ObjectiveAim of this study was to analyze whether children with objectively measured second‐hand cigarette smoke (SHS) exposure suffer from a more severe course of disease when hospitalized with lower respiratory tract infection (LRTI) due to respiratory syncytial virus (RSV).MethodsThis prospective study was conducted at the Department of Pediatrics, Wilhelminen‐Hospital, Vienna, Austria in children aged below 1 year without a history of preceding lung disease and with acute symptoms of LRTI and a positive nasopharyngeal swab for RSV. On admission, urinary cotinine was measured as a marker of recent SHS and clinical severity of LRTI was assessed by oxygen saturation SpO2 and the “admission clinical severity score” (CSSA). Parents/caregivers were asked to complete a customized questionnaire assessing risks for SHS and demographic characteristics.ResultsAfter inclusion of 217 patients, data of 185 patients with a mean (SD) age of 106 days (80) were analyzed. Twenty‐five patients (13.5%) were “cotinine‐positive” (COT+) defined as a urinary cotinine level of ≥7 μg/L. SpO2 on admission was significantly lower in children recently exposed to SHS defined objectively by COT+ (94.8%  ±2.0) in urine on admission compared to children not recently exposed (COT−) (96.8% ±3.0; P < 0.01). Disease severity, assessed via mean clinical severity score on admission (CSSA) for COT+ and COT− was 2.56 and 1.71, respectively (P = 0.03).ConclusionsRecent exposure to SHS was associated with lower O2 saturation and higher clinical severity score, measured by urine cotinine levels in children hospitalized for RSV infection under 1 year of age.

Context Plant-based lifestyle is a global trend, lower bone mineral density and increased fracture risk in vegan people are reported. Objective Primary objective: To assess trabecular and cortical bone microarchitecture in vegans and omnivores. Secondary objectives: To evaluate relationships between bone microarchitecture, nutrition parameters and physical activity. Design Observational study Setting Medical Department II, St. Vincent Hospital (Tertiary referral center for gastrointestinal, metabolic and bone diseases, and Teaching hospital of the Medical University of Vienna) Participants 43 healthy non-obese female and male subjects on a plant-based diet for at least five years; 45 healthy non-obese female and male subjects on an omnivore diet for at least five years. Main outcome measures Parameters of trabecular and cortical bone microarchitecture (high-resolution peripheral quantitative computed tomography), serum markers of bone turnover, nutrients intake (nutrition protocol), self-reported resistance training (physical activity questionnaires). Results In the vegan group, trabecular and cortical structure was altered, compared to omnivores. Vegans not reporting resistance training had diminished bone microarchitecture, compared to omnivores not reporting resistance training. In vegans and omnivores reporting resistance training, bone structure was similar. In both vegan subgroups (resistance training and not resistance training), a small number of correlations between nutrients intake and bone microarchitecture were without conclusive pattern were observed. Conclusions Bone microarchitecture in vegans differed from matched omnivores but could not be explained solely by nutrients uptake. These differences were attenuated between the subgroups reporting resistance training. In addition to a well-planned diet, progressive resistance training on a regular basis should be part of the vegan lifestyle.

Background Nocturnal cough and wheeze are important symptoms when diagnosing any respiratory disease in a child, but objective measurements of these symptoms are not performed. Methods The aim of our study was to analyze the use of an automated detection system to assess breath sounds objectively in comparison to cough and wheeze questionnaires and to evaluate its feasibility in clinical practice. Results Forty-nine recordings of thirty-nine children were processed (asthma n = 13; cystic fibrosis n = 2; pneumonia n = 5; suspicion of habit cough n = 7; prolonged, recurrent or chronic cough n = 13), and cough and asthma scores were compared to the objective nocturnal recordings. Time for audio-validation of recordings took between 2 and 40 min (mean: 14.22 min, (SD): 10.72). Accuracy of the automated measurement was higher for cough than for wheezing sounds. Nocturnal cough readings but not wheeze readings correlated with some of the corresponding scores. Conclusion To our knowledge this is the first study using a new device to assess nocturnal cough and obstructive breath sounds objectively in children with a wide variety of respiratory diseases. The assessment proved user friendly. We obtained additional information on nighttime symptoms, which would otherwise have remained obscure. Further studies to assess possible diagnostic and therapeutic benefits of this device are needed.

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Objective The purpose of this study was to evaluate the impact of chronic obstructive pulmonary disease (COPD) on clinical outcomes in patients referred for transfemoral (TF) as well as transapical (TA) aortic valve implantation and furthermore to delineate possible advantages of the TF access. Methods One thousand eight hundred forty-two patients undergoing transcatheter aortic valve implantation (TAVI) at two study centers were included in the present analysis. The outcome was measured and classified according to Valve Academic Research Consortium-II criteria. Kaplan–Meier estimate was used to assess long-term survival. Results The present analysis suggests that COPD has limited influence on post-procedural outcome after TAVI. Comparing the TF to TA approach, no significant difference on the impact of COPD on clinical outcomes has been found, except for longer post-procedural ventilation times in COPD patients treated via TA access (p < 0.001). Conclusions COPD in patients referred for TAVI procedure was associated with poorer overall long-term survival, thus characterizing a high-risk population for futile treatment; however, the selection of access did not result in a significant difference in most Valve Academic Research Consortium-II-defined clinical outcomes in COPD patients.