Relationship between daily physical activity and aerobic fitness in adults with cystic fibrosis.

Background: The best clinical practice to investigate aerobic fitness includes measurements obtained during cardiopulmonary exercise testing (CPET), however it remains an underutilised clinical measure in cystic fibrosis (CF). To investigate this further, different methods of quantifying exercise capacity in CF are required. The possibility that measuring physical activity (PA) by a portable accelerometer could be used to assess the CF aerobic state and could be added among the CPET surrogates has not been investigated.

Mechanisms, assessment and therapeutic implications of lung hyperinflation in COPD.

The main complaint of patients with chronic obstructive pulmonary disease (COPD) is shortness of breath with exercise, that is usually progressive. The principal mechanism that explains this symptom is the development of lung hyperinflation (LH) which is defined by an increase of functional residual capacity (FRC) above predicted values. Patients with COPD may develop static LH (sLH) because of destruction of pulmonary parenchyma and loss of elastic recoil.

Impact of chronic obstructive pulmonary disease on exercise ventilatory efficiency in heart failure.

Background: Heart failure (HF) and chronic obstructive pulmonary disease (COPD) coexistence increases morbidity and mortality. The intercept of ventilation (VEint) on the VE vs. carbon dioxide production (VCO2) relationship during exercise has been found to vary in proportion with dead space (VD) in HF.

Neurally adjusted ventilatory assist and proportional assist ventilation both improve patient-ventilator interaction.

Introduction: The objective was to compare the impact of three assistance levels of different modes of mechanical ventilation; neurally adjusted ventilatory assist (NAVA), proportional assist ventilation (PAV), and pressure support ventilation (PSV) on major features of patient-ventilator interaction.

Methods: PSV, NAVA, and PAV were set to obtain a tidal volume (VT) of 6 to 8 ml/kg (PSV₁₀₀, NAVA₁₀₀, and PAV₁₀₀) in 16 intubated patients. Assistance was further decreased by 50% (PSV₅₀, NAVA₅₀, and PAV₅₀) and then increased by 50% (PSV₁₅₀, NAVA₁₅₀, and PAV₁₅₀) with all modes.

A novel technique for diaphragm biopsies in human patients.

Background: The diaphragm is difficult to biopsy because of its anatomic location. We describe a new laparoscopic diaphragm biopsy technique.

Material And Methods: Fifty one patients with amyotrophic lateral sclerosis gave their consent to diaphragm biopsy in the context of an implanted phrenic nerve stimulation protocol (NCT01583088).

Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation.

Background: Atrial fibrillation is the most frequent sustained arrhythmia. Atrial fibrillation frequently recurs after restoration of normal sinus rhythm. Antiarrhythmic drugs have been widely used to prevent recurrence, but the effect of these drugs on mortality and other clinical outcomes is unclear.

High Recombinant Frequency in Extraintestinal Pathogenic Escherichia coli Strains.

Homologous recombination promotes genetic diversity by facilitating the integration of foreign DNA and intrachromosomal gene shuffling. It has been hypothesized that if recombination is variable among strains, selection should favor higher recombination rates among pathogens, as they face additional selection pressures from host defenses. To test this hypothesis we have developed a plasmid-based method for estimating the rate of recombination independently of other factors such as DNA transfer, selective processes, and mutational interference.

Quantifiable evaluation of cerebellar signs in children.

Objective: To validate, examine the internal validity, and adapt to children the electronic version of the composite cerebellar functional severity (CCFS) score.

Methods: In this multicenter study, we compared the validated manual device with the new electronic version (n = 46) and analyzed its kinetics in 146 patients with Friedreich ataxia through the EFACTS (European Friedreich's Ataxia Consortium for Translational Studies) network, 77 patients with spinocerebellar ataxia, and 48 controls. We validated the CCFS in cerebellar ataxias in healthy children (n = 120) and children with Friedreich ataxia through the EFACTS network (n = 33).

Expiratory load compensation is associated with electroencephalographic premotor potentials in humans.

In normal humans during quiet breathing, expiration is mostly driven by elastic recoil of the lungs. Expiration becomes active when ventilation must be increased to meet augmented metabolic demands, or in response to expiratory loading, be it experimental or disease-related. The response to expiratory loading is considered to be mediated by both reflex and cortical mechanisms, but the latter phenomenon have not been neurophysiologically characterized.

