Effects of chest physiotherapy and aerobic exercise training on physical fitness in young children with cystic fibrosis

Background Cystic fibrosis is a multisystem disease where the main problems are existing in the respiratory system. Aerobic exercise programs are effective in increasing physical fitness and muscle endurance in addition to chest physiotherapy. Objective The aim of this study was to evaluate the effects of chest physiotherapy and aerobic exercise training on physical fitness in young children with cystic fibrosis. Methods Sixteen patients with cystic fibrosis, between the ages 5-13 years, were included in this study. All children were assessed at the beginning and at the end of 6 week of the training. Modified Bruce protocol was used for assessing the cardiovascular endurance. The sit-up test was used to evaluate the dynamic endurance of abdominal muscles, standing long jump was used to test power, sit and reach, trunk lateral flexion, trunk hyperextension, trunk rotation and forward bending tests were used to assess flexibility, 20 m shuttle run test and 10-step stair climbing tests were used to assess power and agility. All patients received chest physiotherapy and aerobic training, three days a week for six weeks. Active cycle of breathing technique and aerobic exercise training program on a treadmill were applied. Results By evaluating the results of the training, positive progressions in all parameters except 20 m shuttle run and 10 stairs climbing tests were observed (p 0.05). Conclusion It is thought that in addition to medical approaches to the systems affected, the active cycle of breathing techniques along with aerobic training helps to enhance the aerobic performance, thoracic mobility and improves physical fitness in children with cystic fibrosis

Low perfusion index affects the difference in glucose level between capillary and venous blood

AIM: In emergency cases, finger stick testing is primarily used to check the blood glucose value of patients since it takes longer to obtain the venous value. In critical patients, under conditions that cause an increase in metabolic state and level of stress, there occurs considerable difference in glucose levels between capillary and venous measurements. This study aimed to investigate the comparability of capillary and venous glucose values, according to the perfusion index level obtained with the Masimo Radical-7(®) device, in critical patients aged 18 years and over. METHOD: We conducted this prospective and observational study in the emergency department of the Eskisehir Osmangazi University hospital between November 3, 2008 and February 2, 2009. RESULTS: The blood glucose of 300 critical patients was checked by finger stick in the emergency unit. The participants with normal vital signs had perfusion index between 0 and 5; the results obtained by the two methods were more consistent for perfusion index values of 6 and over. The results were most consistent in aged participants with normal vital sign findings and low perfusion index and in young patients with high perfusion index. In the cases where at least one of the vital signs was abnormal, the glucose values obtained by the two methods were more consistent when the perfusion index was 6 or over. In this group, independently from the perfusion index value, the consistency was higher in younger patients compared with aged patients. CONCLUSION: In the emergency department, perfusion index value measured by Masimo Radical-7 and capillary blood glucose levels can serve in blood sugar management in critically ill patients

Demographic, Clinical and Radiological Features of Healthcare Workers and Two Index Cases That Were Infected with COVID-19 (SARS-Cov-2)

To evaluate the index cases leading to the transmission of healthcare workers (HCWs) in Rize/Turkey Recep Tayyip Erdogan University Faculty of Medicine Education and Research Hospital with COVID-19 infection and the clinical features of infected HCWs. The first two COVID-19 test positive patients treated at Rize/Turkey between 10.03.2020 and 12.04.2020 and HCWs those who examined these two patients whose COVID-19 PCR test results were positive were included in this study. In Rize/Turkey, the first and second cases of positive COVID-19 which was recorded on 13.03.2020 on 25.03.2020, 27 HCWs (female, 63%, n = 17 and male, 37%, n = 10 and the mean age was 33.2 ± 6.9 years) who contacted during the treatment of these cases and became COVID-19 positive were examined. The median of symptom duration (days) of the HCWs was 5 days (range: 0–17 days). Fever, 55.6% (n = 15); malaise, 44.4% (n = 12); cough, 40.7% (n = 11); sore throat, 33.3% (n = 9); myalgia, 33.3% (n = 9); dyspnea, 14.8% (n = 4); diarrhea, 22.2% (n = 6); vomiting, 14.8% (n = 4); anosmia, 18.5% (n = 5); ageusia, 22.2% (n = 6) and headache, 37% (n = 10) of the cases. The rates of headache in female HCWs infected with COVID-19 were found to be significantly higher compared to men (52.9%). None of them had severe clinical situation requiring intensive care follow-up or acute respiratory distress syndrome (ARDS). Laboratory measurements of HCWs were carried out at the first when they had symptoms and when they recovered, and results were compared accordingly. The thorax computerized tomography (CT) findings of HCWs were normal in 74.1% (n = 20) of total. HCWs were initially affected by the COVID-19 pandemic. Early measures provided by the Health authorities, access to diagnosis and treatment, and the young age average in HCWs prevented severe outcomes such as severe clinical course and mortality at the beginning of the outbreak

Lack of Correlation of Sinonasal and Otologic Reported Symptoms With Objective Measurements Among Patients With Primary Ciliary Dyskinesia: An International Study.

peer reviewedSinonasal and otologic symptoms are common among patients with primary ciliary dyskinesia (PCD) of all ages. We used baseline data from the ENT Prospective International Cohort of PCD patients (EPIC-PCD), the first PCD cohort focused on ENT disease manifestations. We assessed agreement between patient- or parent-reported symptoms and relevant examination findings, and calculated unweighted Cohen’s kappa to adjust for agreement by chance. We included 404 participants, from 12 centres. We found no correlation between patient-reported sinonasal symptoms and relevant clinical examination findings. Otologic symptoms correlated poorly or weakly with otoscopy and audiometry findings, with age and centre identified as determinants of agreement

The disease-specific clinical trial network for primary ciliary dyskinesia: PCD-CTN

Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by impaired mucociliary clearance leading to irreversible lung damage. In contrast to other rare lung diseases like cystic fibrosis (CF), there are only few clinical trials and limited evidence-based treatments. Management is mainly based on expert opinions and treatment is challenging due to a wide range of clinical manifestations and disease severity. To improve clinical and translational research and facilitate development of new treatments, the clinical trial network for PCD (PCD-CTN) was founded in 2020 under the framework of the European Reference Network (ERN)-LUNG PCD Core. Applications from European PCD sites interested in participating in the PCD-CTN were requested. Inclusion criteria consisted of patient numbers, membership of ERN-LUNG PCD Core, use of associated standards of care, experience in PCD and/or CF clinical research, resources to run clinical trials, good clinical practice (GCP) certifications and institutional support. So far, applications from 22 trial sites in 18 European countries have been approved, including >1400 adult and >1600 paediatric individuals with PCD. The PCD-CTN is headed by a coordinating centre and consists of a steering and executive committee, a data safety monitoring board and committees for protocol review, training and standardisation. A strong association with patient organisations and industrial companies are further cornerstones. All participating trial sites agreed on a code of conduct. As CTNs from other diseases have demonstrated successfully, this newly formed PCD-CTN operates to establish evidence-based treatments for this orphan disease and to bring new personalised treatment approaches to patients

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo