A smart shirt can accurately measure tidal volumes during various tasks of daily living (Preprint)

BACKGROUND The Hexoskin smart shirt (HX) is a shirt measuring continuously and objectively and could be a potential telemonitoring system. OBJECTIVE The main focus is to determine the accuracy of the calibrated HX to measure tidal volumes (TV) in comparison to spirometry (SPIRO) in various tasks. METHODS TV of fifteen healthy subjects were measured in 7 tasks with SPIRO and HX. These tasks were performed in two sessions, between sessions all equipment was removed. A one-time spirometer-based calibration per task was determined in session 1 and applied to the corresponding task in both sessions. Bland-Altman analysis was used to determine the agreement between TV measured with HX and SPIRO. A priori we determined the bias had to be less than ±5% with LOA less than ±15%. Lung volumes were measured and should have LOA less than ±0.150 L. RESULTS In the first session, all tasks had a median bias within the criteria (±0.6%). In the second session, biases were ±8.9%, only two tasks met the criteria. In both sessions, LOA were within criteria in six out of seven tasks (±14.7%). LOA of lung volumes were > 0.150 L. CONCLUSIONS HX is able to correctly measure TV in healthy subjects in various tasks. However, after reapplication of the equipment, calibration factors cannot be reused to obtain results within the determined boundaries. CLINICALTRIAL NTR7130 (Dutch trial registration system)

Outcome of atypical haemolytic uraemic syndrome relapse after eculizumab withdrawal

Background The introduction of eculizumab has significantly improved the outcome of patients with atypical haemolytic uraemic syndrome (aHUS). Because of the risk of relapse after discontinuation, eculizumab was proposed as life-long therapy. However, data on the outcome of relapse are limited. In the Netherlands, patients with aHUS are treated with a restrictive eculizumab regime and are included in a national observational study (CUREiHUS, Dutch Trial Register NTR5988/NL5833). Methods For this interim safety analysis, we evaluated the outcome of all adult patients with a suspected relapse, defined as the need to intensify eculizumab after tapering or withdrawal of therapy. Results We describe 11 patients who received renewed eculizumab therapy because of suspected relapse. In three patients with aHUS in native kidneys, estimated glomerular filtration rate (eGFR) returned to baseline value and remained stable without overt proteinuria after follow-up. Six out of eight transplanted patients responded to eculizumab therapy with improvement in eGFR. After a median follow-up of 24.6 months, a reduction of eGFR ≥25% was observed in three of these transplanted patients, which was attributed to the aHUS relapse in only one patient. Conclusions This interim analysis suggests that re-treatment with eculizumab after relapse is safe and feasible. We will continue to use our restrictive treatment strategy.

Drug utilisation among Dutch adolescents: a pharmacy prescription records study

BackgroundStudies on adolescent drug use are scarce as most studies do not distinguish between children and adolescents. Therefore, we assessed overall drug use in adolescents.MethodsA retrospective cohort study was conducted using pharmacy dispensing records from 62 community pharmacies in the Netherlands. Dispensing records of the previous 5 years were extracted for adolescents (12–18 years).ResultsThe study population consisted of 47 421 adolescents who collected at least one medication prescription during adolescence (mean age 15.5±1.8 years; 48.9% males). Half of them collected dermatologicals (46.2% males; 52.3% females), followed by drugs for the respiratory system (43.4% males; 40.3% females) and anti-infectives for systemic use (31.3% males; 39.1% females). The percentage of males using dermatologicals slightly increased, while the percentage of female users decreased with age. The most prescribed active ingredient was methylphenidate.ConclusionsThese insights into adolescent drug use help us to better understand adolescent healthcare use.Trial registration numberDutch trial register NTR5061.

Russia will shun Dutch trial and deny downing MH17

Headline RUSSIA/NETHERLANDS: Moscow will shun MH17 trial