Quality of Preanesthesia Teleconsultation: The TELECAM Randomized Controlled Trial.

Introduction: Preanesthesia teleconsultation helps reduce availability constraints as well as direct and indirect expenses. The TELECAM trial was performed to assess the quality of preanesthesia teleconsultation in terms of clinical parameters evaluation, feasibility, patient satisfaction and preoperative anxiety, and anesthesiologist satisfaction. Methods: TELECAM was an investigator-initiated, prospective, single-center, randomized, controlled, parallel group, evaluator-blinded, open-label study. Patients with a scheduled ambulatory surgery (orthopedic or hand surgery) were randomized into the in-person preanesthesia consultation group or the preanesthesia teleconsultation (conducted at the patient's home or workplace) group. The quality of the teleconsultation was evaluated through agreement on intubation difficulty, predictable mask ventilation difficulty, and American Society of Anesthesiologists (ASA) scores between the preanesthesia consultation and the preanesthesia in-person visit. Results: A total of 241 patients were included, and 208 were considered in the analyses. The feasibility of teleconsultation was high, with a feasibility ratio of 87.5%. The quality of the preanesthesia consultation regarding the evaluation of predictable intubation, mask ventilation difficulties, and ASA score, did not differ between the two groups (p = 0.23, 0.29, and 0.06, respectively). The preoperative satisfaction was higher for patients who had a preanesthesia teleconsultation (p = 0.04). Patients' preoperative anxiety did not differ between the two groups (p = 0.90). The median satisfaction of the anesthesiologists who performed the teleconsultation reached a maximum of 10 (IQR: 8.0; 10.0). Conclusion: This study showed positive results for the quality of preanesthesia teleconsultation on the evaluation of clinical parameters, with high feasibility and satisfaction of the patients and anesthesiologists. The trial was registered in ClinicalTrials (NCT03470896).

Increased risk of acute kidney injury in the first part of an ultra-trail-Implications for abandonment.

Acute kidneys injuries (AKIs) have been described in marathon and trail running. The currently available data allows assessment of before/after comparisons but does not allow an analysis of what happens during the race. A multidisciplinary assessment protocol was performed during the first trail of Clécy (Normandy France) in November 2021. This allowed an initial assay to be carried out, then at the end of each of the 6 loops of 26 km, and finally after 24 h of recovery. The race extends over 156 km in hilly terrain and 6000 m of elevation gain (D+). The level of impairment according to the RIFLE classification was defined for each runner at each assay. Fifty-five runners were at the start, and the per protocol analysis involved 36 runners (27 men and 9 women, 26 finishers). Fifteen (41.7%) of the riders presented at least one result corresponding to a "RIFLE risk" level. After 24 h of rest, only one runner still had a "RIFLE Risk". The distance around the marathon seems to be the moment of greatest risk. For the first time, we find an association between this renal risk and the probability of abandonment. Many runners are vulnerable to kidney damage during long-duration exercise, which is why it's important to limit risk situations, such as the use of potentially toxic drugs or hydration disorders. The consumption of NSAIDs (nonsteroidal anti-inflammatory drugs) before or during an ultra-distance race should therefore be prohibited. Attention should be paid to hydration disorders.

Evaluating the feasibility and acceptability of an adapted fencing intervention in breast cancer surgery post-operative care: the RIPOSTE pilot randomized trial.

