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Objective  Structured light plethysmography (SLP) is a novel and noncontact respiratory assessment technique. It provides tidal breathing measurement in patients difficult to cooperate. In this study, we aimed to determine data for tidal breathing parameters measured by SLP in newborns. Study Design  Infants between 2 and 5 days of life without having any respiratory symptoms were eligible for this observational study. In total, 5 minutes of tidal breathing was recorded using SLP (Thora-3Di, PneumaCare Ltd, Cambridge, U.K.) in each infant. Various tidal breathing parameters including timing indices, flow-based parameters, and regional parameters were obtained from SLP data. Results  A total of 57 infants underwent measurements in the study. Evaluable recordings from 42 term and 11 late preterm infants were analyzed. Median gestational age and birthweight of the infants were 38 (37–39) weeks and 3,195 (2,790–3,585) g, respectively. In terms of flow-based parameters, "tidal inspiratory flow at 50% of inspiratory volume divided by tidal expiratory flow at 50% of expiratory volume" was 1.29 (1.13–1.53). Relative contribution of the thorax to each breath in percentage was measured as 38.67 (28.21–43.60). Median values of left–right hemithoracic asynchrony and thoraco-abdominal asynchrony were 6.92 (5.35–9.04) and 17.96 (12.98–36.44) degrees in the study population, respectively. There were no differences in tidal breathing parameters except "hemithoracic asynchrony" between term and late preterm infants. Hemithoracic asynchrony was significantly lower in term neonates than late preterms. Conclusion  SLP was found to be feasible to obtain measures of tidal breathing parameters in newborns and it could be performed successfully even in the first days of life. [ABSTRACT FROM AUTHOR]

• The first objective measure to enable tracking of respiratory function for type 1. • Scoring system focuses on ventilation, secretion management and subtype. • By month 18 of treatment, stabilisation of respiratory score noted for all patients. Nusinersen (NUS), the first treatment approved for Spinal Muscular Atrophy type 1 (SMA1), was made available in the UK for SMA1 through the Expanded Access Program (EAP) in 2017. The Great Ormond Street Respiratory (GSR) score was developed as an objective respiratory assessment for children with SMA1 during their treatment. Aims: Track respiratory status of SMA1 children over the course of Nusinersen treatment and compare GSR scores amongst SMA1 sub-types. Single centre study on SMA1 patients using the GSR score at set time points: prior to first NUS dose; 2 weeks post end of loading doses; 2 weeks post-subsequent doses. GSR score ranges 1–28, being 1–9 = Stable minimal support, thorough to 23–28 = Poor reserve with maximum support. 20 SMA1 children underwent NUS treatment between January 2017 - November 2018. Median age of diagnosis was 5.0 months. NUS started at median of 9.57 months. From 5th dose onwards, GSR scores were significantly lower for Type 1C patients compared to Type 1B By month 18, irrespective of subtypes, the whole cohort appears to stabilise GSR Scores. As treatment duration increases, an overall stabilisation of respiratory status across the cohort was observed. Further longitudinal studies are needed to validate the GSR. [ABSTRACT FROM AUTHOR]

The additional mass and fit of current military in-service body armour (ISBA) can reduce pulmonary function in a way that is characteristic of a restrictive respiratory impairment. This could ultimately impair exercise capacity and military performance. This study compared pulmonary function (forced vital capacity [FVC] and forced expiratory volume in 1 s [FEV1]) in UK ISBA (15.3 kg) and three flexible body armours (BAs) (FA1: 10 kg; FA2: 7.8 kg; FA3: 10 kg) in eight male soldiers. The design of the ballistic plates differed between the BAs to improve the flexibility. FVC and FEV1 were reduced by 4–6%, without reduction in FEV1/FVC for ISBA, FA2 and FA3, when compared to NoBA (p < 0.05). No difference was observed between FA1 and NoBA. As expected, wearing BA caused a mild restrictive ventilatory impairment; however, modifications to BA design can reduce the degree of this impairment. Practitioner Summary: This study showed that wearing body armour caused a mild restrictive ventilatory impairment. However, the design of the armour can be modified to reduce the degree of this impairment. This may lead to improvements in soldier performance during tasks that require body armour. [ABSTRACT FROM AUTHOR]

