Illness perceptions: impact on self-management and control in asthma.

Purpose Of Review: Outcome in asthma is determined not only by pulmonary function or other biomedical characteristics. An important determinant of asthma outcome is illness perceptions: patients' subjective beliefs and emotional responses to their illness. Illness perceptions influence patients' coping and self-management behavior, and thereby outcome.

Can sensitization to aeroallergens disappear over time in children with allergic disease?

Background: Remittance of aeroallergen sensitization has been shown in population-based studies, but there is a common perception that sensitization to aeroallergens rarely if ever disappears in children with allergic disease.

Methods: We retrospectively reviewed all specific IgE tests carried out in children aged 0-18 years at our hospital laboratory over a 14-year period. Of 3115 children sensitized to one or more aeroallergens, 244 (7.

Assembly dynamics of PML nuclear bodies in living cells.

The mammalian cell nucleus contains a variety of organelles or nuclear bodies which contribute to key nuclear functions. Promyelocytic leukemia nuclear bodies (PML NBs) are involved in the regulation of apoptosis, antiviral responses, the DNA damage response and chromatin structure, but their precise biochemical function in these nuclear pathways is unknown. One strategy to tackle this problem is to assess the biophysical properties of the component parts of these macromolecular assemblies in living cells.

Disseminating educational innovations in health care practice: training versus social networks.

Improvements and innovation in health service organization and delivery have become more and more important due to the gap between knowledge and practice, rising costs, medical errors, and the organization of health care systems. Since training and education is widely used to convey and distribute innovative initiatives, we examined the effect that following an intensive Teach-the-Teacher training had on the dissemination of a new structured competency-based feedback technique of assessing clinical competencies among medical specialists in the Netherlands. We compared this with the effect of the structure of the social network of medical specialists, specifically the network tie strength (strong ties versus weak ties).

Is home spirometry useful in diagnosing asthma in children with nonspecific respiratory symptoms?

Background: Variation of lung function is considered to be a hallmark of asthma. Although guidelines recommend measuring it as a diagnostic tool for asthma, the usefulness of this approach has not been studied in children.

Aim: To assess the usefulness of home spirometry in children with nonspecific lower respiratory tract symptoms, to diagnose or exclude asthma.

Airway obstruction at time of symptoms prompting use of reliever therapy in children with asthma.

Background: In asthma treatment, doses of inhaled corticosteroids are often adapted to symptoms and need for bronchodilators. However, in cross-sectional studies in emergency room settings, lung function and respiratory symptoms are not always concordant. Available longitudinal data are based on written peak flow diaries, which are unreliable.

Clinical practice: Breastfeeding and the prevention of allergy.

The increase in allergic disease prevalence has led to heightened interest in the factors determining allergy risk, fueled by the hope that by influencing these factors one could reduce the prevalence of allergic conditions. The most important modifiable risk factors for allergy are maternal smoking behaviour and the type of feeding. A smoke-free environment for the child (to be), exclusive breastfeeding for 4-6 months and the postponement of supplementary feeding (solids) until 4 months of age are the main measures considered effective.

Biological effect markers in exhaled breath condensate and biomonitoring in welders: impact of smoking and protection equipment.

Purpose: The objective of this study was to investigate the effect of welding as well as the impact of smoking and protection measures on biological effect markers in exhaled breath condensate. Additionally, biomonitoring of chromium, aluminium and nickel in urine was performed to quantify internal exposure.

Methods: Exhaled breath condensate (EBC) and urine samples of 45 male welders and 24 male non-exposed control subjects were collected on Friday pre-shift and after 8 h of work post-shift.

Prevalence and risk factors of wheeze in Dutch infants in their first year of life.

Factors operating in the first year of life are critical in determining the onset and persistence of wheezing in preschool children. This study was designed to examine the prevalence and risk factors of wheeze in the first year of life in Dutch infants. This was a population-based survey of 13-month-old infants visiting well baby clinics for a scheduled immunization.

Paediatrics in Vienna.

The aim of this article is to describe the paediatric highlights from the 2009 European Respiratory Society Annual Congress in Vienna, Austria. The best abstracts from the seven groups of the Paediatric Assembly (asthma and allergy, respiratory epidemiology, cystic fibrosis, respiratory physiology, respiratory infections and immunology, neonatology and paediatric intensive care, and bronchology) are presented alongside findings from the current literature.

The utility of sputum eosinophils and exhaled nitric oxide for monitoring asthma control with special attention to childhood asthma.

