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BackgroundRespiratory failure is a severe complication in coronavirus disease 2019 (COVID-19) pneumonia that, in addition to oxygen therapy, may require continuous positive airway pressure (CPAP) support. It has been postulated that COVID-19 lung injury may share some features with those observed in hyperoxic acute lung injury. Thus, a correct target arterial oxygen tension (PaO2) during oxygen supplementation may be crucial to protect the lung from further tissue damage. The aims of this study were: 1) to evaluate the effects of conservative oxygen supplementation during helmet CPAP therapy on mortality and intensive care unit (ICU) admission in patients with COVID-19 and respiratory failure, and 2) to evaluate the effect of conservative oxygen supplementation on new-onset organ failure and secondary pulmonary infections.MethodsThis was a single-centre, historically controlled study of patients with severe respiratory failure due to COVID-19 pneumonia, receiving either conservative or nonconservative oxygen supplementation during helmet CPAP. A cohort receiving conservative oxygen supplementation was studied prospectively in which oxygen supplementation was administered with a targetPaO2Results71 patients were included in the conservative cohort and 75 in the nonconservative cohort. Mortality rate was lower in the conservative cohort (22.5%versus62.7%; pversus37.3%; p=0.001 and 9.9%versus45.3%; pConclusionsIn patients with COVID-19 and severe respiratory failure, conservative oxygen supplementation during helmet CPAP was associated with improved survival, lower ICU admission rate and less new-onset organ failure.

The aim of the study was to evaluate occupational exposure to 40 elements among a group of Eritrean adults employed at the Medeber metal market by analysing human scalp hair samples and by investigating the role of some predictors (gender, age, and body mass index-BMI) on their levels. Scalp hair samples were collected from 60 subjects (32 subjects working at the Medeber metal market and 28 subjects not working at Medeber and not employed in other industrial or artisanal activities) and were analysed through inductively coupled plasma mass spectrometry to determine the contents of 40 major and trace elements. Information on participants was collected via questionnaire. Significant differences were found in the hair levels of certain elements between subjects working at the Medeber metal market and subjects not exposed. In particular, working at the Medeber metal market increased hair levels of Be, B, Cu, Zn, Mo, Cd, Sb, Tl, Pb, and Fe from 25 to 100%, while reduced Na, K, and Rb levels from 30 to 50%. With multivariate adjustment for age, gender, and BMI, the results confirm that working at Medeber significantly increased the hair levels of Cu, Zn, Sb, Pb, and Fe. This finding reveals the need for more accurate and routine biomonitoring surveys and the necessity of health promotion campaigns both for local decision-makers and workers to increase health promotion and safety in this workplace.

Small-scale or artisanal mining, using gold-mercury amalgamation to extract gold from ore, is a significant source of exposure for the workers and nearby populations. Few studies on hair mercury (Hg) have been conducted in Africa despite the fact that Africa has several gold deposits. No studies have been conducted in Eritrea that is one of the emerging gold producing countries in Africa. The aim of the study was to assess the Hg concentration in hair samples (n = 120) of a population living in Asmara, capital of Eritrea, and to evaluate the influence of some factors on the Hg levels in hair. Information on age, height, weight, occupation, smoking and fish consumption of participants were collected via questionnaire. Hair Hg concentration was significantly higher among women compared to men (p &lt, 0.001) and among women preparing spicy products in Medeber market compared to those who did other jobs (p = 0.010). These results highlight the need for routine biomonitoring surveys and for health promotion campaigns devoted to local decision makers and workers.

Advancements in sample preparation for performing elemental analysis are coming from the dissemination of microwave-assisted procedures, but there is still room for improvements by looking for fast and easily applicable procedures. In the present study, open-vessel digestion sample treatment (19–21 °C or 95 °C) was compared with closed-vessel microwave-assisted digestion (180 °C). Detection and quantification limits, accuracy, precision, residual carbon content, and residual acidity were quantified with certified and in-field hair samples. Human hair samples (0.02 g) were digested with HNO3/H2O2 (2 : 1) in an open vessel heated to 95 °C. The residual carbon content was

Introduction: Although BD drugs are the mainstay of therapy to prevent EIB, high variability in individual response to treatment has been reported. The presence of different endotypes has been suggested to be responsible for such heterogeneity. However, the impact of the endotype on the BD response has not yet been studied in EIB. Aim: To assess whether the T2-endotype signature could influence the BD response in EIB. Methods: 20 subjects underwent at baseline a standardized exercise challenge (EC) to document EIB (FEV1 fall ≥10%) and were divided into two groups (T2-high and T2-low) on the basis of: (I) specific IgE (+ or -), (II) blood eosinophil count (≥ or Results: In T2-high subjects (n=12) a significant difference in FEV1 fall was observed after salbutamol compared to ipratropium (-5.5±8.6% vs 16.5±14.6%; p=0.0019), with only salbutamol offering clinically relevant (i.e. halving in FEV1 fall compared to the FEV1 fall observed at baseline) and complete (i.e. FEV1 fall 0.05). Conclusions: Our findings firstly show that the T2-endotype influences BD response in EIB, supporting the efficacy of ipratropium in T2-low subjects. This should prompt a Precision Medicine approach in EIB to provide optimal and personalized management.

Introduction: EIB is the transient airway narrowing that occurs as a result of exercise. A fall in FEV1 ≥10% after a standardized exercise challenge (EC) is the gold-standard to diagnose EIB. Baseline respiratory symptoms and spirometry poorly relate to the occurrence of EIB. Aim: To evaluate whether alternative baseline markers could predict EIB. Methods: A series of functional (IOS, MBNW), inflammatory (FeNO, EBT, cell counts, total and specific IgE) and patient-reported (AQUA) baseline endpoints were assessed in 40 subjects (25M-15F; mean age 37±13 yrs.) with a clinical suspect of EIB. Following EC, subjects were divided into EIB+ (n=22) and EIB- (n=18) for comparison. Data were analysed with parametric, non-parametric and linear regression tests. Results: The two groups were matched for age, gender, BMI and exercise-training hours. Of the baseline values, only FeNO was significantly different between EIB+ and EIB- (71±52 vs 32±21 ppb; p=0.006). FeNO also significantly and moderately relate to the degree of post-EC FEV1 fall (p 50ppb, indicative of uncontrolled airway inflammation, had a PPV of 75% for predicting EIB, with sensitivity 55% and specificity 78% (Fig 1). Conclusions: Baseline FeNO values significantly and independently predict EIB. In view of the ease and low-cost of FeNO testing, our findings support FeNO clinical relevance for healthcare settings not equipped to perform EC.