximal and distal airways to NO overproduction. In 18 asthma patients, sites of constriction after methacholine and adenosine 5′-monophosphate (AMP) challenges were assessed by ventilation distribution tests with He and SF6. The resulting decreases in fractional exhaled NO (FENO) were measured. Changes in He and SF6 slopes indicated a pre-acinar bronchoconstriction due to AMP and a more proximal action for methacholine. FENO decreased by 38.7% and 20.2% (p <0.001) after AMP and methacholine challenges, respectively. Significant FENO decreases after AMP and methacholine implies substantial pre-acinar but also, contrary to healthy subjects, more proximal airway production. In conclusion, nitric oxide overproduction in asthma patients appears to involve the most part of the conducting airways. [Copyright &y& Elsevier]

Abstract: Lung transplantation is now accepted as a viable therapeutic option for patients with end-stage lung diseases, but long-term survival is threatened by bronchiolitis obliterans (BO), which is regarded as a manifestation of chronic allograft rejection. We have used studies of ventilation distribution for the early detection of this complication. In a prospective study of 57 bilateral-lung transplant recipients, we showed that the slope of phase III of the helium single-breath washout, which targets inhomogeneities of ventilation distribution in the terminal and respiratory bronchioles, was particularly sensitive to the development of BO. In a preliminary study using nitrogen multiple-breath washouts, we showed that S acin and S cond, which reflect structural changes in the acinar and conductive lung zones, were both markedly increased in patients with BO. Taken together, these studies demonstrate that monitoring the function of the allograft by measuring the distribution of ventilation in the lung periphery may be a clinically valuable tool. [Copyright &y& Elsevier]

• Prolonged apnea affects cognitive functions. • Cognitive mobile games are increasingly used to assess cognition. • Apneic time was recorded in three different conditions. • Apneic time were correlated with cognitive function. • Males and females appeared to differ in their use of cognitive resources. The relationship between cognitive function and breath-holding time is in need of further investigation. We aim to determine whether cognitive mobile games (CMG) are sensitive enough to assess the link between cognition and breath-holding time in non-trained subjects. Thirty-one healthy subjects participated in this study. A set of 3 short CMG: Must Sort (response control), Rush Back (attention, working memory) and True Color (mental flexibility, inhibition) was used. Apneic time was recorded in three different conditions: Total Lung Capacity (TLC): 88 ± 35 s, Functional Residual Capacity (FRC): 49 ± 17 s, and Residual Volume (RV): 32 ± 14 s. In males, breath-holding time at RV was correlated with True Color (r = 0.48) and Rush Back (r = 0.65) and at TLC with True Color (r = 0.45). In women, breath-holding time at TLC and FRC was inversely correlated with Must Sort (r = −0.59 and r = −0.49 respectively). Males and females appeared to differ in their use of cognitive resources during different breath-holding conditions. [ABSTRACT FROM AUTHOR]

This article discusses the impact of anti-IL-5 therapy on lung function in patients with severe eosinophilic asthma. The study found that patients who received anti-IL-5 biologics experienced a significant improvement in lung function, as measured by FEV1, after starting the treatment. However, the improvement was not observed in all patients, with some experiencing a continued decline in lung function. The study suggests that benralizumab may be more effective in improving lung function compared to other anti-IL-5 drugs, but further research is needed to confirm this. The authors conclude that patients who do not respond to anti-IL-5 therapy may benefit from switching to other biologics. [Extracted from the article]

Objectives: To test the hypothesis that referral guidelines are not sufficiently known by prescribers and that medico-legal concerns could influence the prescription of radiographs in minor chest trauma.Methods: We submitted a questionnaire including a typical clinical history and questions on reasons for prescribing radiographs of the ribs in minor chest trauma to 112 prescriptors (33 residents, 18 surgeons, 7 internists, 24 general practitioners and 30 ER physicians). All accepted to participate. Comparisons were performed by Fisher's exact test followed by a post-hoc analysis and by a McNemar test.Results: Fifty-eight percent of prescriptors proposed rib radiographs, most (89%) being unaware of the guidelines. Only 11% of them changed their intention to order radiographs after information on referral guidelines and radiation dose (P=0.057). The mean dose delivered by rib radiographs was 38 times higher than that of a chest X-ray. Legal and medico-legal concerns (requirements from insurance policies and avoidance of lawsuits) were the main reasons for requesting radiographs.Conclusion: Unsharpness of guidelines in addition to social and medico-legal issues, rather than medical reasons or the lack of knowledge of the guidelines, strongly influence the prescription of radiographs of the ribs in minor chest trauma.Key Points: • Most prescriptors order radiographs of the ribs in minor chest trauma. • Only few prescriptors are aware of referral guidelines. • Information on guidelines does not change their need for radiographs. • Motivations for ordering radiographs are rather legal than medical, but poor compliance to guidelines could also be explained by their unsharpness. • Radiation dose of rib radiographs was 38 times that of a PA chest radiograph. [ABSTRACT FROM AUTHOR]