The monitoring of sputum eosinophils has received certain attention as a tool for improving asthma management both in children and in adults. The present paper reviews the technique and also the usefulness of induced sputum in the diagnosis and assessment of asthma, together with its ability to predict the response to treatment and to anticipate asthma exacerbations. Special attention is addressed to childhood asthma.

[Adherence in the case of chronic diseases: patient-centred approach is needed].

Adherence to medication is a common problem in chronically ill patients. Three patients are presented who did not or did not fully adhere to their medication: a 3-year-old girl with asthma, a 57-year-old man with COPD and a 16-year-old boy with diabetes. This illustrates that adherence is not determined by age or illness.

Respiratory medicines for children: current evidence, unlicensed use and research priorities.

This European Respiratory Society task force has reviewed the evidence for paediatric medicines in respiratory disease occurring in adults and children. We describe off-licence use, research priorities and ongoing studies. Off-licence and off-label prescribing in children is widespread and potentially harmful.

Competency-based (CanMEDS) residency training programme in radiology: systematic design procedure, curriculum and success factors.

Objective: Based on the CanMEDS framework and the European Training Charter for Clinical Radiology a new radiology curriculum was designed in the Netherlands. Both the development process and the resulting new curriculum are presented in this paper.

Methods: The new curriculum was developed according to four systematic design principles: discursiveness, hierarchical decomposition, systematic variation and satisficing (satisficing is different from satisfying; in this context, satisficing means searching for an acceptable solution instead of searching for an optimal solution).

The transient value of classifying preschool wheeze into episodic viral wheeze and multiple trigger wheeze.

Background: A recently proposed method for classifying preschool wheeze is to describe it as either episodic (viral) wheeze or multiple trigger wheeze. In research studies, phenotype is generally determined by retrospective questionnaire.

Aim: To determine whether recently proposed phenotypes of preschool wheeze are stable over time.

Angular quasi-phase-matching experiments and determination of accurate Sellmeier equations for 5%MgO:PPLN.

We validated the theory of angular quasi-phase-matching (AQPM) by performing measurements of second-harmonic generation and difference-frequency generation. A nonlinear least-squares fitting of these experimental data led to refine the Sellmeier equations of 5%MgO:PPLN that are now valid over the complete transparency range of the crystal. We also showed that AQPM exhibits complementary spectral ranges and acceptances compared with birefringence phase matching.

Inter-reader variability in chest radiography and HRCT for the early detection of asbestos-related lung and pleural abnormalities in a cohort of 636 asbestos-exposed subjects.

Purpose: To compare inter-reader variability of chest X-ray and high resolution computed tomography (HRCT) scans of formerly asbestos-exposed employees over a 4-year period.

Methods: In this longitudinal study, 636 formerly asbestos-exposed persons were annually examined with chest radiographs and HRCT scans. Ten observer pairs classified the radiographs and HRCT scans, using the ILO classification and a custom-made CT classification.

Lung deposition of a liposomal cyclosporine A inhalation solution in patients after lung transplantation.

Background: Bronchiolitis obliterans is the most important long-term sequelae of lung transplantation limiting survival. Optimized immunosuppression, including inhalation of cyclosporine A (CsA), may be a promising approach to overcome this problem.

Methods: In this study a liposomal CsA solution was characterized in vitro, doses of 10 and 20 mg were inhaled with the PARI eFlow inhaler by 12 stable lung transplant recipients, and lung deposition was evaluated by gamma scintigraphy.

Spirometry, impulse oscillometry and capnovolumetry in welders and healthy male subjects.

Background: Welding processes emit fine and ultrafine aerosol particles which are potentially harmful to the lungs of welders. In the past, changes in lung function were mostly determined by conventional spirometry. In this study spirometry was combined with new techniques such as Impulse Oscillometry (IOS) and Capnovolumetry (CVS) in order to assess welding associated changes in lung function.

Lung deposition of inhaled alpha1-proteinase inhibitor in cystic fibrosis and alpha1-antitrypsin deficiency.

Individuals with alpha(1)-antitrypsin (AAT) deficiency and cystic fibrosis (CF) have a protease-antiprotease imbalance in their lungs, which leads to early onset progressive lung disease. Inhalation of AAT may restore protective levels in the lungs. This study aimed to determine the efficiency of delivering AAT using a novel inhalation device in subjects with AAT deficiency and CF compared with healthy subjects.