Asthma and COVID-19: In Defense of Evidence-Based SABA.

There have recently been major objections to the use of short-acting beta-agonist (SABA) in episodic acute asthma culminating in a call for replacing SABA with combination of inhaled corticosteroids and long-acting beta-agonists despite little evidence supporting this point of view. It is regrettable to note that this attack on SABA occurs in the midst of an unprecedented demand for, and shortage of, SABA inhalers during the current COVID-19 pandemic, and the worldwide efforts to increase SABA supplies. In this commentary, we defend the well-established role of SABA and argue that the call for the phase out of SABA is inappropriate, since it is not solidly evidence based.

Evaluation of clinically and physiologically atypical asthma: If it doesn't wheeze it may still be asthma.

Objective: Children with asthma-like symptoms may not clinically wheeze. The objectives of this study were to evaluate if children, without physician-documented wheeze, wheeze during bronchial-challenge-testing (BCT), and if measurements of OSat and respiratory rate during BCT improve the BCT sensitivity?

Methods: Seven hundred and twenty-four children, who were referred for suspicion of asthma, performed a BCT. Positive BCT was determined by the provocation concentration (PC) which resulted in a 20% decrease in FEV (PC), (in those who were able to perform spirometry, group B), or (in those unable to perform spirometry, group A) a 50% increase in respiratory rate (PC), or a 5% decrease in oxygen-saturation (PC) or appearance of wheezing (PC).

More Realistic Face Model Surface Improves Relevance of Pediatric In-Vitro Aerosol Studies.

Background: Various hard face models are commonly used to evaluate the efficiency of aerosol face masks. Softer more realistic "face" surface materials, like skin, deform upon mask application and should provide more relevant in-vitro tests. Studies that simultaneously take into consideration many of the factors characteristic of the in vivo face are lacking.

Computerized Dead-Space Volume Measurement of Face Masks Applied to Simulated Faces.

Background: The dead-space volume (VD) of face masks for metered-dose inhaler treatments is particularly important in infants and young children with asthma, who have relatively low tidal volumes. Data about VD have been traditionally obtained from water displacement measurements, in which masks are held against a flat surface. Because, in real life, masks are placed against the face, VD is likely to differ considerably between masks depending upon their contour and fit.

Feasibility of aerosol drug delivery to sleeping infants: a prospective observational study.

Objectives: Delivery of inhaled medications to infants is usually very demanding and is often associated with crying and mask rejection. It has been suggested that aerosol administration during sleep may be an attractive alternative. Previous studies in sleeping children were disappointing as most of the children awoke and rejected the treatment.

Nasal versus oral aerosol delivery to the "lungs" in infants and toddlers.

Objectives: The oral route has been considered superior to the nasal route for aerosol delivery to the lower respiratory tract (LRT) in adults and children. However, there are no data comparing aerosol delivery via the oral and nasal routes in infants. The aim of this study was to compare nasal and oral delivery of aerosol in anatomically correct replicas of infants' faces containing both nasal and oral upper airways.

Design of aerosol face masks for children using computerized 3D face analysis.

Background: Aerosol masks were originally developed for adults and downsized for children. Overall fit to minimize dead space and a tight seal are problematic, because children's faces undergo rapid and marked topographic and internal anthropometric changes in their first few months/years of life. Facial three-dimensional (3D) anthropometric data were used to design an optimized pediatric mask.

Deposition of small particles in the developing lung.

Infancy is a time of marked and rapid changes in respiratory tract development. Infants (0-1 year of age) and young children (1- 3 years of age) are a unique subpopulation with regard to therapeutic aerosols. Anatomical, physiological and emotional factors, peculiar to these age groups, present significant challenges for aerosol delivery to the respiratory tract.

Lung aerosol deposition in suckling infants.

Introduction: Aerosol therapy in infants may be greatly compromised by face mask rejection due to squirming and crying. Lung aerosol deposition in crying infants may thereby be greatly reduced. Since 'suckling' on a pacifier calms infants, they should more readily accept a face mask that incorporates a pacifier.

Lead, mercury, cadmium, chromium, and arsenic levels in eggs, feathers, and tissues of Canada geese of the New Jersey Meadowlands.

The New Jersey Meadowlands are located within the heavily urbanized New York/New Jersey Harbor Estuary and have been subject to contamination due to effluent and runoff from industry, traffic, and homes along the Hackensack River and nearby waterways. These extensive wetlands, though heavily impacted by development and pollution, support a wide array of bird and other wildlife species. Persistent contaminants may pose threats to birds in these habitats, affecting reproduction, egg hatchability, nestling survival, and neurobehavioral development.

Factors that affect the efficacy of inhaled corticosteroids for infants and young children.

Infants (0-1 years of age) and young children (1-3 years of age) are a unique subpopulation with regard to inhaled therapies. There are various anatomic, physiological, and emotional factors peculiar to this age group that present significant difficulties and challenges for aerosol delivery. Most studies of therapeutic aerosols that have been performed with patients of this age group, particularly recent studies with inhaled corticosteroids (ICSs), administered aerosols with relatively large particles (ie, >3 microm in mass median aerodynamic diameter).

Impact of host community composition on Lyme disease risk.

The drivers of variable disease risk in complex multi-host disease systems have proved very difficult to identify. Here we test a model that explains the entomological risk of Lyme disease (LD) in terms of host community composition. The model was parameterized in a continuous forest tract at the Cary Institute of Ecosystem Studies (formerly the Institute of Ecosystem Studies) in New York State, U.

Facilitation of aerosol ventilation scanning for diagnosis of pulmonary emboli in uncooperative dyspneic patients.

Acute pulmonary thromboembolism (PE) is a common cause of death in hospital patients. Quick and accurate diagnosis significantly decreases mortality. Many medical facilities still have ventilation/perfusion lung scans as the only available and preferred screening test for suspected PE.