Physical activity is reduced in patients with chronic pulmonary diseases. Activity monitors can measure physical activity objectively and accurately over prolonged periods of time. Research grade and commercially available devices, using accelerometer technology, are being increasingly used in clinical studies. Physical activity levels have been found to have a moderate to strong correlation with important measures such as pulmonary function, exercise capacity, quality of life, and mortality and hospitalizations in patients with COPD, interstitial lung disease, pulmonary arterial hypertension and cystic fibrosis. Their use as a clinical trial end-point and as a tool to augment rehabilitation efforts has also been explored in patients with COPD with variable results. Due to the ease of use, economic viability, widespread availability and good patient compliance, their use in adult and pediatric medicine is expanding. This narrative review summarizes the current evidence of use of activity monitors in COPD, interstitial lung disease, asthma, pulmonary arterial hypertension, cystic fibrosis and lung transplant patients for the purposes of prognostication, monitoring, outcome measures and intervention.

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Two enzyme immunoassays for rheumatoid factor (RF) were compared with the traditional latex agglutination test. Preference is expressed for an ELISA specific for IgM-RF because it yields specific, quantitative results. Variability of this assay was least in sera containing moderate levels of RF and it was less precise at low concentrations. Survey of a random selection from the local population showed a similar prevalence of IgM-RF positivity as revealed by previous surveys using agglutination techniques. We conclude that measurement by ELISA yields no great increase in the discriminative ability of RF testing.

Background Sternal complications are common following transverse thoracosternotomy in patients undergoing bilateral lung transplantation. We present a single‐institution experience using a next generation rigid fixation system for primary sternal closure following transverse sternotomy for bilateral lung transplantation. Methods Retrospective review was performed on all patients who had bilateral sequential lung transplants utilizing a transverse thoracosternotomy from 2016 to 2020. Demographics, baseline characteristics, peri‐operative data, and outcomes were collected, reviewed and summarized. Two groups of patients were identified: wire cerclage (Group A), combination plate‐and‐band rigid fixation (Group B). The primary outcome was sternal complications, which were divided into mechanical and non‐mechanical. Results Twenty‐two patients met inclusion criteria. Three patients (13.6%) were in Group A, nineteen patients (86.4%) in Group B. Two patients in each Group A (66.6%) and Group B (10.5%) experienced a sternal complication. Sternal complications included sternal dehiscence (2), sternal malunion (1), and surgical site infection (1). One patient with plate‐and‐band fixation (5.2%) had a mechanical sternal complication. Three patients required reoperation secondary to sternal complication. Conclusions The utilization of a combination plate‐and‐band rigid fixation system for primary closure is safe and may be an effective method to reduce sternal complications following transverse thoracosternotomy for lung transplantation.