Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease.

BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice' care for the diagnosis, treatment and prevention of post-COVID-19 lung disease.METHODS: A panel of international experts representing scientific societies, associations and groups active in post-COVID-19 lung disease was identified; 45 completed a Delphi process. A 5-point Likert scale indicated level of agreement with the draft standards. The final version was approved by consensus (with 100% agreement).RESULTS: Four clinical standards were agreed for patients with a previous history of COVID-19: Standard 1, Patients with sequelae not explained by an alternative diagnosis should be evaluated for possible post-COVID-19 lung disease; Standard 2, Patients with lung function impairment, reduced exercise tolerance, reduced quality of life (QoL) or other relevant signs or ongoing symptoms ≥4 weeks after the onset of first symptoms should be evaluated for treatment and pulmonary rehabilitation (PR); Standard 3, The PR programme should be based on feasibility, effectiveness and cost-effectiveness criteria, organised according to local health services and tailored to an individual patient's needs; and Standard 4, Each patient undergoing and completing PR should be evaluated to determine its effectiveness and have access to a counselling/health education session.CONCLUSION: This is the first consensus-based set of clinical standards for the diagnosis, treatment and prevention of post-COVID-19 lung disease. Our aim is to improve patient care and QoL by guiding clinicians, programme managers and public health officers in planning and implementing a PR programme to manage post-COVID-19 lung disease.

Do fatty acids help in overcoming reading difficulties? A double-blind, placebo-controlled study of the effects of eicosapentaenoic acid and carnosine supplementation on children with dyslexia.

BACKGROUND: There are claims that dietary supplementation of unsaturated fatty acids could help children with dyslexia to overcome their reading problems. However, these claims have not yet been empirically tested. METHODS: This study was designed to test whether dietary supplementation was superior to placebo in treating reading, spelling or other reading-related skills of children with dyslexia. The experimental group (eicosapentaenoic acid, EPA, n = 30) ate dietary supplements and the control group (placebo, n = 31) placebos during the 90-day treatment period. The supplements contained omega-3 fatty acid (ethyl-EPA, 500 mg/day) and carnosine (400 mg/day). The groups were matched for reading skills, grade, gender, attention problems, intelligence and amount of special education. The literacy-related skills of the two groups were assessed before and after the treatment period. RESULTS: No group differences were observed between EPA and placebo in measures of reading accuracy or speed, spelling, decoding fluency, arithmetical skills, reading-related language skills, attention or behavioural problems. CONCLUSION: The present findings do not support the hypothesis that omega-3 fatty acid (ethyl-EPA) or carnosine has a role in the treatment of reading and spelling problems in children with dyslexia.

Performance of Zambian children on the NEPSY: a pilot study.

Forty-five literate schoolchildren aged 9 (n = 25) and 11 (n = 20) from urban Zambia were given core and expanded tests on the NEPSY and their performance was scored according to age-equivalent norms for U.S. children. This study indicates that in urban, literate Zambian children, the NEPSY is relatively insensitive to language and cultural influences that often compromise the applicability of Western tests in the developing world. No consistent improvement in the standard scores was found as a function of educational experience. Comparison against the U.S. normative average revealed that both age groups were poorer in the domains of language and attention and executive functions, whereas their performance was better in the visuospatial processing domain. It is concluded that the NEPSY in its present form may be clinically useful, but its results should still be treated with caution, taking into account cultural, language, and personal demographic information. More studies, with divergent and larger samples of varying age ranges are required. It seems that the NEPSY could serve as the initial step in the development of neuropsychological practices in Zambia.

The development of phonological abilities and their relation to reading acquisition: case studies of six Finnish children.

The relation between phonological abilities and reading acquisition and the interindividual variation in the development of different phonological manipulation skills were assessed for six 7-year-old Finnish nonreaders. Intensive time series data were collected by following the children for 13 months. Assessments were conducted every 4 weeks with five phonological manipulation tests. The results indicated gradual progress at the group level. However, analysis of the individual profiles indicated large interindividual variation in the rate of improvement and in the relation between different manipulation skills and reading acquisition.

E-wave and heart rate responses during anticipation of nonmotor events.

This study concentrated on three main questions: 1) can anticipatory late negative shift (expectancy wave, E-wave) be elicited in nonmotor S1-S2 paradigm, 2) is it sensitive to variation of emotional aspects of the task and 3) is there a connection between heart rate (HR) responses and E-wave. S1 was a letter row that was replaced tachistoscopically by another letter row (S2). The task of the subjects (n = 12) was to detect if the critical aspects of S2 were similar to S1. After their delayed response they received feedback of their performance. The emotional aspects of the task were varied by presenting aversive noise bursts at the end of the feedback period either always, contingently to their performance or not at all. A negative shift was present both before S2 and aversive noise (when presented). Varying the emotional aspects of the task had an effect on the amplitude of the E-wave. There was also a connection between E-wave and heart rate responses: heart rate response seemed to be a precondition for E-wave elicitation. The results support Simons's conclusion that nonmotor E-wave reflects specifically emotional anticipation.

IgG subclass composition of monomeric and polymeric IgG in the serum of patients with nephrotic syndrome.

The serum levels of immunoglobulins G, A and M and of the four subclasses of IgG have been measured in 54 patients with the nephrotic syndrome; 27 had minimal change disease (MCD), 9 membranous glomerulopathy (MGN), 5 focal glomerulosclerosis (FGS), 5 proliferative glomerulonephritis (PGN) and 8 miscellaneous forms of nephrotic syndrome (Table 1). Low levels of IgG and A, previously described in MCD, were found in all histological diagnoses; only about half the cases of MCD showed a high IgM. Measurement of the subclasses IgG 1-4 showed all to be depressed. Proportionately, however, the IgG2 was most affected (8.8% total IgG, cf 18.3% controls). Urinary protein loss, either total or IgG, only partially correlated with IgG suppression, while IgG2 in the urine usually comprised an even lower proportion of total IgG than in serum. The polyethylene glycol (PEG) 6,000 precipitate from serum at 4% concentration was also examined for IgG and subclasses in MCD (27 cases), MGN (9 cases) and PGN (3 cases). Raised levels above those of 14 normal controls were found in nearly all cases of MCD, even in remission, but in no cases of MGN. In MCD no IgG4 was found in any of the precipitates, while IgG2 was proportionately raised (22% of total) in the precipitate as compared with whole serum (8.8%). Serial studies on 9 adults (3 MCD, 3 MGN, 1 FGS, 1 PGN, 1 IgA nephropathy) showed only that the low levels of IgG and subclasses were associated with relapses and reverted toward normal in remission.