Background: Adapted physical activity programs have shown promising results in reducing the physical, social and psychological side effects associated with breast cancer, but the extent to which they can be effectively adopted, implemented and maintained is unclear. The aim of this study is to use the framework to guide the planning and evaluation of programs according to the 5 following keys: Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate a fencing program under the French acronym RIPOSTE (Reconstruction, Image de soi, Posture, Oncologie, Santé, Thérapie, Escrime) literally in English (Reconstruction, Self-Image, Posture, Oncology, Health, Therapy, Fencing). This program is an innovative intervention focused on improving the quality of life (QoL) of breast cancer surgery patients through fencing. Methods: A convergent mixed methods pilot study was conducted to preliminary evaluate the different RE-AIM dimension of the pilot program. Twenty-four participants who have just undergone surgery for invasive breast cancer were randomly allocated in two groups: one group started immediately after their inclusion (Early RIPOSTE group) and the other started 3 months following their inclusion (Delayed RIPOSTE group). Participants answered a questionnaire at inclusion and at the end of the program on QoL, shoulder functional capacity, fatigue, anxiety-depression and physical activity. Results: RIPOSTE program was able to reach mainly young and dynamic participants, attracted by the originality of fencing and keen to improve their physical condition. Regarding effectiveness, our results suggest a trend to the improvement of QoL, shoulder functional capacity, fatigue and anxiety-depression state, even without any significant differences between the Early RIPOSTE group and the Delayed RIPOSTE group. Discussions: The cooperation, exchanges and cohesion within the group greatly facilitated the adoption of the program, whereas interruptions during school vacations were the main barriers. The intervention was moderately well implemented and adherence to the protocol was suitable. Conclusion: RIPOSTE is an acceptable and effective program for involving breast cancer survivors in physical activity, that needs to be tested at a larger scale to investigate its effectiveness, but has the potential to be transferred and scaled up worldwide.

The Impact of COVID-19 on the Response to Hypoxia.

Louis, Alexandre, Charlotte Pröpper, Yann Savina, Corentin Tanne, Guy Duperrex, Paul Robach, Pascal Zellner, Stéphane Doutreleau, Jean-Michel Boulet, Alain Frey, Fabien Pillard, Cristina Pistea, Mathias Poussel, Thomas Thuet, Jean-Paul Richalet, and François Lecoq-Jammes. The impact of COVID-19 on the response to hypoxia. High Alt Med Biol. 24:321-328, 2023. Background: Severe high-altitude illness (SHAI) and coronavirus disease 2019 (COVID-19), while differing in most aspects of pathophysiology, both involve respiratory capacity. We examined the long-term impact of COVID-19 on response to hypoxia in individuals free of symptoms but having tested positive during the pandemic. The need for recommendations for such individuals planning a stay at high altitude are discussed. Methods: This multicenter study recruited participants from the multiSHAI cohort, all of whom had previously undergone a hypoxic exercise test. These participants were classified into two groups depending on whether they had since suffered mild-to-moderate COVID-19 (COVID+) or not (Control) and then asked to retake the test. Primary outcomes were: desaturation induced by hypoxia at exercise (ΔSpE), hypoxic cardiac response at exercise, hypoxic ventilatory response at exercise, and SHAI risk score. Results: A total of 68 participants retook the test, 36 classified in the COVID+ group. Analyses of primary outcomes showed no significant differences between groups. However, the COVID+ group showed significantly increased ventilation (VE) parameters during both hypoxic (p = 0.003) and normoxic exercise (p = 0.007). However, only the VE/oxygen consumption relationship during hypoxic exercise was significantly different. Conclusion: This study demonstrates no negative impact of COVID-19 on response to hypoxia as evaluated by the Richalet test. Clinical Trial Registration: NTC number: NCT05167357.

Guidelines for the management of chronic cough in adults. Endorsed by the French speaking society of respiratory diseases (Société de Pneumologie de Langue Française, SPLF), the Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou (SFORL), the Société Française de Phoniatrie et de Laryngologie (SFPL), the Société Nationale Française de Gastro-entérologie (SNFGE).

Patients with chronic cough experience a high alteration of quality of life. Moreover, chronic cough is a complex entity with numerous etiologies and treatments. In order to help clinicians involved in the management of patients with chronic cough, guidelines on chronic cough have been established by a group of French experts. These guidelines address the definitions of chronic cough and the initial management of patients with chronic cough. We present herein second-line tests that might be considered in patients with cough persistence despite initial management. Experts also propose a definition of unexplained or refractory chronic cough (URCC) in order to better identify patients whose cough persists despite optimal management. Finally, these guidelines address the pharmacological and non-pharmacological interventions useful in URCC. Thus, amitryptilline, pregabalin, gabapentin or morphine combined with speech and/or physical therapy are a mainstay of treatment strategies in URCC. Other treatment options, such as P2 × 3 antagonists, are being developed.

