Abstract Background Contamination is a key element in cystic fibrosis. For this reason, nebulizer hygiene is an important, but complex and time-consuming task for cystic fibrosis patients. The aim of ...this study was to compare different steam disinfection and drying protocols. Methods One hundred nebulizer parts were inoculated with cystic fibrosis-related bacteria in high concentrations ( Burkholderia multivorans 3.9 × 1010 /ml, Staphylococcus aureus 8.9 × 108/ ml and Pseudomonas aeruginosa 2.1 × 109 /ml). Tubes with Mycobacterium abscessus complex were additionally tested. Six steam disinfectors were compared. Different methods of drying were examined. Results All tested bacteria were efficiently killed by the different steam disinfectors tested. The risk of contamination depended on the method of drying. Conclusions Steam disinfection is a safe disinfection method. It is better to leave the nebulizers wet after steam disinfection than to manipulate them by active drying, which seems to be a source of recontamination.
Oxygenation through High Flow Delivery Systems (HFO) is described as capable of delivering accurate F
iO2
. Meanwhile, peak inspiratory flow
V
˙
I
) of patients with acute hypoxemic respiratory ...failure can reach up to 120 L/min, largely exceeding HFO flow. Currently, very few data on the reliability of HFO devices at these high
V
˙
I
are available. We sought to evaluate factors affecting oxygenation while using HFO systems at high
V
˙
I
in a bench study. Spontaneous breathing was generated with a mechanical test lung connected to a mechanical ventilator Servo-i®, set to volume control mode. Gas flow from a HFO device was delivered to the test lung. The influence on effective inspired oxygen fraction of three parameters (F
iO2
0.6, 0.8, and 1,
V
˙
I
from 28 to 98.1 L/min, and HFO Gas Flows from 40 to 60 L/min) were analyzed and are reported. The present bench study demonstrates that during HFO treatment, measured F
iO2
in the lung does not equal set F
iO2
on the device. The substance of this variation (ΔF
iO2
) is tightly correlated to
V
˙
I
(Pearson’s coefficient of 0.94, p-value < 0.001). Additionally, set F
iO2
and Flow at HFO device appear to significatively affect ΔF
iO2
as well (p-values < 0.001, adjusted to
V
˙
I
). The result of multivariate linear regression indicates predictors (
V
˙
I
, Flow and set F
iO2
) to explain 92% of the variance of delta F
iO2
through K-Fold Cross Validation. Moreover, adjunction of a dead space in the breathing circuit significantly decreased ΔF
iO2
(p < 0.01). The present bench study did expose a weakness of HFO devices in reliability of delivering accurate F
IO2
at high
V
˙
I
as well as, to a lesser extent, at
V
˙
I
below equivalent set HFO Flows. Moreover, set HFO flow and set F
IO2
did influence the variability of effective inspired oxygen fraction. The adjunction of a dead space in the experimental set-up significantly amended this variability and should thus be further studied in order to improve success rate of HFO therapy.
Deep sampling (DS) is the gold standard for microbiological diagnosis of post-sternotomy mediastinitis (PSM), however superficial swab (SS) are frequently performed in some centers and antibiotherapy ...initiated base on their results. We analysed the concordance between superficial swab and deep sampling in PSM.
We analysed retrospectively patients with a PSM between 2010 and 2014 at Saint-Luc University hospital (Belgium). We considered that there was a concordance between SS and DS when the same microorganism was found in the two sampling method in each patient. Patients were stratified in six groups according to microbiology results as Staphylococcus Aureus (SA) sensitive or resistant, coagulase negative Staphylococcus (CoNS), Gram negative bacilli (GNB), other Gram positive bacteria (GPB) and fungi.
Thirty-six patients were included. Twenty-five men (69%) and a mean age of 66 years old. The overall concordance between SS and DS was 57%. SA and GNB showed high concordance (100% and 85.7% respectively). For the other groups the concordance was low. The sensitivity and specificity of SS was 97% and 33% respectively. The PPV and NPV of superficial swab was 96% and 50% respectively.
