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Objectives: Assessment of pain is challenging given its subjective nature. Standard pain assessment tools have limitations. We aimed to compare the verbal numeric rating scale (NRS) and Grasp, a novel handheld electronic device that reports pain by squeezing., Methods: To compare Grasp and NRS, healthy adult volunteers were invited to undergo two subsequent standardised tests of cold-triggered pain using a cold pressor test (CPT) at a temperature of 3°C. Pain intensity was in a randomised manner reported by NRS (scale 0-10) or by squeezing Grasp (0-3 V) during the two CPTs. A third CPT was performed 1 to 14 days later where subjects reported pain by Grasp a second time in order to study the association of repeated Grasp measurements. Acceptable association was a priori considered as mean Kendall's τ - b coefficient ( τ - b ) ≥ 0.7. The subjects reported their experience of using Grasp in a purpose-made questionnaire., Results: In total, 102 subjects were included, and 96 subjects (56 females) completed all three tests. The association of pain intensity reported by Grasp and NRS was moderate with a mean τ - b of 0.53 (95% confidence interval [CI] 0.47-0.58). The association between the repeated Grasp measurements was weak with a mean τ - b of 0.43 (95% CI 0.37-0.48). Most subjects reported that Grasp was intuitive and easy to use., Conclusions: Pain intensity reported by squeezing Grasp did not show acceptable association with pain intensity reported by NRS during CPTs. The association between pain intensity reported by Grasp during two CPTs on separate days was weak. Further improvements of the Grasp ball are needed before use in clinical settings., (© 2024 the author(s), published by De Gruyter.)

Background: The Western Norway Regional Health Authority uses SATS Norge (SATS-N), a modified version of the South African Triage Scale, in all accident and emergency departments (A&E) and ambulance services in the region. The purpose of the study was to examine the validity of the paediatric component of SATS-N used for children transported to hospital by ambulance for emergency medical assistance., Material and Method: We conducted a retrospective observational study which included all children in the age group 0-14 years, admitted by ambulance to A&E at Haukeland University Hospital for emergency medical assistance in the period from January to June 2020. The five triage levels in SATS-N were dichotomised to high triage level (the two highest triage categories) or low triage level (the three lowest triage categories). Sensitivity was calculated as the proportion of patients assigned to the high triage level among those who were directly transferred from A&E to a high dependency unit, and specificity as the proportion of patients assigned to the low triage level among those who were not directly transferred to a high dependency unit., Results: Of a total of 303 patient transports, 270 (89 %) were triaged in the ambulance and 243 (80 %) in the A&E. In the pre-hospital and A&E settings, the sensitivity of SATS-N was 96 % and 88 %, and specificity was 46 % and 60 %, respectively., Interpretation: For children admitted to hospital by ambulance, SATS-N had high sensitivity and low specificity for identifying patients who needed to be directly transferred from A&E to a high dependency unit.

Introduction: Exercise-induced laryngeal obstruction (EILO) is a common cause of exertional breathing problems in young adults. Current management generally consists of breathing advice, speech therapy, inspiratory muscle training or supraglottoplasty in highly motivated subjects with supraglottic collapse. Inhaled ipratropium bromide (IB) is a muscarinic receptor antagonist used to treat asthma that is suggested in a few reports to improve EILO symptoms. The aim of the present study was to investigate effects of inhaled IB in EILO diagnosed by continuous laryngoscopy exercise (CLE) test and classified by CLE scores., Methods: A randomised crossover trial was conducted at Haukeland University Hospital, Bergen, Norway, enrolling participants diagnosed with EILO defined by characteristic symptoms and CLE score ≥3 (range 0-12). Two consecutive CLE tests were performed within 2 weeks, one test with and one test without prior administration of inhaled IB in a randomised order. Main outcomes were the CLE score, dyspnoea measured using a modified BORG scale (range 0-10) and cardiopulmonary exercise data provided by the CLE test., Results: 20 participants (14 females) aged 12-25 years participated, and all ran to exhaustion on both tests. Mean CLE score, BORG score and peak oxygen consumption were similar in tests performed with and without IB; mean differences (95% confidence interval) were 0.08 (-0.28-0.43), 0.35 (-0.29-0.99) and -0.4 (-1.9-1.1) mL·kg -1 ·min -1 , respectively., Conclusion: Inhaled IB did not improve CLE score, dyspnoea or exercise capacity in subjects with EILO. The study does not support the use of inhaled IB to treat EILO., Competing Interests: Conflict of interest: The authors have no conflicts of interest to disclose., (Copyright ©The authors 2023.)