Prevalence of and Factors Associated with Respiratory Symptoms Among Patients with Inflammatory Bowel Disease: A Prospective Study.

BACKGROUND: No large, prospective study has investigated respiratory symptoms in patients with inflammatory bowel diseases. We aimed to describe the prevalence of and factors associated with respiratory symptoms in patients with inflammatory bowel disease. METHODS: In an observational, prospective, cross-sectional study, we evaluated the frequency of respiratory symptoms using a validated self-reporting questionnaire from February 2019 to February 2021 during routine follow-up outpatient visits of patients with inflammatory bowel disease followed in the Gastroenterology Department of the Nancy University Hospital. In case of a positive questionnaire, patients were systematically offered a consultation with a pulmonologist in order to investigate a potential underlying respiratory disease. RESULTS: There were 325 patients included, and 180 patients had a positive questionnaire (144 with Crohn's disease). Of the included patients, 165 (50.8%) presented with respiratory symptoms, with dyspnea being the most frequent symptom (102 patients). There were 102 patients (56.7%) who benefited from a consultation in the pulmonology department: 43 (42.2%) were diagnosed with a respiratory disease, mainly asthma (n = 13) or chronic obstructive pulmonary disease (n = 10). Fourteen patients (13.7%) had obstructive sleep apnea. A body mass index increase, being a smoker or ex-smoker, and having articular extra-intestinal manifestations were independently associated with a higher prevalence of respiratory symptoms. CONCLUSIONS: Half of patients with inflammatory bowel disease reported respiratory symptoms in our study. Patients with inflammatory bowel disease should be systematically screened, as pulmonary disease is frequently present in this population, with specific attention being given to smokers or ex-smokers and patients with extra-articular intestinal manifestations.

We conducted a large-scale, prospective study, finding a high prevalence of respiratory symptoms in patients with inflammatory bowel disease, which led to a variety of respiratory diseases, including asthma and obstructive pulmonary disease. Patients should therefore be systematically screened for pulmonary manifestations.

Is There a Relationship between Hyperventilation Syndrome and History of Acute SARS-CoV-2 Infection? A Cross-Sectional Study.

Following COVID-19 infection, many patients suffer from long-lasting symptoms that may greatly impair their quality of life. Persisting dyspnea and other functional respiratory complaints can evoke hyperventilation syndrome (HVS) as a putative contributor to long-COVID presentation in COVID-19 survivors. We aimed to assess the possible relationship between HVS and previous acute COVID-19 infection. We designed a cross-sectional, single-center study, including all patients consecutively referred to our Lung Function and Exercise Testing Department between January and June 2021. Participants completed a systematic Nijmegen Questionnaire, a modified Medical Research Council dyspnea scale assessment, a post-COVID screening questionnaire, and performed a standardized lung function test. The population was divided according to HVS diagnosis, defined as a Nijmegen score of > 23/64. The occurrence of previous COVID-19 infection was compared according to the Nijmegen score after adjustment for potential confounders by multivariate logistic regression. In total, 2846 patients were included: 1472 men (51.7%) with a mean age of 56 (±16.6) years. A total of 455 patients (16%) declared a previous SARS-CoV-2 infection, and 590 patients presented a positive score (>23/64) in the Nijmegen Questionnaire (20.7%). Compared with COVID-19-free patients, there was an increased occurrence of HVS+ in cases of COVID-19 infection that did not require hospitalization (aOR = 1.93 [1.17−3.18]). The results of this large-scale, cross-sectional study suggest an association between HVS diagnosis and a history of COVID-19 disease in patients who were not hospitalized.