Microbiological results from SS, even with flocked swabs, except for SA and GNB have low concordance with those obtained from deep sampling. Our data confirm that in PSM, deep sampling is the gold standard for microbiological assessment.
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•Steps released during 3MST very strongly associated to walked distance during 6MWT in children 6 to 12 years old.•Reliability was excellent in 3MST justifying a good reproducibility ...of the test.•Observed learning effect justifies the need for a training test.
Field tests are useful to assess the functional exercise capacity. The 6minute walking test (6MWT) is the most common field test even if alternatives are needed. The main aim of the study was to verify if the 3minute step test (3MST) is a valid tool to measure the functional exercise capacity and can surrogate the 6MWT in healthy children from 6- to 12-years-old.
This randomized cross-over trial recruited 30 healthy children from 6 to 12 years. One 6MWT and two 3MST (3MST1 and 3MST2) were performed randomly on 3 consecutive days. The variables were the distance (6MWT), the number of steps (3MST) and the cardiorespiratory parameters.
The distance walked during 6MWT was very strongly correlated to the number of steps during the 3MST (3MST1: rho=0.833; P<0.001 and 3MST2: rho=0.868; P<0.001). Heart rate (HR) was lower than the theoretical maximal HR at the end of both tests. The change in HR and perceived fatigue were significantly higher after the 3MST. A learning effect was observed in the 3MST (+8 steps; P<0.001).
The 3MST is validated and can be a surrogate for the 6MWT in healthy children population between 6 and 12 years old. A training test is required in these children.
Aims
The oropharyngeal dysphagia (OD) poses substantial health risks and affects quality of life. Patient-reported outcome measures (PROMs) are gaining prominence for their crucial role in early ...detection and adapting rehabilitation and management decisions. This highlights the need for culturally pertinent versions in different languages, especially when addressing conditions like OD. This study aimed to translate, culturally adapt, and assess the test-retest reliability of the Sydney Swallow Questionnaire (SSQ), a PROM designed to detect the risk of OD, for Dutch-speaking populations.
Materials and Methods
The SSQ was translated and adapted based on Beaton’s guidelines. Validity and test-retest reliability were assessed in 100 healthy participants, with a subset of 30 participants assessed over a 15-day interval. Intra-class correlation coefficient (ICC) values were calculated to determine test-retest reliability.
Results
The SSQ-Dutch was well received and well understood, with a median total score of 65.5/1700. Notably, 95% of participants scored below the established dysphagia risk cut-off, consistent with previous validations. The 15-day interval ICC for the SSQ-Dutch total scores was 0.82 (CI 95%: 0.66–0.91), indicating good reliability. While most questions had moderate-to-good reliability, five showed slightly lower ICC.
Conclusion
The SSQ-Dutch emerges as a validated and reliable tool for assessing OD risk in Dutch-speaking individuals. Future studies should evaluate its efficacy in symptomatic populations and consider cultural variations in Dutch-speaking regions.
Eighty percent of COPD patients experience dyspnea during activities of daily life (ADL). To the best of our knowledge, the Modified Medical Research Council (MMRC) dyspnea scale is the only ...validated scale designed to quantify dyspnea during ADL available in the French language. Two other instruments are only available in English versions: the London Chest Activity of Daily Living (LCADL) scale that allows a specific evaluation of dyspnea during ADL and the Dyspnea-12 questionnaire that evaluates the affective (emotional) and sensory components of dyspnea in daily life. The aim of this study was to translate and validate French versions of both LCADL and Dyspnea-12 questionnaires and to determine the reliability of these versions for the evaluation of dyspnea in severe to very severe COPD patients.