Introduction: Over the last 5 years, the analysis of respiratory patterns presents a growing usage in clinical and research purposes, but there is still currently a lack of easy‐to‐use and affordable devices to perform such kind of evaluation. Objectives: The aim of this study is to validate a new specifically developed method, based on Kinect sensor, to assess respiratory patterns against spirometry under various conditions. Methods: One hundred and one participants took parts in one of the three validations studies. Twenty‐five chronic respiratory disease patients (14 with chronic obstructive pulmonary disease (COPD) [65 ± 10 years old, FEV1 = 37 (15% predicted value), VC = 62 (20% predicted value)], and 11 with lung fibrosis (LF) [64 ± 14 years old, FEV1 = 55 (19% predicted value), VC = 62 (20% predicted value)]) and 76 healthy controls (HC) were recruited. The correlations between the signal of the Kinect (depth and respiratory rate) and the spirometer (tidal volume and respiratory rate) were computed in part 1. We then included 66 HC to test the ability of the system to detect modifications of respiratory patterns induced by various conditions known to modify respiratory pattern (cognitive load, inspiratory load and combination) in parts 2 and 3. Results: There is a strong correlation between the depth recorded by the Kinect and the tidal volume recorded by the spirometer: r = 0.973 for COPD patients, r = 0.989 for LF patients and r = 0.984 for HC. The Kinect is able to detect changes in breathing patterns induced by different respiratory disturbance conditions, gender and oral task. Conclusions: Measurements performed with the Kinect sensors are highly correlated with the spirometer in HC and patients with COPD and LF. Kinect is also able to assess respiratory patterns under various loads and disturbances. This method is affordable, easy to use, fully automated and could be used in the current clinical context. Respiratory patterns are important to assess in daily clinics. However, there is currently no affordable and easy‐to‐use tool to evaluate these parameters in clinics. We validated a new system to assess respiratory patterns using the Kinect sensor in patients with chronic respiratory diseases. [ABSTRACT FROM AUTHOR]

When heated by an electronic cigarette, propylene glycol and glycerol produce a nicotine-carrying-aerosol. This hygroscopic/hyperosmolar aerosol can deposit deep within the lung. Whether these deposits trigger local inflammation and disturb pulmonary gas exchanges is not known. The aim of this study was to assess the acute effects of high-wattage electronic cigarette vaping with or without nicotine on lung inflammation biomarkers, transcutaneous gas tensions, and pulmonary function tests in young and healthy tobacco smokers. Acute effects of vaping without nicotine on arterial blood gas tensions were also assessed in heavy smokers suspected of coronary artery disease. Using a single-blind within-subjects study design, 25 young tobacco smokers underwent three experimental sessions in random order: sham-vaping and vaping with and without nicotine at 60 W. Twenty heavy smokers were also exposed to sham-vaping (n = 10) or vaping without nicotine (n = 10) in an open-label, randomized parallel study. In the young tobacco smokers, compared with sham-vaping: 1) serum club cell protein-16 increased after vaping without nicotine (mean ± SE, -0.5 ± 0.2 vs. +1.1 ± 0.3 μg/l, P = 0.013) and vaping with nicotine (+1.2 ± 0.3 μg/l, P = 0.009); 2) transcutaneous oxygen tension decreased for 60 min after vaping without nicotine (nadir, -0.3 ± 1 vs. -15.3 ± 2.3 mmHg, P < 0.001) and for 80-min after vaping with nicotine (nadir, -19.6 ± 2.8 mmHg, P < 0.001). Compared with sham vaping, vaping without nicotine decreased arterial oxygen tension for 5 min in heavy-smoking patients (+5.4 ± 3.3 vs. -5.4 ± 1.9 mmHg, P = 0.012). Acute vaping of propylene glycol/glycerol aerosol at high wattage with or without nicotine induces airway epithelial injury and sustained decrement in transcutaneous oxygen tension in young tobacco smokers. Intense vaping conditions also transiently impair arterial oxygen tension in heavy smokers. [ABSTRACT FROM AUTHOR]