Accurate and Reliable Assessment of Heart Rate in Real-Life Clinical Settings Using an Imaging Photoplethysmography.

Remote photoplethysmography imaging (rPPGc) is a new method measuring essential parameters, such as heart rate (HR), which uses a video camera during teleconsultation. Our work aimed to evaluate the accuracy of such remote measurements compared with existing contact point measurement methods in real-life clinical settings. The prospective hospital-based study recruited 1045 patients who required a pulmonary function test. For each patient, measurements of HR using a standard electrocardiogram acquisition system (gold standard) were carried out concomitantly with the measurements made by the rPPGc system (Caducy v1.0.0) taken within a 60 s timeframe. Age, gender, and skin phototype were collected. We performed an intraclass coefficient correlation (ICC) and Bland-Altman plotting to determine the accuracy and precision of the rPPGc algorithm readings. We achieved measurement of HR using the two methods in 963 patients. The ICC measured at a 60 s timeframe, and when we compared the rPPGc with the gold standard, it had a 95% confidence interval (CI95) value of 0.886 [0.871:0.899]. In all, 94.6% (n = 911) patients showed promising results with a CI95 in Bland-Altman plotting. Fifty-two measurements were discordant, and further analysis established the method's accuracy at 96.2%. Our results described a good accuracy and correlation between the rPPGc system and the gold standard, thus paving the way for more precise care via telemedicine.

Remote Photoplethysmography Is an Accurate Method to Remotely Measure Respiratory Rate: A Hospital-Based Trial.

Remote photoplethysmography imaging (rPPG) is a new solution proposed to measure vital signs, such as respiratory rate (RR) in teleconsultation, by using a webcam. The results, presented here, aim at evaluating the accuracy of such remote measurement methods, compared with existing measurement methods, in a real-life clinical setting. For each patient, measurement of RR, using the standard system (control), has been carried out concomitantly with the experimental system. A 60-s time frame was used for the measurements made by our rPPG system. Age, gender, BMI, and skin phototype were collected. We performed the intraclass correlation coefficient and Bland-Altman plot to analyze the accuracy and precision of the rPPG algorithm readings. Measurements of RR, using the two methods, have been realized on 963 patients. Comparison of the two techniques showed excellent agreement (96.0%), with most of the patients (n = 924-standard patients) being in the confidence interval of 95% in Bland-Altman plotting. There were no significant differences between standard patients and outlier patients for demographic and clinical characteristics. This study indicates a good agreement between the rPPG system and the control, thus allowing clinical use of this remote assessment of the respiratory rate.

Real intensity of physical activity capacity of patients with chronic disease: a cross-sectional study.

The aim of this study was to evaluate the real intensity level of exercise in a sample of patients with chronic disease from obesity, rheumatology, hematology and other departments involved in a hospital-based program of adapted physical activity (APA). For this cross-sectional study, we studied seventy-five patients with chronic disease and no beta-blocker treatment. They systematically performed a cardiopulmonary exercise test before participating in a supervised APA practice using a telemetry wireless system to monitor heart rate (HR) during the first session. Based upon the results of the functional evaluation of exercise performance, we studied two groups of patients: (1) No limitation in exercise performance (maximal oxygen uptake greater than or equal to 80% of the theoretical reference) and (2) limited exercise performance (maximal oxygen uptake less than 80% of the theoretical value). Fifty-two patients (69.3%) were women, mean age was 42.6 (± 13.8), and mean BMI was 36.7 (± 10.6). Most patients had been referred for obesity (57.3%). We found 39 patients with normal exercise capacities and 36 patients with limited exercise performance. There were no significant differences in demographic and clinical characteristics between the two groups. For all populations, the mean and median real intensity levels of exercise in a sample of patients were moderate (55-70% HR max) and were the same for both groups. During the most intensive 15-min bout of the APA session, the HR for patients in both groups was greater than 70% of the actual maximum HR. This study observed a moderate level of APA exercise intensity in patients suffering from various chronic diseases. We found no significant difference in intensity level of exercise between patients' capacities, i.e., with and without limitation of their maximal performance.