Background & Aims Bilirubin has potent antioxidant properties in vitro and raised serum levels have been associated with lower rates of respiratory disease. The enzyme uridine diphosphate glucuronosyltransferase polypeptide 1A1 (UGT1A1) is solely responsible for clearing bilirubin from the blood and homozygosity for seven thymine-adenine (TA) repeats in the TATA box regulatory element of the UGT1A1 gene underlies a mild hereditary unconjugated hyperbilirubinaemia (Gilbert’s syndrome). Our aim was to investigate whether this genetic variation is associated with differences in respiratory health. Methods The relationship between the promoter genotype underlying Gilbert’s syndrome ( UGT1A1 rs8175347 [TA]7/7) and respiratory outcomes assessed at ages 43, 53, and 60–64 were examined in 2190 members of the 1946 British birth cohort. Results The (TA)7/7 genotype, present in 9% of the cohort, was associated with higher forced expiratory volume (FEV1) and forced vital capacity (FVC). The relationship was strongest for heavy smokers (⩾20 cigarettes per day) at age 53 with mean FEV1 409 ml higher (191 to 627; p <0.001) and mean FVC 530 ml higher (95% CI 262–798; p <0.001) for UGT1A1 (TA)7/7 Gilbert’s syndrome participants than for all others, indicating a protection from the pulmonary consequences of heavy smoking. The odds of respiratory disease (chronic obstructive pulmonary disease, self-reported asthma, or prescription of respiratory drugs) were half in those with Gilbert’s syndrome genotype (odds ratio 0.49 [95% CI 0.39–0.74]; p <0.001) compared to those without this genotype. Conclusions Genetically raised unconjugated serum bilirubin is associated with higher adult respiratory function and protection from respiratory disease. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate the association between occupational social class and respiratory function, as measured by forced expiratory volume in one-second (FEV1). We examined the cross sectional relationship between lung function and social class in a population study of 21,991 men and women aged 39–79 years living in the general community in Norfolk, United Kingdom, recruited using general practice age–sex registers in 1993–1997. There was a significant socioeconomic gradient in age adjusted lung function with a difference of 0.37 in mean FEV1 in men and 0.20 in women, respectively between social class I and V. The age adjusted OR for having poor lung function was 4.13 (95% CI 2.66–6.42) in men and 2.64 (95% CI 1.74–3.99) in women for social class V compared to I. This difference was substantially attenuated after adjustment for height, weight, smoking status, respiratory illness, educational level, living in a deprived area, physical activity and plasma vitamin C levels. There was a strong socioeconomic gradient in respiratory function. In men the gradient appeared to be largely explained by smoking status and height; in women a large part of the gradient was explained by potentially modifiable factors. This suggests that socioeconomic inequalities in respiratory function may be preventable or modifiable and highlights factors for further exploration. [ABSTRACT FROM AUTHOR]

The article presents the communicable disease and health protection quarterly review from October to December 2003 from Health Protection Agency and Communicable Disease Surveillance Centre in Great Britain. The review comprises several updates including the vaccination policy for health care workers in England, the gastroenteritis outbreak in a cruiser liner, and the clusters of clinical tetanus in injecting drug users. An update on Neisseria gonorrhoae in England and Wales is also featured.

Objectives: Male sex in prematurely born infants has been associated with worse respiratory outcomes in early childhood., Working Hypothesis: Respiratory outcomes at 11 to 14 years of age in children born very prematurely and routinely exposed to antenatal corticosteroids and postnatal surfactant would differ according to sex., Study Design: Analysis of follow-up data., Patient-Subject Selection: Three hundred and nineteen children born before 29 weeks of gestational age from the United Kingdom Oscillation Study., Methodology: Spirometry was used to assess forced expiratory flow at 75%, 50%, and 25% of expired vital capacity (FEF 75 , FEF 50 , and FEF 25 ), forced expiratory volume in 1 second (FEV 1 ), peak expiratory flow (PEF), and forced vital capacity (FVC). Lung volumes were measured using a helium dilution technique (FRC He ) and by plethysmography (FRC pleth ). Total lung capacity (TLC) and residual volume (RV) were calculated. Mean lung function measurements were compared using linear mixed models and reported as unadjusted and adjusted for neonatal and age 11 to 14 years factors. The participants also completed health questionnaires and provided a urine sample for assessment of passive or active smoking., Results: Three (FEF 25 , FEF 25-75 , FEV 1 ) lung function measures showed significant differences in favor of females after adjustment. The percentage of children with abnormal lung function (below 5th centile for normal) had adjusted differences between 10 and 30 percentage points, for example, for FEF 25 15% females compared with 26% males., Conclusions: Among extremely prematurely born school children airway function was significantly worse in males., (© 2020 Wiley Periodicals, Inc.)