Multidimensional approach to dyspnea.

Purpose Of Review: This review focuses on sensory-perceptual and affective/emotional domains of dyspnea.

Recent Findings: Recent studies have underscored the multidimensional aspect of dyspnea, which comprises three major dimensions: the sensory-perceptual domain, the affective distress, and the symptom impact or burden. Sensory-perceptual dimension includes ratings of dyspnea intensity and its quality, that is, 'how breathing feels like.

Source of ventilatory complexity in the postmetamorphic tadpole brainstem, Pelophylax ridibundus: A pharmacological study.

The neural respiratory output of isolated brainstems of post-metamorphic tadpoles displays two motor patterns, the buccal and the lung rhythms. Their global dynamics are complex and chaos-like. This study aimed at determining the source of this complexity.

[Cutaneous adverse drug reactions].

Cutaneous adverse drug reactions (CADR) represent a heterogeneous field including various clinical patterns without specific features suggesting drug causality. Exanthematous eruptions, urticaria and vasculitis are the most common forms of CADR. Fixed eruption is uncommon in western countries.

Very early screening for sleep-disordered breathing in acute coronary syndrome in patients without acute heart failure.

Background: Obstructive sleep apnea (OSA) is frequently associated with acute coronary syndrome (ACS). Screening of sleep-disordered breathing (SDB) has not been previously evaluated in ACS within 72 h in intensive care settings and its management could potentially enhance patients' prognosis. This pilot study assessed the feasibility of SDB screening at the early phase of ACS.

The cerebral cost of breathing: an FMRI case-study in congenital central hypoventilation syndrome.

Certain motor activities--like walking or breathing--present the interesting property of proceeding either automatically or under voluntary control. In the case of breathing, brainstem structures located in the medulla are in charge of the automatic mode, whereas cortico-subcortical brain networks--including various frontal lobe areas--subtend the voluntary mode. We speculated that the involvement of cortical activity during voluntary breathing could impact both on the "resting state" pattern of cortical-subcortical connectivity, and on the recruitment of executive functions mediated by the frontal lobe.

Reprint of "Breathing and sense of self: visuo-respiratory conflicts alter body self-consciousness".

Bodily self-consciousness depends on the processing of interoceptive and exteroceptive signals. It can be disrupted by inducing signal conflicts. Breathing, at the crossroad between interoception and exteroception, should contribute to bodily self-consciousness.

Increased diaphragmatic contribution to inspiratory effort during neurally adjusted ventilatory assistance versus pressure support: an electromyographic study.

Background: Neurally adjusted ventilatory assist (NAVA), regulated exclusively by the electromyographic activity (EA) of the diaphragm (EAdi), could affect the distribution of neural drive to the various inspiratory muscles. The objective of this study was to compare EAdi, EA of the scalene (EAscal), and EA of the alae nasi (EAan), according to the ventilatory mode and assist level in 12 mechanically ventilated patients.

Methods: Seven assist levels of pressure support ventilation (PSV) and NAVA were sequentially applied.

Breathing and sense of self: visuo-respiratory conflicts alter body self-consciousness.

Bodily self-consciousness depends on the processing of interoceptive and exteroceptive signals. It can be disrupted by inducing signal conflicts. Breathing, at the crossroad between interoception and exteroception, should contribute to bodily self-consciousness.

Negative emotional stimulation decreases respiratory sensory gating in healthy humans.

We tested the hypothesis that negative emotions decrease the respiratory-related evoked potentials (RREP) sensory gating (RSG). RREP were elicited by paired inspiratory occlusions. RSG was calculated as the difference in the averaged RREP peak N1 amplitude between the second (S2) and the first occlusion (S1).

Postural disturbances resulting from unilateral and bilateral diaphragm contractions: a phrenic nerve stimulation study.

Thoracoabdominal breathing movements are a complex source of postural disturbance, but there are contradictory reports in the literature with inspiration described as having either a backward or a forward disturbing effect. To elucidate the mechanisms underlying this phenomenon, the present study studied the postural disturbance caused by isolated contractions of the diaphragm. Eight male and four female healthy subjects followed an original paradigm of phrenic nerve stimulation (bilateral and unilateral) and "diaphragmatic" voluntary sniff maneuvers in the seated and standing postures.