Physical Activity Capacity Assessment of Patients with Chronic Disease and the Six-Minute Walk Test: A Cross-Sectional Study.

Background: This study aimed to evaluate the efficacy of the Six-Minute Walk Test (6MWT) to determine the physical activity capacities of patients with chronic disease. Methods: For this cross-sectional study, we investigated 156 patients with chronic disease and no beta-blocker treatment. They systematically performed a maximal cardiopulmonary exercise test to determine their heart rate peak (HRPeak) and maximal oxygen uptake (V'O2max). We considered two groups of patients based upon the results of the functional evaluation of exercise performance: (1) No limitation in exercise performance (V'O2max greater or equal to 80% of the theoretical reference) and (2) limited exercise performance (V'O2max less than 80% of the theoretical value). All patients also received a 6MWT on the same day as the exercise test. Results: We found 68 (43.6%) patients with normal exercise capacities and 88 (56.4%) patients with limited exercise performance. In this sample, 6MWT mean distances were 510 (87) and 506 (86) m, respectively. There were no significant differences between the two groups for distance and end-test heart rate. The correlation between matrix V'O2max measured during the maximal incremental exercise test and the 6MWT distance displayed a positive slope (r = 0.549 CI95 [0.431−0.656]­p < 0.001). Conclusion: Our results showed a moderate relationship between 6MWT and physical activity capacity for patients with chronic disease.

Occurrence of Alexithymia and Its Association with Sports Practice from a Sample of University Students: Results from a French Cross-Sectional Study.

BACKGROUND: This study aimed to assess the prevalence of alexithymia in a sample of university students and to determine its association with specific sports practice characteristics (competition and training). METHODS: In this cross-sectional study, anthropometric data and characteristics of sport practice were collected, as well as level of alexithymia (Toronto Alexithymia Scale, (TAS-20)). RESULTS: The study included 253 French university students who completed a questionnaire specifying their regular sports practice and level of alexithymia (TAS-20). We found 76 subjects (30%) who had proven alexithymia and 92 (36.4%) who were borderline alexithymic. A significant positive relationship between alexithymia and the weekly amount of training practice was observed. It should be noted that students who engage in more than 5 h of physical activity are more prone to be borderline or alexithymic (respectively, 19.6 and 19.7% versus 7.1% for non-alexithymics; p = 0.03). CONCLUSION: With a 30% frequency, alexithymia is more prevalent in this context than in the general population. Furthermore, alexithymia and borderline alexithymia are most favorably associated with higher physical activity (over 5 h per week).

Physical Activity Capacity Assessment of Patients With Chronic Disease and the 1-Minute Sit to Stand Test: Is There an Interest?

Objective: This study aimed to evaluate the efficacy of the 1-minute Sit to Stand test (1MSTS) to determine physical activity capacities for patients with chronic disease. Methods: For this cross-sectional study, we studied fifty patients with chronic disease and no beta-blocker treatment. They systematically performed a cardiopulmonary exercise test to determine maximal oxygen uptake (V'O2max). We considered two groups of patients based on the results of the functional evaluation of exercise performance: (1) No limitation in exercise performance (V'O2max greater or equal to 80% of the theoretical reference) and (2) limited exercise performance (V'O2max <80% of the theoretical value). All patients also received an 1MSTS on the same day. Results: We found 22 (44.0%) patients with normal exercise capacity and 28 (56.0%) patients with limited exercise performance. In this sample, mean 1MSTS repetitions were 27.1 (7.1) and 25.2 (8.7), respectively. There were no significant differences between the two groups for repetition and Borg Scale end test. The correlation between V'O2max measured during the exercise test and 1MSTS repetitions displayed a positive slope [r = 0.401 (95% CI 0.114-625)]. Conclusion: This study demonstrated a moderate relationship between 1MSTS and V'O2max for patients with chronic disease. 1MSTS did not permit the precise determination of physical activity capacities in this sample.