In this work, we aim to analyze and compare the mechanisms controlling the volume of mucus in the bronchial region of the lungs of a healthy human adult, at rest and in usual atmospheric conditions. This analysis is based on a balance equation for the mucus in an airway, completed by a computational tool aiming at characterizing the evaporation, during respiration, of the water contained in the bronchial mucus. An idealized representation of the lungs, based on Weibel’s morphometric model, is used. The results indicate that the mechanisms controlling the volume of mucus in an airway depend on the localization of the airway in the bronchial region of the lungs. In the proximal generations, the volume of mucus in an airway is mainly controlled by the evaporation of the water it contains and the replenishment, with water, of the mucus layer by epithelial cells or the submucosal glands. Nevertheless, cilia beating in this part of the bronchial region remains of fundamental importance to transport the mucus and hence to eliminate dust and pathogens trapped in it. On the other hand, in the distal generations of the bronchial region, the volume of mucus in an airway is mainly controlled by the mucociliary transport and by the absorption of liquid by the epithelium. This absorption is a consequence of the mucus displacement by the cilia along generations with an interface between the epithelium and the airway surface layer of decreasing area. The numerical results obtained are in good agreement with previously published experimental data, thus validating our approach. We also briefly discuss how our results can improve the understanding and, possibly, the treatment of pulmonary diseases. [ABSTRACT FROM AUTHOR]

The article presents a study which discusses effect of total lung capacity (TLC), gender and height on computed tomography (CT) airway measurements. Topics include inclusion of healthy never-smoking volunteers, measurement of TLC using CT, testing of correlations between height and CT airway measurement using a Pearson correlation analysis, and conclusion of CT airway measurements being influenced by gender and height.

Highlights: [•] The lung diffusing capacity for nitric oxide (DLNO) was determined in healthy humans at ambient pressures ranging 0.5–4.0 atmospheres absolute (ATA). [•] The diffusivity for NO in the background gas was 8 times lower at the highest pressure than at the lowest. [•] Data fitted a model with a decreasing conductance through the gas phase in the peripheral lung with higher pressure. [•] DLNO was estimated to be 5% lower than DmNO at 1.0 ATA and 17% lower than DmNO at 4.0 ATA. [Copyright &y& Elsevier]

Abstract: Alveolar (CA NO) and exhaled nitric oxide (FE NO) concentrations, mainly regarded as inflammation surrogates, may also be affected by perfusion redistribution changing alveolar transfer factor (DA NO). A model of blood redistribution is hypergravity, found, at 2G, increases of 22% and 70%, for FE NO, and CA NO, respectively. The present study aimed at theoretically estimating the amplitude of DA NO changes that mimic these experimental data. An equation describing convection, diffusion and NO sources was solved in a 2-trumpet model (parallel dependent and non-dependent lung units). Acinar airways lumen reduction was also simulated. A reduction of 33% of the overall DA NO (−51% in the non-dependent unit) along with a 36% reduction of acinar airways lumen reproduced experimental findings. In conclusion, substantial FE NO and CA NO increases may be accounted for by a decrease of the alveolo-capillaries contact surface, here hypergravity-induced. Acinar airway constriction may also have a part in the overall FE NO increase. [Copyright &y& Elsevier]

Background: The bovine spongiform encephalopathy (BSE) epidemic presented homogeneity of the phenotype. This classical BSE (called C-type) was probably due to the contamination of the food chain by a single prion strain. However, due to the active surveillance and better techniques, two rare variants of BSE have been recently reported in different continents without a clear correlation to the BSE epidemic. These emerging types behave as different strains of BSE and were named H-type and L-type according to the high and low molecular mass of the unglycosylated fragment of their proteinase K resistant prion protein (PrPres). In these types, the proportion of the un-, mono- and di-glycosylated fragments of PrP (glycoprofile) is also atypical and represents an effective diagnostic parameter. This study evaluated the presence of such types in bovine of 7 years and older in Belgium. Results: The Belgian BSE archive contained 41 bovines of at least 7 years of age. The biochemical features of their PrPres were analyzed by Western blot with five antibodies recognising different regions of PrPres, from N- to C-terminus: 12B2, 9A2, Sha31, SAF84 and 94B4. All antibodies clearly detected PrPres except 12B2 antibody, which is specific for N-terminal region 101-105, a PrP region that is only retained in H-types. The glycoprofiles did correspond to that of C-type (with more than 55% of diglycosylated PrPres using antibody 94B4). Therefore, all cases have the features of C-type BSE. Conclusions: This study supports that, among the BSE cases of 7 years and older identified in Belgium, none was apparently of the H- or L- type. This is consistent with the very rare occurrence of atypical BSE and the restricted dimension of Belgium. These results shed some light on the worldwide prevalence of atypical BSE. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about asbestosis-induced lung disease.