Aims: A cardiopulmonary exercise test (CPET) is the gold standard to evaluate symptom-limiting exercise intolerance, while continuous laryngoscopy performed during exercise (CLE) is required to diagnose exercise-induced laryngeal obstruction. Combining CPET with CLE would save time and resources; however, the CPET data may be distorted by the extra equipment. We therefore aimed to study whether CPET with CLE influences peak oxygen uptake ( V ' O 2 peak) and other gas exchange parameters when compared to a regular CPET., Methods: Forty healthy athletes without exercise-related breathing problems, 15-35 years of age, performed CPET to peak exercise with and without an added CLE set-up, in randomised order 2-4 days apart, applying an identical computerised treadmill protocol., Results: At peak exercise, the mean difference (95% confidence interval) between CPET with and without extra CLE set-up for V ' O 2 peak, respiratory exchange ratio (RER), minute ventilation ( V ' E ) and heart rate (HR) was 0.2 (-0.4 to 0.8) mL·kg -1 ·min -1 , 0.01(-0.007 to 0.027) units, 2.6 (-1.3 to 6.5) L·min -1 and 1.4 (-0.8 to 3.5) beats·min -1 , respectively. Agreement (95% limits of agreement) for V ' O 2 peak, RER and V ' E was 0.2 (±3.7) mL·kg -1 ·min -1 , 0.01 (±0.10) units and 2.6 (±24.0) L·min -1 , respectively. No systematic or proportional bias was found except for the completed distance, which was 49 m (95% CI 16 to 82 m) longer during CPET., Conclusion: Parameters of gas exchange, including V ' O 2 peak and RER, obtained from a maximal CPET performed with the extra CLE set-up can be used interchangeably with data obtained from standard CPET, thus preventing unnecessary additional testing., Competing Interests: Conflict of interest: M. Engan has nothing to disclose. Conflict of interest: I.J. Hammer has nothing to disclose. Conflict of interest: M. Bekken has nothing to disclose. Conflict of interest: T. Halvorsen has nothing to disclose. Conflict of interest: Z.L. Fretheim-Kelly has nothing to disclose. Conflict of interest: M. Vollsæter has nothing to disclose. Conflict of interest: L.P.V. Bovim has nothing to disclose. Conflict of interest: O.D. Røksund has nothing to disclose. Conflict of interest: H. Clemm has nothing to disclose., (Copyright ©ERS 2021.)

Objectives: To compare physical activity and body composition in a cohort of children born extremely preterm/extremely low birth weight (EP/ELBW) with term-born (TB) controls., Methods: A regional cohort of children born during 1999-2000 at gestational age <28 weeks or with birth weight <1000 g and their individually matched TB controls were examined in 2010-2011. Information on physical activity was obtained from parental questionnaires, and body composition was determined by anthropometry and dual X-ray absorptiometry., Results: Fifty-seven EP/ELBW and 57 TB controls were included at a mean age of 11.6 years. Compared with the TB children, the EP/ELBW-born children exercised less often (22% vs 44% exercised more than 3 days per week), had lower physical endurance and poorer proficiency in sports and play and were less vigorous during exercise (p<0.05). They also had lower values (mean; 95 % CI) for muscle mass (0.9; 0.3-1.5 kg), total bone mineral density z-score (0.30; 0.13-0.52 units) and fat mass ratio (0.14; 0.06-0.21 units). The association between physical activity and bone mineral and skeletal muscle mass accrual was significantly weaker for the EP/ELBW-born than the TB children., Conclusions: The EP/ELBW-born children were less physically active, had signs of an unfavourable body composition with less muscle mass and lower bone mineral density than the TB controls. The association between physical activity and the measures of body composition was weaker in the group of EP/ELBW-born children., Competing Interests: Competing interests: None declared.