Adapted Fencing for Patients With Invasive Breast Cancer: The RIPOSTE Pilot Randomized Controlled Trial.

Introduction: Even if indications for mastectomy have been progressively reduced in loco-regional breast cancer (BC) treatment, the harmful effects of surgery are still numerous and can impact physical and psychological wellbeing of women. The RIPOSTE (Reconstruction, self-Image, Posture, Oncology, "Santé"-Health, Therapy, "Escrime"-Fencing) program aimed to propose adapted fencing to patients with BC. This study aims to investigate the effect and conditions of effectiveness of the RIPOSTE program. Methods and analysis: This is a prospective randomized controlled trial including 24 patients with invasive BC who have just undergone surgery. The study will be proposed to the patient and if interested, the patient will be referred to a sports physician for a medico-sportive evaluation. At the end the evaluation, if the patient meets the inclusion criteria, she will be randomly assigned to one of the 2 groups based on a 1:1 principle: Early RIPOSTE group (receive one fencing session per week for 3 months immediately after their inclusion), Delayed RIPOSTE group (receive one fencing session per week for 3 months but within the 3 months following their inclusion). Patients will be included for 6 months with 3 follow-up times (0, 3, and 6 months) by a sport physician. The primary outcome is the evolution of quality of life score. Secondary outcomes are disability score, fatigue, anxiety-depression, cost-effectiveness and process evaluation. Ethics and dissemination: The study protocol has been approved by a French ethics committee (CPP Sud Méditerranée IV, N°ID-RCB: 2020-A01916-33). Results will be submitted for publication, at scientific conferences and through press releases. Trial Registration: NCT04627714.

An Association between Alexithymia and the Characteristics of Sport Practice: A Multicenter, Cross-Sectional Study.

BACKGROUND: This was a multicenter, cross-sectional study which aimed to investigate the relationship between the characteristics of sport practice (weekly training duration, level of practice) and alexithymia in adults who were officially licensed at a sports club. METHODS: From a sample of sports club licensed adults, 188 participants were included. The participants completed computerized questionnaires on anthropometric data and characteristics of sport practice (level and weekly time spent on sport practice) as well as alexithymia (TAS 20), depression (BDI-13) and anxiety traits (STAI-Y form B). RESULTS: In this sample, 91 (48.4%) and 97 (51.6%) athletes engaged in recreational and competitive sport practice, respectively. We observed a prevalence of 31.9% for alexithymia. Moreover, alexithymics were more involved in competitive than recreational practice (40.2% versus 23.1%, respectively; p = 0.019) and they were less anxious (63.9% versus 80.2%, respectively; p = 0.010). Finally, alexithymia was significantly more pronounced than non-alexithymia among sports competition practitioners (OR: 3.57 (95 CI [1.26-10.08]; p = 0.016) and we observed less alexithymia in team sports practice than confrontation sports (OR: 0.20 (95 CI [0.05-0.78]; p = 0.020). CONCLUSIONS: Alexithymic athletes were more involved in competition than recreational sports compared to non-alexithymic subjects, whilst there were more alexithymic athletes in confrontation sports than in team sports.

Alexithymia and Athletic Performance: Beneficial or Deleterious, Both Sides of the Medal? A Systematic Review.

BACKGROUND: Numerous studies have been published on alexithymia among athletes in the last decades. The objective, here, is to provide a critical review on alexithymia in sport and identify elements demonstrating that alexithymic athletes can attain a competitive advantage. METHODS: The Center for Reviews and Dissemination guidelines were used. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines served as the template for reporting the present systematic review. We searched PubMed, Embase, Science Direct, and PsycINFO, without language or date restrictions. RESULTS: Within 72 eligible studies, 23 articles fulfilling the selection criteria were included in the review. Alexithymia is associated with various pathologies and considered to be counter-performing. However, despite considerable suspicion of an advantageous performance effect of alexithymia, there is a lack of data to quantify this effect. Studies identified are heterogeneous (different scales of measurement of alexithymia used or outcomes, different sports), that do not allow us to conclude on an observed causal relationship, because the studies are mostly observational. CONCLUSION: This systematic review opens a new search field on alexithymia, as possibly promoting performance.