Background: Few data are available on the long-term effect of pulmonary rehabilitation (PR) and on long PR programs in interstitial lung diseases (ILD). We aimed to evaluate the effects of PR on exercise capacity (6-Minute Walking Distance, 6MWD; Peak Work Rate, Wmax), quality of life (St George's Respiratory Questionnaire, SGRQ), quadriceps force (QF) and objectively measured physical activity in ILD after the 6-month PR-program and after 1 year.Methods: 60 patients (64 ± 11 years; 62% males; 23% with IPF) were randomly assigned to receive a 6 month-PR program or usual medical care.Results: Exercise capacity, quality of life and muscle force increased significantly after the program as compared to control (mean,95%CI[ll to ul]; 6MWD + 72,[36 to 108] m; Wmax 19, [8 to 29]%pred; SGRQ - 12,[- 19 to - 6] points; QF 10, [1 to 18] %pred). The gain was sustained after 1 year (6MWD 73,[28 to 118] m; Wmax 23, [10 to 35]%pred; SGRQ - 11,[- 18 to - 4] points; QF 9.5, [1 to 18] %pred). Physical activity did not change.Conclusions: PR improves exercise tolerance, health status and muscle force in ILD. The benefits are maintained at 1-year follow-up. The intervention did not change physical activity.Trial Registration: Clinicaltrials.gov NCT00882817 . [ABSTRACT FROM AUTHOR]

Background There are several tests available for the long-term evaluation of exercise capacity. Of these tests, the 10 m and 20 m Shuttle Tests can be performed in CF patients but they may be either too short or too long in patients who are doing fine or who are very ill, respectively. The aim of this study was to assess the feasibility of a 15 m Shuttle Test (15MST) in CF children, adults and lung transplant recipients (LTR). Methods and Patients Forty-one stable patients performed a 15MST: 19 CF children (FEV1 83±13% pred), 16 CF adults (FEV1 67±23%) and 6 LTR (FEV1 83±14%). Results In CF children, level variability (LV) was between 4 and 12, performed distance was 654±253 m, extrapolated VO 2 max (eVO 2 max) was 43±3 ml/kg/min, heart rate (HR) was 133±15 bpm, SaO 2 was 97±1% and dyspnea score (Borg Scale) was 5±3. In CF adults, LV was between 2 and 10, performed distance 611±334 m, eVO 2 max 30±6 ml/kg/min, HR 159±17 bpm, SaO 2 89±6% and dyspnea score 8±1. In LTR, LV was between 2 and 5, performed distance 330±117 m, eVO 2 max 20±13 ml/kg/min, HR 140±14 bpm, SaO 2 96±1% and dyspnea score 8±1. Conclusion The 15MST is feasible and usable in CF children and adults as well as LTR patients. It can be an alternative to 10 m and 20 m Shuttle Tests but it must still be validated. This work was supported by a grant from the Belgian Cystic Fibrosis Association and is part of our educational project ‘Just move it! move it!’. [ABSTRACT FROM AUTHOR]

Background Many CF patients complain of altered sleep quality and, in some of them, polysomnography shows sleep disorders with frequent awakenings, night cough, lower sleep efficiency (SE) and less REM sleep. The SWA, which measures body movement, surface body temperature, galvanic and heat flux skin response, proposes a non-invasive and simple way to measure sleep stages at home. Objectives Our study 1. examined the validity of SWA to detect sleep stages in normal controls compared to published normative values (Ohayon et al, Sleep 2004) and 2. compared SWA-derived sleep architecture between normal controls and stable CF patients. Methods 15 CF adults (31.6±12.3 yrs; FEV 1 65.5±24.4% pred) and 19 CF children (10.5±3.4 yrs; FEV 1 83±13.4%) were compared with 13 healthy adults (32.3±11.5 yrs) and 11 healthy children (10±1.9 yrs). CF patients and healthy subjects wore the SWA for an average of 5 and 2 nights, respectively. Light sleep (LS, stages 1 and 2), deep sleep (DS, stages 3 and 4); REM stage and SE were evaluated as the % of total sleep time. Results In healthy subjects, SWA showed SE and DS measures consistent with published normative values whereas LS and REM seemed to be over- and underestimated, respectively. In CF adults, but not in CF children, SE was lower when compared to normal controls (adults: 77.3±8.5% vs 86.3±4.7%; p = 0.003; children: 81.0.3±6.8% vs 84.4±5.0%; p = 0.154). None of the sleep stages differed between patients and controls, except for REM sleep which was lower in CF children. Conclusion SWA is a simple and promising method to detect sleep architecture disorders in CF patients, notably sleep efficiency. [ABSTRACT FROM AUTHOR]