Both translation and cultural adaptation were based on Beaton's recommendations. Fifty consecutive patients completed the French version of LCADL and Dyspnea-12 and other questionnaires (MMRC, Saint George's Respiratory Questionnaire SGRQ, Hospital Anxiety and Depression HAD), at a 2-week interval. Internal consistency, validity, and reliability of LCADL and Dyspnea-12 were evaluated.
The French version of LCADL and Dyspnea-12 demonstrated good internal consistency with Cronbach's α of, respectively, 0.84 and 0.91. LCADL was correlated significantly with item activity of SGRQ (ρ=0.55,
<0.001), total score of SGRQ (ρ=0.63,
<0.001), item impact of SGRQ (ρ=0.57,
<0.001), and HAD-depression (HAD-D) (ρ=0.47,
=0.001); and Dyspnea-12 was correlated significantly with MMRC (ρ=0.39,
<0.001), HAD-anxiety (ρ=0.64,
<0.001), and HAD-D (ρ=0.64,
<0.001). The French version of LCADL and Dyspnea-12 demonstrated good test-retest reliability with, respectively, intraclass coefficient =0.84 (
<0.001) and 0.91 (
<0.001).
The French versions of LCADL and Dyspnea-12 questionnaires are promising tools to evaluate dyspnea in severe to very severe COPD patients.
•Current knowledge:∘AAssessing the muscle strength is relevant in patients with respiratory diseases,∘Valid and feasible tests are lacking in children.•This paper contributes to our knowledge:∘We ...verified the validity of the one-minute sit-to-stand test to assess the quadriceps strength in healthy children,∘This test can be considered as a valuable alternative to evaluate the muscle strength when expressed as the product of body weight.
Clinical tools for assessment of the skeletal muscle strength are scarce and have rarely been validated in children. The aims of this study were to verify the construct validity of the one-minute sit-to-stand test (1-MSTST) to evaluate the quadriceps strength in healthy children between 12 and 18 years old and to correlate these outcomes with the anthropometric parameters.
Healthy children were recruited and consecutively performed 1-MSTST and maximal voluntary contraction of the quadriceps (QMVC).
Eighty-three children (15±2 years old) were analyzed. Contrarily to the QMVC, neither the number of 1-MSTST repetitions nor the sit-to-stand work (1-MSTST expressed as the product of body weight) differed between genders. The QMVC was not correlated with the number of repetitions (rho=−0.056; P=0.617) but correlated with 1-MSTST when expressed as a product of body weight (r=0.491; P<0.001). The QMVC was also correlated with age (r=0.314; P=0.004), height (r=0.672; P<0.001), weight (r=0.721; P<0.001) and BMI (r=0.451; P<0.001) whereas 1-MSTST did not correlate with any of these parameters. The leg length was related to the results of both tests.
We demonstrated that the one-minute sit-to-stand test can be considered as a valid and valuable alternative to evaluate the muscle strength when expressed as the product of body weight.
•Complementary therapies have been recently included in evidence-based guidelines on the management of different chronic diseases.•This systematic review shows heterogeneity of the protocols for the ...reviewed complementary therapies.•It highlights the promising results of complementary therapies on lung function and functional exercise capacity in COPD patients.•Their effects on quality of life and dyspnea are less convincing.
The aim of this systematic review was to summarize the effects of yoga, qi gong or tai chi in COPD patients.
Studies evaluating effects of the selected complementary therapies on lung function, dyspnea, quality of life or functional exercise capacity in COPD patients were identified and reviewed from three databases.
Eighteen studies were included. Six studies evaluated the effects of yoga and the others focused on tai chi or qi gong separately or combined. The duration of the programs ranged from 6 weeks to 6 months and the frequency from 2 to 7 times a week. Each session reached 30 to 90 minutes. Benefits were observed on lung function and functional exercise capacity but benefit was clearly stated neither on quality of life nor on dyspnea.
This systematic review highlights the potential of these therapies as complementary therapeutic approach in COPD patients.
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