Progression to a severe form of COVID-19 among patients with chronic respiratory diseases.

RATIONALE: Viral respiratory infections, including SARS-CoV-2 infection, can trigger respiratory symptoms among patients suffering from chronic respiratory diseases, leading to exacerbations and hospitalizations. Despite the tropism of SARS-CoV-2 into the respiratory tract, chronic respiratory diseases do not seem to be risk factors for severe forms of COVID-19. OBJECTIVES: To assess whether hospitalized patients for COVID-19 with chronic respiratory diseases were at lower risk of developing a severe form than other patients. METHODS: This French study included patients admitted to hospital in COVID-19 ward, suffering from a SARS-CoV-2 infection, diagnosed on RT-PCR or chest computed tomography associated with clinical symptoms, from March 15 to June 30, 2020. Ambulatory patients who were tested in the emergency department and patients with severe hypoxaemia requiring intensive care were not included. All data were collected from electronic medical records up to discharge of the patient. MAIN RESULTS: 617 patients were included: 125 with a chronic respiratory disease, mainly chronic obstructive pulmonary disease (45%) and asthma (30%). The percentage of patients scoring 6 or higher on the WHO Clinical Progression Scale during hospital stay was lower in patients with chronic respiratory disease compared to those without chronic respiratory disease (21.6% versus 31.3%, respectively, p = 0.03). Among patients with chronic respiratory disease, temperature above 38 °C on admission (OR 16.88 (95% CI 4.01-71.00)), lymphopenia (OR 5.08 (1.25-20.72)), CPAP therapy (OR 4.46 (1.04-19.17)) and age (OR 1.09 (1.02-1.16)) were associated with an increased risk to reach a score of 6 or above. CONCLUSIONS: Hospital admissions in COVID-19 ward of patients suffering from chronic respiratory diseases are at lower risk of developing a severe form of COVID- 19, especially in patients with chronic obstructive pulmonary disease or asthma. Prospective studies would confirm our results and allow to better organize the follow-up of these patients in a pandemic period.

The interest of rehabilitation of respiratory disorders in athletes: Myth or reality?

BACKGROUND: Healthy trained athletes generally have an "overbuilt" respiratory system in order to face the huge ventilation and gas-exchange demand imposed by strenuous exercise. Athletes frequently complain of respiratory symptoms regardless of whether they have a diagnosed respiratory disease, therefore evoking a kind of respiratory limitation during exercise. Some respiratory pathologies athletes present are closely linked to exercise and include asthma, exercise-induced bronchoconstriction (EIB) or exercise-induced laryngeal obstruction. Management of asthma and EIB are mainly based on pharmacological treatments. However, many athletes still complain of respiratory symptoms despite optimal pharmacological treatments, which highlights the need for non-pharmacological approaches including breathing retraining, inspiratory muscle training and/or laryngeal exercise performed under the guidance of a physiotherapist in this specific population. OBJECTIVES: With this literature overview, we aimed to report evidence supporting the interest of rehabilitation for athletes with respiratory disorders and discuss whether inspiratory muscle training programs can improve performance in healthy athletes. METHODS: We searched MEDLINE and Cochrane databases for trials, reviews and meta-analyses assessing respiratory rehabilitation and muscle training programs in athletes by using the MesH terms "athletes", "asthma", "dyspnea", "rehabilitation" and "education" published from January 2010 to March 2020. The selection of articles was based on the author's expertise to elaborate this review of the literature. RESULTS: Major findings suggest that breathing retraining may help asthmatic athletes better control their respiratory symptoms and that inspiratory muscle training may improve respiratory symptoms of exercise-induced laryngeal obstruction in athletes. Improvement of performance by respiratory muscle training still remains controversial. CONCLUSIONS: Respiratory rehabilitation could be of interest in the specific population of athletes but should be further evaluated to improve the level of evidence of such strategies.

Post-exercise accumulation of interstitial lung water is greater in hypobaric than normobaric hypoxia in adults born prematurely.

We aimed to gauge the interstitial lung water accumulation following moderate-intensity exercise under normobaric and hypobaric hypoxic conditions in a group of preterm born but otherwise healthy young adults. Sixteen pre-term-born individuals (age = 21±2yrs.; gestational age = 29±3wk.; birth weight = 1160±273 g) underwent two 8 -h hypoxic/altitude exposures in a cross-over manner: 1) Normobaric hypoxic exposure (NH; FIO2 = 0.142±0.001; PIO2 = 90.6±0.9 mmHg) 2) Hypobaric hypoxic exposure (HH; terrestrial high-altitude 3840 m; PIO2 = 90.2±0.5 mmHg). Interstitial lung water was assessed via quantification of B-Lines (using lung ultrasound) before (normoxia) and after 4-h and 8-h of respective exposures. At each time point, B-Lines were quantified before (Pre) and immediately after (Post) a 6-min moderate-intensity exercise. The baseline B-lines count were comparable between both conditions (P = 0.191). A higher B-lines count was noted at Pre-H4 in HH versus NH (P = 0.0420). At Post-H8 B-lines score was significantly higher in HH (4.6 ± 1.6) than in NH (3.1 ± 1.4; P = 0.0073). Furthermore, at this time point, a significantly higher number of individuals with B-line scores ≥5 was observed in HH (n = 7) than in NH (n = 3; P = 0.0420). These findings suggest that short moderate-intensity exercise provokes a significant increase in the interstitial lung water accumulation after 8 h of exposure to terrestrial but not simulated altitude (≈3840 m) in prematurely born adults. Further work is needed to elucidate the exact mechanisms of (moderate-intensity) exercise-induced interstitial lung water accumulation in this population and directly compare the obtained data to full-term born adults.

Long-Term Effects of Prematurity on Resting Ventilatory Response to Hypercapnia.

Manferdelli, Giorgio, Benjamin J. Narang, Mathias Poussel, Damjan Osredkar, Grégoire P. Millet, and Tadej Debevec. Long-term effects of prematurity on resting ventilatory response to hypercapnia. High Alt Med Biol. 22:420-425, 2021. Background: This study investigated the resting ventilatory response to hypercapnia in prematurely born adults. Materials and Methods: Seventeen preterm and fourteen full-term adults were exposed to normoxic hypercapnia (two 5-minute periods at 3% and 6% carbon dioxide [CO2] interspersed by 5-minute in normoxia). Pulmonary ventilation ([Formula: see text]) and end-tidal partial pressure of CO2 (Petco2) were measured continuously. Results: No difference in lung function was observed between preterm and full-term adults. Petco2 was lower in preterm than in full-term adults (p < 0.05) during normoxia. During exposure to 3% CO2, both [Formula: see text] and Petco2 increased in a similar way in preterm and full-term adults. However, at the end of the 6% CO2 period, there was a significantly higher [Formula: see text] in preterm compared with full-term adults (30.2 ± 7.5 vs. 23.7 ± 4.5 L/min, p < 0.0001), whereas no difference was observed for Petco2 (46.9 ± 2.1 vs. 50.6 ± 2.1 L/min, p = 0.99). Breath frequency was higher in preterm than in full-term adults (17.9 ± 4.0 vs. 12.8 ± 3.5 b/min, p < 0.01) during 6% CO2 exposure. Conclusions: Although data suggest that prematurity results in resting hypocapnia, the exact underlying mechanisms remain to be elucidated. Moreover, preterm adults seem to have increased chemosensitivity to hypercapnia.